By Debbie Bunch
July 29, 2024
Have you ever wondered whether the procedure you are using to deliver a treatment to a patient is the best possible method? Or questioned the value of a new piece of equipment acquired by your department? Or do you think your patients could benefit from additional services delivered by an RT?
Health care is driven by clinical research, and questions like these often lead to studies that are published in peer-reviewed journals or presented at medical conferences. While most of that research is conducted by physicians, a fair amount is conducted by people in other professions as well—respiratory care included.
In this three-part series, we will take a closer look at therapists who have gotten involved in clinical research and why they believe it is important to their careers.
Part 1 covers three RTs who have taken their interest in three different directions.
An RT with the desire to investigate
Mika L. Nonoyama, PhD, RRT, is a great example of how far an RT can go in the research setting.
While she is now a health clinical scientist at the Hospital for Sick Children (SickKids) in Toronto, Canada, an associate professor at Ontario Tech University, and an assistant professor at the University of Toronto, she started out simply as an RT with a desire to investigate.
It all started with an interest in chronic respiratory disease management. “I became involved in this after being hired as a research assistant for a long-term oxygen therapy project,” she explained. “After that I started getting more and more responsibility and became a research coordinator.”
After earning a master’s degree and then her PhD, she turned to long-term mechanical ventilation (LTMV), mainly because the institution where she did her PhD also had a large LTMV program. She credits her drive to investigate LTMV with her successful acquisition of funding at the national level.
The post-doc led to her interest in pediatric respiratory therapy, which was spurred by an RT at SickKids who wanted to increase scholarly practice and the research capacity of respiratory therapy there. Since Dr. Nonoyama was one of the few RTs in Canada with a PhD, she seemed like a natural fit.
She says her clinical scientist position at SickKids is unique. “I do not know of any other position like this in Canada for RTs,” she said. “I support RTs in their evaluative work, be it QI, retrospective studies, knowledge synthesis, etc. We’ve published, presented, secured grants, integrated volunteers and students, and established a working group within the critical care unit.”
Dr. Nonoyama says it took her time to get where she is today, but she believes the common thread throughout it all was being proactive and acquiring collaborative mentors. “As a consequence of these collaborations, I have established networks within the institutions, but also across Canada, some in the USA, Europe, and Japan,” she said. “It’s so wonderful learning from these folks.”
The research coordinator’s route
Michael Terry, BSRT, RRT, RPFT, CCRC, has spent much of his career as a full-time researcher in respiratory care as well — in his case, as a research coordinator responsible for helping investigators bring their projects to fruition.
“I first became involved in clinical trials as a shift supervisor for our Adult Intensive Care Services,” he explained. The year was 1998 and the study examined whether inhaled nitric oxide (INO) would make a difference in treating ARDS. Terry came on board because the team needed someone in the ICU who could oversee management of the investigational device being studied and train fellow bedside clinicians to conduct the trial.
He ended up as not only one of the bedside practitioners, but the study coordinator as well.
Terry, who is now a senior research coordinator at Loma Linda University Medical Center in Loma Linda, CA, says the team made sure he knew what he was doing. “I received training about Institutional Review Board (IRB) requirements, research ethics, and how to perform the study coordinator role,” he said. The study demonstrated that improved oxygenation was possible using INO and that it did not significantly change ARDS survival.”
The investigators published their work in Critical Care Medicine.
Terry finds clinical research to be a fascinating role for an RT. “I am constantly learning about new diseases like COVID-19, new drugs, and new devices,” he said.
Multiple roles
Matthew Anderson, RRT, RRT-NPS, has been involved in several research projects over the years and has taken on multiple roles in those projects. He helped design a study looking at an earlier application of pulmonary rehabilitation in the inpatient setting, he was a coordinator/trainer on the SMART CPAP trial, and he participated along with others in his department in placing the airway and completing a survey post-placement in a trial on supraglottic airway use in medical emergencies.
While not all these studies made it to the publication stage, Anderson, who serves as co-chair of the NICU transport team and as an ECMO specialist at Marshfield Children’s Hospital in Marshfield, WI, still believes they represent time well spent.
“I came up with the idea of studying the benefits of inpatient pulmonary rehab and suggested it to our research partners,” he said. “Unfortunately, the project fizzled out as my primary investigators were residents and moved on prior to completion of the project.” He got involved in the SMART CPAP study when his supervisor asked him to help coordinate the project and educate staff about the study protocol, but his facility eventually dropped out of the trial due to a lack of qualifying patients.
His entire department was recruited to assist with the supraglottic airway trial, which was eventually published in Respiratory Care. The results showed that having an RT place a supraglottic airway during a code greatly reduced time to continuous CPR.
Anderson says he’s learned a lot along the way about conducting clinical studies. “I didn’t realize what all goes into research or how complex research can be, nor did I realize how rewarding participating in it can be,” he said. Research is one of the best ways to move the health care field forward.”
What it takes
Clearly, there are many ways for an RT to get involved in clinical research. While higher education helps, you don’t have to have a doctorate degree to join the movement.
In the next installment of this series, we’ll explore the role hospital size and reputation play in an RTs’ ability to get involved in clinical research.
