Arzu Ari, PhD, FCCP

Arzu Ari, PhD, FCCP

Arzu Ari, PhD, FCCP

In the Republic of Turkey, where Arzu Ari, PhD, FCCP, a Regent’s Professor and Associate Dean for Research at Texas State University, grew up, no formal respiratory care training programs are available. Instead, physical therapists learn skills on the job.

That matters, as Turkey mirrors the rest of the world in facing an increase in noncommunicable diseases, according to a joint report from the World Health Organization and Republic of Turkey Ministry of Health. That includes many chronic respiratory diseases, such as asthma. Take COPD: As of 2021, it’s the third most common cause of mortality in the country, affecting as much as 19% of the population.

“We can live for a few days without water and food, but breathing is a moment-by-moment requirement for life. In an emergency, seconds matter,” Dr. Ari said. In Turkey, a “lack of formal education threatens the overall quality of respiratory care.”

That’s precisely what prompted Dr. Ari to apply for a CHEST community impact grant, which allowed her to create and run programs providing respiratory care training to respiratory and physical therapists in Turkey from September 2021 to September 2022. It was the first service grant she ever received, and she described it as “an incredible honor.”

Setting up training programs—and overcoming pandemic-related hurdles

With the CHEST grant in place, Dr. Ari created curriculum and content—including relevant case studies, exams, training sessions, and lectures—for two short-term education programs on respiratory care and noninvasive ventilation.

The grant also allowed Dr. Ari to purchase necessary equipment and funded her application for approval of the programs’ content, instructor qualifications, and evaluation methods from the International Education Recognition System (IERS). Getting this approval allowed program participants to receive IERS certificates of recognition.

Crafting the training was an intentionally collaborative process: Dr. Ari developed the curriculum and brainstormed ways to draw attention to the program with Seniha Avcil, PhD, Hulya Arikan, PhD, and Cuneyt Akgol, PhD, leaders at Istanbul Memorial Hospital, Atilim University, and Okan University, respectively. Professors from five different universities in the country presented topics.

The first training program focused on respiratory care. While it was originally slated to be a 2-day, in-person training, a rise in COVID-19 cases meant the conference room at the Istanbul Memorial Hospital was transformed into a testing center. Unphased, Dr. Ari and her collaborators nimbly changed to a virtual format, recording videos and developing interactive online sessions for 50 physical therapists from 36 health care institutions and universities. The second program, which focused on noninvasive ventilation, was able to take place in person and was limited to 25 attendees in order to provide ample hands-on opportunities for learning.

‘Kind comments made me happy’

This program succeeded in several key ways.

“The findings of our pre- and post-exams showed that the participants’ knowledge increased from 43% to 91%,” Dr. Ari noted.

And this increase in knowledge and skills doesn’t end with the 75 participants across the two programs. There’s an intentional ripple effect in place. Participants—who hail from health care institutions and higher education institutions all over the country—were able to return to their full-time roles with shareable skills and knowledge.

“Empowering junior faculty and clinicians to upskill their students and colleagues is clearly an excellent way to disseminate knowledge, and its impact on health care is invaluable,” Dr. Ari said. “We also developed a network of Turkish physical therapists and placed them as a ‘go-to person’ in respiratory care.”

Along with increasing participants’ knowledge—and providing them with tools to share newly learned skills with peers and students—the program was also interesting to and well-received by attendees, who were asked to evaluate it anonymously. The training, instructors, and overall program content all received good scores and complimentary feedback.

“Reading their kind comments made me happy,” Dr. Ari said. Also included in the feedback were requests for more training programs—the ultimate affirmation.

The bottom line result: Thanks to these training programs, there will be a direct effect on the health and well-being of patients with pulmonary disease in the Turkish Republic, Dr. Ari said.

“The funding from CHEST helped us promote a love of and confidence in teaching and sharing valuable information with our colleagues,” Dr. Ari said. She plans to hold more training sessions in the Turkish Republic. “I also plan on offering similar programs to other countries where the respiratory care profession needs to develop.”