Course Information:
This one day NIOSH-approved refresher course will review recent changes in spirometry standards and guidelines published by the American Thoracic Society (ATS) and European Respiratory Society (ERS). This course is especially useful for testing technicians who originally trained before these important changes occurred. This program will also provide additional insight towards the understanding, significance, and interpretation of lung function tests. Students will also gain a better understanding of sub-maximal effort, invalid maneuvers, and other factors that affect interpretation of the test. Examples of poorly conducted tests will be used to provide insight towards improving coaching technique.

Requirement for Refresher Training:
Previously NIOSH did not mandate spirometry refresher courses. However, after reviewing compelling evidence from the National Institutes of Health’s Lung Health Study, the National Center for Health Statistics’ NHANES III study, and the recommendations from professional societies such as the American Thoracic Society and the American College of Occupational and Environmental Medicine, NIOSH reconsidered the need for refresher training programs. Based upon their analysis, NIOSH concluded that refresher training should be mandatory.

The Refresher course curriculum differs in many respects from the initial training course. To meet the requirements for an update refresher, students will not be permitted to take portions of an initial training program. This means the refresher course must be distinctly different (i.e., separate) from initial spirometry training classes. Refresher courses must also be “approved” by NIOSH. Course providers are not permitted to mix students taking refresher training with students taking an initial (basic) spirometry course. Prospective students who desire to take a refresher class should check to ensure the program provider has actually met the NIOSH requirements and has been specifically approved by NIOSH to offer these special training classes. Prior to enrollment in a NIOSH-Approved Spirometry Refresher course, students must demonstrate eligibility by providing a copy of a valid NIOSH-Approved Spirometry training certificate to the course director. If a certificate is lost or misplaced, the student must obtain a duplicate from their original course sponsor prior to taking the refresher class.

Technicians who wish to maintain a valid NIOSH-Approved Spirometry course certificate must complete a NIOSH-Approved Refresher course (or repeat the full course) every 5 years.

Technicians whose NIOSH-Approved Spirometry course certificates are dated January 1, 2000 or later may register for a NIOSH-Approved Spirometry Refresher Course. These eligibility criteria will remain in effect until December 31, 2012.

Technicians with NIOSH-Approved Spirometry Course certificates dated prior to January 1, 2000, are generally not eligible to take a NIOSH-Approved Spirometry Refresher course. To maintain valid certificates, these students will need to successfully repeat the entire initial NIOSH-Approved Spirometry course. However, there is an exception for those who have taken refresher training from Dr. McKay. If the refresher program taken from Dr. McKay was at least 7-hours duration (refer to your certificate), then you may qualify for the exception and be eligible for the NIOSH-approved refresher training. For details, see the eligibility requirement examples below.

Summary:
Technicians whose NIOSH-Approved Spirometry course certificates are dated January 1, 2000, through December 31, 2007, must successfully complete a NIOSH-Approved Spirometry Refresher Course by December 31, 2012, to maintain a valid NIOSH-Approved Spirometry course certificate.

Technicians whose NIOSH-Approved Spirometry course certificates are dated January 1, 2008, or later must successfully complete a NIOSH-Approved Spirometry Refresher Course within 5 years of the date of their course to maintain a valid NIOSH-Approved Spirometry Course certificate.

Eligibility Requirement Examples:

Training Date	Content
June 2004	Original NIOSH-approved training completed
Decision:	Eligible for Refresher. Must complete before December 31, 2012.

Training Date	Content
May 2007	Original NIOSH-approved training completed
Decision:	Eligible for Refresher. Must complete within 5 years.

Training Date	Content
June 1998	Original NIOSH-approved training completed
Decision:	Not Eligible for Refresher.

Training Date	Content
June 1998	Original NIOSH-approved training completed
June 2002	7-hour Refresher training with Dr. McKay
June 2006	7-hour Refresher training with Dr. McKay
Decision:	Eligible for Refresher. Must complete before December 31, 2012.

Training Date	Content
June 1998	Original NIOSH-approved training completed
May 2006	Refresher training at AAOHN Symposium (< 7 hours)
Decision:	Not Eligible for Refresher. Refresher training not of sufficient duration.

Training Date	Content
June 1998	Original NIOSH-approved training completed
June 2002	4-hour refresher training at conference
June 2007	3-hour refresher training at conference
Decision:	Not Eligible for Refresher. Refresher training not of sufficient duration.

Questions & Answers Regarding Refresher Requirements:

Are there Eligibility Criteria to Attend a NIOSH-Approved Refresher?
Yes. NIOSH established eligibility criteria to attend an “approved-refresher”. One of these criteria requires the sponsor of the training program to receive and review student training certificates to establish proof that the student attended and successfully passed the original NIOSH-approved course requirements. Documentation of previous refresher training should also be provided, in particular, the refresher class must have been a minimum of 7 hours duration. Students who can’t provide copies of their training certificates are not eligible for the “NIOSH-approved Refresher” and are required to repeat the initial training.

Can I attend a NIOSH-approved Refresher class if I don’t meet the eligibility criteria?
Yes. Although other course providers may have different requirements, anyone can attend Dr. McKay’s refresher class. However, only those who meet the eligibility criteria established by NIOSH will receive the special NIOSH-approved Refresher certificate with our unique approval number. Those who don’t meet the eligibility criteria will receive a different certificate. This different certificate will not have any reference to NIOSH or NIOSH-approval. Both certificates will show that the class has been approved for 7.0 continuing education contact hours for nurses by the Ohio Board of Nursing (OBN approval Unit at the University of Cincinnati College of Nursing Continuing Education Program), but only those who meet the eligibility criteria will receive the special certificate with the unique NIOSH approval number.

I took my original training with Dr. McKay in 1998, prior to the January 2000 cutoff date. However, I also took Dr. McKay’s one-day (7 hour) Refresher class in 2002 and again in 2006. NIOSH-approved refresher classes did not exist prior to 2009. Am I still eligible to take a NIOSH-approved Refresher class or must I repeat the initial course?
Yes, you are eligible since the NIOSH approval committee is comfortable with the quality of the training you received. Reasons are:

	1.	Dr. McKay was member of the ATS-ERS committee that wrote the current spirometry standards.
	2.	His initial NIOSH-approved training program has been evaluated by NIOSH and received high scores.
	3.	His refresher classes are distinct training programs (i.e., not a repeat of the initial course material).
	4.	They were at least 7 hours in length.

I have a colleague that took initial training in 1999 and refresher training in 2004, but not with Dr. McKay. Is she eligible to attend a NIOSH-approved Refresher?
Maybe. The problem is some refresher course providers had an inferior training product. Consequently, NIOSH is uncomfortable allowing students who attended poor quality programs to meet the eligibility criteria. In the last several years, NIOSH has evaluated initial training programs. Some of these were unacceptable and their NIOSH approval was rescinded. Consequently there is an understandable hesitancy to accept all training programs equally. As a result, each situation is being handled on a case by case basis. Further clarification on this issue should be coming in the future. Obviously there are advantages to attending quality driven training programs.

Is there a “Grace Period” if a previous refresher class lapsed by a few months?
Essentially yes. Students have up to December 2012 to complete the refresher requirement.

What if I Lost my Certificate?
If you took your training with Dr. McKay, send an email to info@DrMcKay.com or call 513-558-1234 and request a “Certificate Replacement Form”. We will review our records to insure the student successfully passed the course requirements, verify the date, and re-issue another certificate. A small fee is charged to locate, verify, print, and mail a replacement certificate.

Refresher training helps ensure that persons who perform spirometry testing learn new information regarding changes in test procedures, review new protocols, and have the opportunity to discuss problems not foreseen during initial training.

Is Refresher Training Required ????
	Consider the following questions.
	1.	Does your employer desire (expect) testing to be conducted according to the most recent recommendations and guidelines established by the ATS and others?
	2.	Are you fully aware of the most recent changes and are you in compliance?

Note:
Our refresher - update is NOT a repeat of our NIOSH approved spirometry training course. Unlike other programs where the student simply repeats the original course material, our course is designed to review prior information while providing new material to improve testing skills. The emphasis of this course is learning how to get more information from computerized spirometry systems and learning how to improve testing technique. There is NO hand measurements or calculations to be performed by the student, and there is NO examination at the end of this class.

We don't manufacture or sell spirometry equipment. The University of Cincinnati is a teaching and learning institution. Students will receive unbiased solutions to their spirometry problems.