• Brigitte M Borg, Moegamat Faizel Hartley, Mo T Fisher, and Bruce R Thompson.
• Department of Allergy, Immunology, and Respiratory Medicine, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia. b.borg@alfred.org.au
• Resp Care. 2010 Jun 1; 55 (6): 689-94.

BackgroundMany healthcare professionals performing spirometry in primary care have had less than half a day's training in spirometry practice, and the validity of the test results is questionable. Longer training periods, with or without follow-up training, may improve test validity.ObjectiveTo determine if a 14-hour spirometry training course provides sufficient skill to produce valid results, and if follow-up training improves test validity.MethodsNurses and physiotherapists from rural health facilities chosen by their local area health service undertook a 14-hour spirometry course facilitated by respiratory scientists with at least 5 years experience. Participants consented to on-site reviews at 5, 7, and 9 months after the course. Participants were assessed for adherence to American Thoracic Society (ATS) acceptability and repeatability criteria by undertaking an assessment of spirometry on a naïve subject and a retrospective review of a selection of spirometry results at each site at each visit. Further education was provided following the reviews at 5 and 7 months.ResultsFifteen participants from 10 sites were available for all 3 visits. The prospective phase revealed poor adherence to ATS criteria at 5 months, though this improved over the study period with follow-up training (40% at 5 months, 67% at 7 months, 87% at 9 months). The retrospective review showed that 37%, 60%, and 58% of the tests at 5, 7, and 9 months, respectively, met the ATS criteria and had correctly selected the best test.ConclusionA 14-hour spirometry training course alone does not provide sufficient skill to perform spirometry to ATS criteria, and short-term follow-up is an essential component for improving test validity.

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