Continuing Education Requirements for Respiratory Therapists

To ensure the ongoing competence and quality of care provided by respiratory therapists, various regulatory bodies mandate continuing education (CE) as a condition for license renewal and credential maintenance. These requirements vary by state and certifying organization. This article provides an overview of the continuing education requirements for respiratory therapists, drawing on specific examples and general principles.

The Necessity of Continuing Education

The field of respiratory therapy is constantly evolving, with new technologies, treatment modalities, and research findings emerging regularly. Continuing education ensures that respiratory therapists stay abreast of these advancements, maintaining and enhancing their skills and knowledge. This ultimately leads to improved patient outcomes and a higher standard of respiratory care. As a prerequisite for registration, respiratory care practitioners are required to complete continuing education.

State Licensing Requirements: A Case Study of Massachusetts

Many states have established specific continuing education requirements for licensed respiratory therapists. The Massachusetts Respiratory Care Licensure Board, for instance, mandates that every respiratory therapist obtain 20 contact hours of continuing education every two years (biennially) to renew and maintain their state license. The subject matter must be related to professional practice to be acceptable to the State Board.

Several specific stipulations accompany this requirement:

Limitations on Recredentialing Exams: No more than 4 contact hours from recredentialing exams can be applied towards the 20-hour requirement.
Exclusion of Basic Life Support: The Board does not grant continuing education credits for Basic Cardiac Life Support (BLS) courses.
American Heart Association (AHA) Course Standardization: Specific CEU values are assigned to AHA courses, such as 6.5 CEUs for ACLS, 3.75 CEUs for PALS, and 9 CEUs every other renewal cycle for NRP. These credits can typically only be used for initial certification, not for renewals.
Exemption for New Licensees: Continuing education is typically not required for a new licensee during their first license renewal period. By law, the first registration cycle is three years in length. The second registration cycle is adjusted, anywhere from 28 months to 40 months so that future registration cycles correspond with your month of birth. For that second registration cycle, respiratory therapists must take .83 hours of approved coursework for each month of the registration cycle; respiratory therapy technicians must take .67 hours for each month of registration. From then on registration cycles are fixed at three-year intervals based on your birth month.

Defining Contact Hours and CRCE

Understanding the terminology used to quantify continuing education is crucial. A Contact Hour is generally defined as a unit of organized learning lasting 50 consecutive minutes in non-clinical experience offerings and 100 consecutive minutes for clinical experience.

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CRCE, which stands for Continuing Respiratory Care Education, encompasses a variety of learning experiences designed to enhance the knowledge of respiratory therapists. These experiences enable them to provide safe and effective respiratory care to patients. Continuing education may also be used to define learning experiences related to the education and management of respiratory therapists and respiratory therapy services, health promotion and disease management, patient safety, health care cost containment, healthcare law and ethics and emergency preparedness. One CRCE® contact hour is defined as 60 minutes of learning activity.

Maintaining Records and Compliance

Licensees are responsible for demonstrating compliance with continuing education requirements. This typically involves:

Applying for license renewal on a form provided by the relevant Board, certifying compliance with the continuing education requirements and signed under the pains and penalties of perjury.
Maintaining authenticated records of attendance for each continuing education activity/program for two consecutive full licensure periods. You will need to keep the following five items of information on each course for six years from the date you completed it: (1) title of the course or program and any identification number assigned to it by the sponsor, (2) number of contact hours completed, (3) the sponsor's name and any identifying number, (4) verification by the sponsor of your attendance, and (5) the date and location of the program or course. All five elements are likely to be provided on a certificate of completion issued from the sponsor. BE SURE TO KEEP IT!
Submitting a notarized copy of the authenticated record(s) of attendance for the required number of continuing education contact hours within the time period requested by the Board. With respect to each continuing education course or program that you completed, you must provide documentation from the course or program sponsor that includes the five items of information described above.

It is important to note that you are not required to send continuing education records to the Education Department when you renew your registration. You will, however, have to attest to the fact that you have completed the requirement. You are required to make your continuing education records available for inspection by the Education Department upon our request.

NBRC's Credential Maintenance Program (CMP)

In addition to state licensing requirements, the National Board for Respiratory Care (NBRC) has a Credential Maintenance Program (CMP). If you obtained a credential after July 1, 2002, you are required to maintain continuing education to be able to renew your credential (e.g., CRT, RRT, RRT-NPS, and others).

Current requirements for respiratory care practitioners are summarized below:

Respiratory care practitioners need to complete at least 24 credits/hours of continuing education (CE) every 24 months (24 month timeline goes by the biennial registration period, not the calendar year).
24 total hours acceptable CE required per biennium (2 year registration period)
At least 12 contact hours must be in traditional courses. The remainder of contact hours may be in non-traditional courses or from passage of examinations detailed below under “Acceptable Continuing Education”
At least 2 contact hours must be in ethics. These ethics hours may be completed via traditional courses or non-traditional courses.

Acceptable Continuing Education Activities

Continuing education activities can take various forms, including traditional courses, non-traditional courses, and the passage of certain examinations.

Traditional courses typically involve direct interaction between the learner and the instructor. The State Education Department considers a telecourse or teleconference in which you and other practitioners discuss a taped presentation with the facilitator's assistance is a live course. A course offered by computer in which you interact directly with the instructor is a "live" course.

Non-traditional courses may include self-directed study, teaching a CE course, or completing an academic semester unit. Self-directed study is defined as study directly related to the profession of respiratory care that does not include interaction between the learner and the instructor. A test at the conclusion of the self-directed study is required.

Non-traditional CE must be approved, recognized, accepted, or assigned CE credit by a professional organization or association (such as TSRC, NBRC or AARC) or offered by a federal, state, or local government entity. Completion of one academic semester unit or hour that is a part of the curriculum of a respiratory care education program or a similar education program in another health-care related field offered by an accredited institution shall be credited 15 contact hours of non-traditional CE. A respiratory care practitioner who teaches or instructs a CE course shall be credited one (1) contact hour in non-traditional CE for each contact hour actually taught. CE credit will be given only once for teaching a particular course. Respiratory Therapists may earn up to a maximum of 10 continuing education credits for experience gained as a clinical instructor where such experience demonstrates that the instructor has met competency standards.

Passage of Examinations: Credit hours can be earned through passage of an official credentialing or proctored self-evaluation examination, as follows:

NBRC Therapist Multiple Choice (TMC) credentialing or re-credentialing examination - 10 contact hours;
NBRC Clinical Simulation Examination (credentialing or re-credentialing) - 10 contact hours;
NBRC Neonatal/Pediatric Respiratory Care Specialist (NPS) examination - 10 contact hours;
NBRC Adult Critical Care Specialist (ACCS) examination - 10 contact hours;
NBRC Sleep Disorder Specialist (SDS) examination - 10 contact hours;
NBRC Certified Pulmonary Function Technologist (CPFT) examination or NBRC Registered Pulmonary Function Technologist (RPFT) examination - 10 contact hours
Board of Registered Polysomnographic Technologists (BRPT) registration examination - 10 contact hours
National Asthma Educator Certification Board (NAECB) Certified Asthma Educator (AE-C) examination (credentialing or re-credentialing) - 10 contact hours
Advanced cardiac life-support (ACLS), pediatric advanced life-support (PALS), neonatal advanced life-support (NALS) or neonatal resuscitation program (NRP), basic trauma life-support, or pre-hospital trauma life-support - 8 contact hours;

Examinations listed above may be counted only once for credit.

Special Requirements: Ethics and Human Trafficking Prevention

Some jurisdictions mandate specific continuing education topics. For example, in some states, at least 2 contact hours must be in ethics. These ethics hours may be completed via traditional courses or non-traditional courses.

Of the 12 non-traditional courses, a course in human trafficking prevention approved by the executive commissioner of the Texas Health and Human Services Commission must be completed. As part of the 24 formal hours required, a course in human trafficking prevention must be completed. The course must be approved by HHSC, and The course may be credited towards the requirements for medical ethics or professional responsibility for any physician. See HHSC's Health Care Practitioner Human Trafficking Training page to access the free course that satisfies these requirements, and for more information about this requirement.

Senate Bill 415 (2023) requires physicians to complete at least 1 hour of CME in the identification and assistance of trafficked persons in their first renewal period after license issuance, and at least 1 hour every third renewal period thereafter. As part of its 2016-2017 review, the Sunset Advisory Commission adopted a non-statutory management action directing TMB to dedicate one page of its quarterly bulletin to three topics in continuing medical education that the Board considers relevant; at least one of the annual 12 continuing medical education topics must be related to tick-borne diseases, including Lyme disease.

Consequences of Non-Compliance

Failure to comply with continuing education requirements can have serious consequences, including:

Inability to renew a license or credential.
Disciplinary proceedings for professional misconduct. Willfully making or filing a false report is unprofessional conduct, according to Section 29.1(b)(6) of the Rules of the Board of Regents.
Conditional registration. On a case-by-case basis, the Department may issue a conditional registration for up to one year. At the end of one year, if you do not comply with the conditions of the conditional license, you will be unable to renew your registration and practice respiratory therapy.

Exceptions to the Requirements

There are some circumstances under which a respiratory therapist may be exempt from continuing education requirements. If you have notified the Department that you are not practicing your profession and your registration is in inactive status, you do not have to complete the continuing education requirement.

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