Ask the Clinical Instructor:A Q&A column for those new to the cath lab

Questions are answered by: Todd Ginapp, EMT-P, RCIS, FSICP
Questions are answered by: Todd Ginapp, EMT-P, RCIS, FSICP
The Registered Cardiovascular Invasive Specialist (RCIS) credential is increasingly becoming a standard in cath labs. As governmental agencies and healthcare insurance companies look for a standard of care or minimal credentialing, the RCIS is the most relevant and most specific credential provided for the cath lab today. The RCIS examination is administered through Cardiovascular Credentialing International (www. cci-online.org). The current information booklet, as well as exam applications and details, are available through their website. If you do not have a copy of the booklet, you should download it for review. Your hospital either decided that a credentialing standard is desired, or has seen that credentialing of staff may someday be required and they are getting an early start. For the record, I commend your hospital for taking this jump. I personally believe that it should be required for all cath lab staff who participate in diagnostic and/or interventional procedures in the lab. It ensures a basic knowledge base through the administration of the exam. However, the exam does miss a clinical component, so it does not assure competency in the job performed. We have all seen those individuals who are text-book smart, but something happens when that knowledge must be applied in the real world. Where do I start? First, I will share processes that I have seen work. I understand that every learner has a different need and a different method of learning. What works well for one person does not necessarily work well for another. You have to decide what your learning style is, and this just gives a basic foundation for that learning. First, you should understand what you will be tested on. Table 1 shows the topics and what percentage covering this topic you will likely see on the exam. Now that you know what you will be tested on, you need to develop a plan to review materials. This can’t be understated. Even if you have worked in a cath lab for 15 years, this still doesn’t mean you are prepared for the exam. I speak with a lot of individuals in my classes who are experienced cath lab staff, but did not properly prepare for the examination and failed their first attempt. There are still items on the examination that aren’t used by most labs on a day-to-day basis (shunt calculations, myocardial biopsies, manual calculations of cardiac outputs and valve areas are some examples). Undoubtedly, the most popular RCIS exam-preparedness materials are the products sold by Wes Todd (www.westodd.com). Whether your method of study is active interaction or book learning, his materials have been proven effective for many years. As I was changing careers from a paramedic to a cath lab professional, I found these invaluable. As a testimony, I would not have been able to pass the exam on my first try without utilizing these materials. The CD is structured in such a way that you are given a question to think through, and asked to choose what you think the answer is. Whether you choose the right or wrong answer, you are provided a mini-education session that explains the rationale behind why certain answers are wrong, and why certain answers are right. With graphics and interaction between the learner and the CD, an enhancement to learning is provided for the user. For those people who prefer reading and studying a textbook, Wes Todd’s series of books are, essentially, the CD put on paper. While there isn’t the level of interactivity, the same materials, questions and answers, and explanations are provided. Many people also prefer to study from a variety of invasive cardiology textbooks. Some of the more common books are The Cardiac Catheterization Handbook by Kern (ISBN 0-323-02247-2) and Grossmans’ Cardiac Catheterization by Baim (ISBN 0-683-30741-x). While not specifically directed towards the preparation of the RCIS exam, these books would contain the information needed to be ready for the exam. Of course, there are many more books on the market that can be reviewed, and I only mention a couple with which I have personal experience. What do you do if you review these materials, but feel that you are still not prepared for the exam? The Society for Invasive Cardiovascular Professionals (SICP) provides RCIS Review Courses on a regular basis. Some are provided at national conferences, and some are provided independently for facilities that are requiring their staff obtain the credential in the near future. These are usually 1 or 2-day courses that cover a majority of the content on the exam. These courses are intended to provide a review of materials, but also helps direct the learner to the areas where they need to concentrate their studies. If you come away from the review session thinking you are still not ready or you are the type of person who needs a structured direction for studying over a period of time, you could also participate in an online RCIS Review program, such as the one I facilitate through Spokane Community College. This continuing education program requires the use of the Wes Todd CD. There are required weekly assignments, as well as weekly interactive discussions through a discussion board. There are also weekly Virtual Classes that allow real-time interaction with the instructor and other students. These classes are broken down into two parts (able to be taken in either order) and are offered in concurrent 11-week quarters to make one semester. Some of you may have to take a basic science examination as a precursor to obtaining your RCIS credential. Most individuals with a nursing degree or who have graduated from an accredited CVT program will be exempt from this requirement. You will have to work with CCI to determine your eligibility of exemption. If you must take the basic science exam, remember that most people find it to be more difficult because it covers basic items that you may have not had to deal with since high school. The matrix for that examination is also available in the CCI booklet. The information for the basic science review is also available through the Wes Todd materials, and there are some organizations who provide review sessions a few times a year to help learners prepare for the exam. One of those organizations is Pegasus Lectures (www.pegasuslectures.com). Their main function is to provide echo and vascular learners a review session for those specific registry examinations. They provide a one-day class that covers most all of the topics covered on the basic science exam, including the dreaded math and statistics materials. If you still need help with study materials and advice, please do not hesitate to email me. I have many more resources that can help direct you in your studies to prepare you for your successfully completion of the RCIS examination. If you work in a cath lab, you CAN pass the exam. Sometimes you might just need to be pointed in the right direction. Next month, we will address a reader question concerning beta blockers. The only foolish question is one left unasked. New Staff: Your suggested topics and questions are needed! (You are welcome to remain anonymous.) Email us at: tginapp@rcisreview.com