Spirometry training does not guarantee valid results

Respir Care. 2010 Jun;55(6):689-94.


Background: Many 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.

Objective: To determine if a 14-hour spirometry training course provides sufficient skill to produce valid results, and if follow-up training improves test validity.

Methods: Nurses 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.

Results: Fifteen 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.

Conclusion: A 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allied Health Personnel / education*
  • Clinical Competence*
  • Curriculum
  • Education, Nursing, Continuing*
  • Humans
  • Spirometry / standards*