Competency gaps in respiratory therapy: evidence from a global survey

Purpose: Respiratory therapy (RT) has become a vital component of modern healthcare, particularly in managing acute and chronic pulmonary conditions. The rising global burden of respiratory diseases has amplified the demand for skilled RT professionals capable of performing high-risk, low-frequency procedures with precision. Despite the shift toward competency-based education in healthcare, RT training remains fragmented. Disparities in training quality, assessment methodologies, and simulation access result in inconsistent clinical competencies among RT graduates. The absence of a standardized, globally recognized competency framework further compounds these challenges, affecting workforce readiness and patient safety. To date, no global study has systematically quantified competency disparities across RT programs using a standardized framework, leaving a critical gap in comparative evidence needed to guide educational policy and global accreditation. Methods: A cross-sectional survey was conducted targeting RT professionals, educators, and institutional leaders across multiple countries. Quantitative data were analyzed using descriptive statistics, chi-square tests, and gap percentage analysis to identify variations in training practices, competency expectations, and observed deficiencies. Results: Findings revealed significant competency gaps, especially in advanced interventions like extracorporeal membrane oxygenation and lung ultrasound. Inconsistencies in assessment tools, simulation integration, and remediation protocols were noted across institutions. The majority of respondents emphasized the need for competency standardization. Conclusion: The study confirms a pressing global need for a structured, evidence-based competency framework in RT education. Standardization will improve clinical consistency, facilitate workforce mobility, and enhance patient care outcomes worldwide.