Laurie Smith, RCIS, is the Program Coordinator and Primary Instructor for the Cardiac Electrophysiology Technologist program at Carnegie Institute in Troy, Michigan (Troy is a northern suburb of Detroit). In this article, Carnegie’s Clinical Coordinator Michael Hacala meets with Laurie Smith to get a more in-depth view of the new electrophysiology program.

Figure 1.

Carnegie Institute, located in Troy, Michigan (a northern suburb of Detroit). (Photo credit: Michael Hacala)

How long has your program been in operation?
       Our 15-month Cardiac Electrophysiology Technologist Program at Carnegie Institute began in March 2005, incorporating six quarters of technical instruction. Prior to that time, a successful pilot program was initiated to provide continuing education and advanced training in Electrophysiology. Preparation for the CAAHEP (Commission on Accreditation of Allied Health Education Programs) program accreditation is projected for later in 2006 — the school’s goal is to have the first CAAHEP-accredited Cardiac Electrophysiology program in the United States.

Figure 2.

The 2006 Carnegie Institute Electrophysiology Technology class. Back row, left to right: Shannon Hartwig, Elisa Macari, Jaime Graebner, Staci Wilcosh, Marianna Palu, Ofelia Faur. Front row, left to right: Nick Bulka, RJ Ziemba. (Photo credit: Michael Hacala)

Describe your program syllabus, both clinical and classroom.
       For the first two quarters, students entering our EP program begin on a common educational tract with the Invasive, Non-Invasive, and Vascular Technologist programs, and receive core courses in basic and advanced ECG, Anatomy & Physiology, Cardiovascular Pharmacology, and Physics.
       Students start their specialized electrophysiology courses at Carnegie Institute in the third quarter of training and stay focused in EP until they graduate. In addition to the classroom didactics, students complete 10 clinical hours per week at an assigned hospital clinical site. All students have a 150-hour EP Lab externship at the end of the program.
       Subjects are organized into modules based on the National Model Curriculum. We begin with introductory history and principles, sterile technique and radiation safety, then quickly move to more advanced applications in diagnosis and treatment. We’ve designed the program so the student’s clinical objectives are integrated with classroom objectives.
       ACLS certification is incorporated into our EP and Invasive programs to give the graduating students advanced training and the best opportunity for employment.

Figure 3.

EP students (L to R) Marianna Palu, Nick Bulka, and Ofelia Faur. (Photo credit: Michael Hacala)

How many students do you accept each year?
       Currently our EP Program admits nine students per year. We hope to be able to increase class size to meet the anticipated growth in the cardiac EP field. There is a rapidly growing interest in our EP program among our incoming cardiovascular technology students, as well as from regional hospitals.

What textbooks, CDs, websites, and innovative teaching tools are used in the classes?
       Our texts include Electrophysiology Testing by Richard Fogoros, Drugs for the Heart by Lionel Opie, and Cardiac Pacing and ICDs by Kenneth Ellenbogen. Materials from the AHA are utilized in preparation for the ACLS. Many CD/DVD educational resources are utilized by instructors for classroom presentations and are available for student use. In addition, a large reference library is maintained for the benefit of the students.
       A strong educational partnership has been established between the school and industry representatives. These relationships enable classroom support in the form of guest lectures, so the very latest technologies are presented as they become available. Our students are often invited to attend various EP-related seminars and conferences at regional hospitals and training sites, and we attend two large local cardiology conferences as a class during the program.

Figure 4.

Clinical Preceptors at Work: Nicole Vendal (L) and Carnegie Institute EP graduate Manu Sehgal (R) at Providence Hospital in Southfield, Michigan. (Photo credit: Michael Hacala)

What types of clinical experience do you offer the students?
       Students rotate each quarter through EP labs that offer exposure to adult and pediatric EP studies, ablations, various mapping systems, and device implants of all types. In addition to the dedicated EP labs utilized for clinical sites, additional Cath Labs that perform EP procedures afford students the opportunity to gain crossover experience. We have just added Pacemaker/ICD Clinic clinical rotations so the students have experience with the follow-up that the patients will receive after they leave the EP lab, and some of our clinical sites provide the students an opportunity to observe an open-heart surgery during their clinical rotation.
       Field trips to several local EP and Cath Labs during non-patient hours are scheduled during the program. A preceptor from the host lab gives a detailed guided tour, and the students receive exposure and practice that is not available when the labs are in operation. Students are able to practice a variety of skills, from table panning, data input, and navigational mapping, to defibrillator and pacemaker programming. We are committed to providing extensive hands-on practice with simulations before program completion.

Figure 5.

Aim High: Carnegie Institute’s EP and Invasive CVT classes tour Midwest Medflight’s BK 117 air medical helicopter during a recent field trip to St. Joseph Mercy Hospital in Ann Arbor, Michigan. (Photo credit: Michael Hacala)

When do the students start their “hands-on” exposure?
       Students start their weekly in-hospital clinical rotations in just the third week of the EP specialty. We currently have nine affiliated EP labs and three shared Cath/EP labs in Southeast Michigan (Detroit, Ann Arbor, Saginaw, and Lansing), as well as one in Windsor, Ontario, Canada. We assign only one student at a time to each site to maximize the individual instruction with the clinical preceptor.
       There are currently 25 clinical skills objective checklists for the EP students to complete with their preceptor(s) during the program — everything from patient and table prep to device implants, ablations, venous hemostasis, tilt table tests, and even scrub assistant. Additional objectives are incorporated into the program as new technologies are introduced into the labs. We are finding that students come to be counted on as full members of the host hospital’s EP lab team as they master skill after skill.

Figure 6.

EP students (L to R) Elisa Macari, Jaime Graebner, and Shannon Hartwig. (Photo credit: Michael Hacala)

What is the current demand and employment outlook for your graduates?
       Last year was our pilot EP class, and all three of the students that participated in the pilot were such strong performers that they were hired by EP labs before they completed the program. Two of them are currently interviewing with device companies for clinical positions less than a year after they graduated. Due to the dramatic increase in EP cases across the country, and as EP lab employees are being recruited into industry positions, we see a booming demand for cardiovascular technologists that have had training specifically in electrophysiology.

What are typical starting salaries for your graduates?
       Starting salaries range from $18–$20 per hour locally, plus benefits.

What is your program’s annual tuition?
       Prospective students may contact the Admission’s Office at Carnegie Institute at (248) 589-1078 for the latest tuition information. Tuition budget plans are available to help students budget educational costs. Financial aid is available for those who qualify, and application assistance is provided through our Financial Aid Office.

Figure 7.

Carnegie Institute''s EP Technology Program Faculty (L to R): Alan Bennett, RCIS (Instructor), Laurie Smith, RCIS (Program Coordinator and Primary Instructor), and Michael Hacala, EMT-P (Clinical Coordinator). (Photo credit: Michael Hacala)

Who does your classroom and clinical teaching?
       We have two principal classroom instructors. I teach Basic and Advanced ECG, along with Introductory Electrophysiology. Alan Bennett, RCIS, instructs Anatomy & Physiology, Pharmacology, Physics, Introduction to Diagnostic Techniques, and Cardiac Pathology.
       In addition, Arthur Mize, TESTAMUR AP/Pacing and Defibrillation, teaches Advanced Electrophysiology. Clarence Brooks of Biosense Webster has been a valuable consultant and guest lecturer.
       Michael Hacala, EMT-P, is our Clinical Site Coordinator for both our Cardiac EP and Invasive Cardiovascular Technology programs.

How and why did you become an Educator?
       I began my career in education at Carnegie Institute in 1991 teaching basic and advanced 12-lead ECG interpretation. In my long-standing career in cardiovascular technology, I have found my 15 years in education to be the most rewarding.
       I have a diverse cardiology background. I graduated from an accredited Cardiac Ultrasound program in 1985, and worked in non-invasive cardiology for four years. I was recruited for a position in a Cardiac Cath Lab, and was employed for the next 13 years in Invasive Cardiology (including nine years at William Beaumont Hospital in Royal Oak, Michigan), and became a Registered Invasive Cardiovascular Technologist in 1993.
       Carnegie Institute has been providing highly trained Invasive CVTs (RCIS-eligible) through our fully-accredited, two-year program for the last five years. Within the last few years, we’ve started receiving requests from area hospitals and former students to expand the EP training during the Invasive CVT program. It was evident that there was enough of a demand for Carnegie to start a stand-alone EP program to fulfill a regional need for technologists, so I developed the curriculum.

What do you consider unique about your program?
       We are especially proud of the strong collaborative efforts between the school and the hospital clinical sites, the development of our curriculum to date, and the maturity of our students. We require extensive education and experience before admission to our programs, and we design and schedule our classes to be accessible to working adults. We have a number of highly educated immigrants to the US as well as nearby in Canada, including foreign medical graduates, who add a rich diversity to our student body.
       Given the increasing shortage of nursing and other allied health personnel, we believe in a creative approach to utilizing the talent around us that is not readily served by the traditional high school-to-college-to-work routine. We find that the mature students bring motivation, emotional balance and self-discipline so valuable in serving in an invasive, critical care environment. Our support as they balance family, work and school is well rewarded by their success in their own eyes and in the eyes of their employers.
       Looking towards the future, we hope to recruit more students from outside our region to relocate to Carnegie for training and then return to their home states for employment upon graduation. With the growth of invasive cardiology in the emerging economies of Asia and Latin America, we believe that an opportunity exists to train cath and EP professionals at remote locations through interactive web-based technologies. We are currently seeking partners to explore such opportunities with us.

Carnegie accepts applications for classes starting each March and September. They can be contacted at (248) 589-1078. You can also visit their website at: www.carnegie-institute.com