NIOSH SSS study plan

Explain, in writing, the purpose and sequence of the forced vital capacity maneuver (maximal inhalation, blast without hesitation, continued effort to plateau) well enough to teach it to a colleague.

List the indications for spirometry and the absolute versus relative contraindications, and justify each relative contraindication by the physiologic risk it creates.

Demonstrate coaching cues for the three most common participant errors (slow start, early termination, submaximal inhalation) and record which cue corrects which error.

Describe how to recognize and respond to a vasovagal event or bronchospasm during a maneuver.

Apply the acceptability criteria for a single curve (back-extrapolated volume, end-of-test plateau, no cough in the first second, no glottis closure, no leak, no obstructed mouthpiece) to at least ten practice tracings.

Practice identifying and naming the specific acceptability defect in each of 20 flawed curves rather than labeling them simply 'poor effort'.

Coach a volunteer through maneuvers and document the coaching intervention that converted an unacceptable curve into an acceptable one.

State the reproducibility criteria for FEV1 and FVC and explain why the best two values, not the average, are reported.

Distinguish acceptability from reproducibility and explain why a curve can be acceptable but not reproducible, and vice versa.

Explain the session termination rules, including when to stop after repeated unacceptable efforts and when extra efforts are justified.

Describe how to obtain a slow vital capacity and when it adds information beyond the forced maneuver.

Practice coaching under time pressure with a checklist so that no acceptability criterion is skipped during a busy session.

Describe the components of spirometer calibration verification, including the use of a calibrated 3-L syringe and the tolerance for volume accuracy.

Explain how to perform and document a daily calibration check, including acceptance limits, and what to do when a check fails.

Outline the required frequency and documentation for biologic control testing and explain what drift in a biologic control signals.

Summarize equipment hygiene measures, including single-use filters, mouthpiece handling, and cleaning of reusable surfaces between participants.

Explain the effect of environmental conditions (temperature, humidity, barometric pressure) on spirometer performance and on reported values, and describe when correction is needed.

List the participant preparation steps that must occur before the first maneuver, including height and weight measurement, and explain why each matters.

Describe screening questions that identify recent surgery, acute illness, or other conditions requiring postponement of testing.

Explain how to verify that the spirometer is set to the correct reference equations and units before testing begins.

Describe how to select appropriate reference equations and explain why values from the wrong population or device type can mislead interpretation.

Explain the role of the lower limit of normal versus a fixed percent-of-predicted cutoff, and describe the error introduced by using fixed ratios in older adults.

Recognize the obstructive, restrictive, and mixed patterns from FEV1, FVC, and the FEV1/FVC ratio, and explain when a bronchodilator response or full lung volumes are needed.

Describe how to grade test quality and communicate uncertainty when results are borderline or the effort was suboptimal.

Draft a complete test report that includes the best values, the predicted values and percent predicted, the quality grade, and the technologist's comments on effort.

Explain the retention and confidentiality requirements for spirometry records and who is entitled to receive results.

Describe how to communicate abnormal results to a participant without offering a diagnosis, including the limits of what a screening test can establish.

Identify the documentation needed when a session is terminated early or results are deemed unusable.

Complete a timed full-length practice examination and score it by domain to identify remaining weak areas.

Re-review the two domains with the lowest practice scores and correct the specific misconceptions found.

Rehearse the maneuver coaching sequence aloud until it can be delivered without notes.

Verify recall of calibration tolerances, acceptability criteria, and reproducibility thresholds without reference material.