Roy McKay Ph.D.

The Spirometry Refresher (NIOSH-approved) course is offered in person and online.


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About Dr. Roy McKay

  In-Person Spirometry Refresher (NIOSH-approved)

Course Schedule

  • September 24, 2024

Course Fee: $320

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Course Information:
This one day NIOSH-approved refresher course meets NIOSH requirements for recertification and reviews spirometry standards and guidelines published by the American Thoracic Society (ATS) and European Respiratory Society (ERS). Students will also gain a better understanding of sub-maximal effort, invalid maneuvers, and other factors that affect interpretation of the test. Examples of poorly conducted tests will be used to provide insight towards improving coaching technique.

Requirement for Refresher Training:
Previously NIOSH did not mandate spirometry refresher courses. However, after reviewing compelling evidence from the National Institutes of Health’s Lung Health Study, the National Center for Health Statistics’ NHANES III study, and the recommendations from professional societies such as the American Thoracic Society and the American College of Occupational and Environmental Medicine, NIOSH reconsidered the need for refresher training programs. Based upon their analysis, NIOSH concluded that refresher training should be mandatory.

The Refresher course curriculum differs in many respects from the initial training course. To meet the requirements for an update refresher, students will not be permitted to take portions of an initial training program. This means the refresher course must be distinctly different (i.e., separate) from initial spirometry training classes. Refresher courses must also be “approved” by NIOSH. Course providers are not permitted to mix students taking refresher training with students taking an initial (basic) spirometry course. Prospective students who desire to take a refresher class should check to ensure the program provider has actually met the NIOSH requirements and has been specifically approved by NIOSH to offer these special training classes. Prior to enrollment in a NIOSH-Approved Spirometry Refresher course, students must demonstrate eligibility by providing a copy of a valid NIOSH-Approved Spirometry training certificate to the course director. If a certificate is lost or misplaced, the student must obtain a duplicate from their original course sponsor prior to taking the refresher class.

Technicians who wish to maintain a valid NIOSH-Approved Spirometry course certificate must complete a NIOSH-Approved Refresher course (or repeat the full course) every 5 years.

NIOSH-Approved Spirometry course certificates currently expire 5 years after the course is completed. To renew their official NIOSH course certificates, technicians should complete a NIOSH-Approved Spirometry Refresher course before their current course certificate expires.

However, since NIOSH-Approved Spirometry Refresher Courses may not always be available at the specific time needed, NIOSH is currently instituting a 7-month grace period to extend the window of time for completing the needed NIOSH-Approved Refresher training. For example, if the current certificate was awarded on April 1, 2009, then the technician may take a NIOSH-Approved Spirometry Refresher Course within 5 years and 7 months of that date, i.e., until November 1, 2014.

Course Content (subject to change):

Recent Changes in Standards and Guidelines
Is your equipment configured to meet the most recent ATS-ERS standards and guidelines?
Definitions & Significance of FVC, FEV1, FEF25-75%, etc.
The FEF25-75% is frequently reported. Should it be used to identify "small airways disease"?
How to use a Flow - Volume display
Most spirometry systems offer a Flow - Volume display that can help the testing technician recognize hesitating starts, coughs, and other causes of poor subject effort that may invalidate the test and may not be recognizable on the standard volume versus time tracing.
How to Use Peak Flow to Improve Test Performance
Did you know that Peak Flow measurements obtained during routine spirometry can be used to help evaluate subject effort and identify tracings with unacceptable starts?
Proper Test Procedures and subject preparation
Learn additional methods to improve testing technique to enhance performance, especially when using computerized spirometry systems.
Selection & Limitations of Predicted Normal Values
Do you know how to handle race and ethnic groups other than Caucasian and African American?
Appropriate Lower Limits of Normal
Recent guidelines have identified flaws in the most commonly used lower limits of normal. Are you following current recommendations?
Examples of Obstructive & Restrictive Patterns and Causes
Plenty of examples to help understand this important area. This information is especially helpful when responding to questions your patients may have regarding their test results.
How to Identify an Improperly Performed Test
Learn the most common spirometry mistakes, and methods you can use to prevent them from happening again.
Methods You Can Use To Improve Test Quality
Important, if quality test results are important to you.
Instrument Display and Printing Requirements Recommended by the ATS
Can you verify that your tests were conducted on a spirometer that meets the new ATS-ERS spirometry guidelines for proper print format?

This program is usually held at a local hotel, located between downtown Cincinnati and the Cincinnati International Airport.

When you register, a confirmation letter will be sent with the name, location, and phone number of the host hotel.

Special arrangements will be made to reserve a block of rooms at a discounted rate. Your confirmation letter will have specific details; however, when in doubt identify yourself as a participant with the "University of Cincinnati".

8:00 Registration begins
8:30 Lectures begin
5:00 Lectures end

Tuition: refer to registration form for current fee
Tuition includes all course materials and a comprehensive workbook. Students are enrolled in the order in which payment and registration is received. After payment is received, a confirmation letter will be sent to each student. Students should not make non-refundable travel arrangements until the confirmation letter is received. In the unlikely event the program is canceled due to accident, injury, or other unexpected event, your registration fee will be refunded in full. Liability is however, limited to the course fee. After your registration request is submitted, an email reply should be received within 48 hours. If a reply is not received, send an email to

Substitution, Transfer, Cancellation, & No-Show Policy:

  • Substitutions: We will gladly substitute another student for the same course date at any time at no charge.
  • Transfers: A one-time transfer request received at least 30 days prior to the course date is permitted. A new course date must be provided at the time of the transfer request. An administrative transfer fee (see schedule below) must be paid within 7-days, otherwise the request is denied and handled as a cancellation. Transfer requests received within 30 days of the course date are not permitted.
    • Request received more than 60 days prior to course date - Administrative Transfer Fee: None
    • Request received 30 - 60 days prior to course date - Administrative Transfer Fee: 40%
  • Cancellations: Written cancellation requests received within 30 calendar days are non-refundable.
    • Request received more than 60 days prior to course date - Amount Refunded: 75%
    • Request received 30 - 60 days prior to course date - Amount Refunded: 25%
  • No Shows: Refunds are not provided if student doesn't attend their confirmed course date.

Course Schedule

  • September 24, 2024

Course Fee: $320

Register Now