BREATHE-SD builds rural respiratory care workforce

In rural communities across South Dakota, access to healthcare often comes down to access to people.

According to Marissa Trosen, director of the respiratory care program in South Dakota State University’s College of Pharmacy and Allied Health Professions, this is especially true for those needing access to the specialized care provided by respiratory therapists.

“At the time that we applied for the grant, there were fewer than 140,000 respiratory therapists across the nation. By 2030, it was projected that over 93,000 would retire or leave the profession, and the profession has a projected growth of 12% (from 2024-2034), which is must faster than average,” she said.

“There was a tremendous deficit between the number of therapists needed and the number being trained,” she said. “And when we looked specifically at South Dakota, there were multiple position openings and multiple locations using traveling respiratory therapists, working in understaffed situations.”

The BREATHE‑SD initiative set out to change that by building a stronger workforce pipeline in respiratory care. Funded through the U.S. Health Resources and Services Administration’s Rural Public Health Workforce Training Network Program, the project focused on expanding recruitment, training, placement and job development in respiratory therapy throughout rural South Dakota.

Collaboration and recruitment

BREATHE‑SD was driven by a collaboration.

Trosen and her team partnered with Brookings Health System, Huron Regional Medical Center and Madison Regional Health System, three independent rural hospitals across the state, to share expertise, resources and training capacity. According to Trosen, the collaborative approach was essential to the success of the initiative, as recruitment challenges often come down to connection.

“It can be hard to recruit folks to rural areas if they don't have a tie there,” she said. “We used a grow‑your‑own model. We identify potential candidates already in the community and then provide them with the education that they need to return or stay there to work.”

They also wore out their shoe leather. The BREATHE‑SD team attended more than 103 recruitment events and connected with over 7,800 individuals, raising awareness about careers in respiratory care.

How BREATHE‑SD worked

A defining feature of BREATHE-SD was its integration of education directly into rural healthcare settings. Students trained at partner hospitals, using the same equipment. That hands-on experience built both confidence and connection.

“By training our students within their hospital walls, they connect with their department from day one,” Trosen said. “We utilize the same supplies in lab to train them that they then see in clinicals, out with patients.”

Faculty hired through the grant held shared roles, contributing to hospital operations while teaching students. In addition, the program introduced cross‑training opportunities and free, on‑demand educational videos to allow healthcare workers to grow their skills at their own pace.

BREATHE‑SD also made tangible investments in rural health care infrastructure. Grant funding supported the purchase of critical equipment, including ventilators and a pediatric simulator.

“The equipment really had two purposes,” Trosen said. “One was to educate our trainees. The other was to enhance care.”

A compelling success

BREATHE‑SD, at its core, was about building and strengthening the respiratory care pipeline in South Dakota, and its results are compelling.

Through BREATHE‑SD, SDSU expanded the capacity of its Associate of Science degree from 24 to 40 students per year, significantly increasing enrollment. At the same time, 18 students completed respiratory care training through rural sites established by the program. Of those graduates, 17 remained in South Dakota to work.

Another 13 students who participated in BREATHE‑SD further enhanced their education by completing a graduate-level certification in public health.

“I think adding that level of expertise to their experience is valuable to those rural communities,” Trosen said, pointing to the importance of disease prevention and community health capacity.

Training programs remain in place across Brookings and Madison, with clinical experiences continuing in Huron, Trosen said. Enrollment gains have been sustained, and SDSU’s Bachelor of Science in respiratory care recently earned provisional accreditation from the Commission on Accreditation for Respiratory Care.

For Trosen, the most meaningful outcome of BREATHE-SD goes beyond pure numbers. “I think I am most proud of bringing a spotlight to rural healthcare,” she said. “There's going to be a continued need for specialty care like respiratory care. By expanding our training program and delivering it effectively, we’ve helped improve patients’ access to care in rural areas.”