The Use of Cognitive Task Analysis to Improve Anesthesia Skills Training for Postoperative Extubation

Abstract

This study examines knowledge gains in 25 nurse anesthesia trainees, following the implementation of a novel instructional design, which incorporated cognitive task analysis (CTA) to teach an adult postoperative extubation procedure. CTA is a knowledge elicitation technique employed for acquiring expertise from domain specialists to support the effective instruction of novices. Instruction guided through CTA is effective in improving surgical skills training for medical students and surgical resi-dents. The standard, current method of teaching clinical skills to novices in nurse anesthesia practice relies on recall-based instruction from domain experts. However, this method is limited by the constraints of expertise, including automation of procedural knowledge by the expert practitioner.Automated knowledge escapes conscious awareness and access, thus impeding clear explication of comprehensive essentials for task execution during instruction. CTA guided instruction has been shown to maximizeconceptual, declarative and procedural knowledge gains in novice practitioners by clearly explicating the essentials employed when experts execute tasks. Knowledge gains for the task of postoperative extubation in 13 junior and senior nurse anesthesia trainees were compared to those of 12 trainees, receiving standard instruction. The study results indicate that CTA-based instruction has a positive and significant effect on procedural knowledge gains in the novice anesthetist.