Nurse Anesthesia Program Research Articles

Experience of Student Nurse Anesthetists’ Learning in the Operating Room During the COVID-19 Pandemic: A Qualitative Interview Study

PurposeThis study explores student nurse anesthetists’ (SNAs) learning in the operating room during the coronavirus 2019 pandemic. DesignAn explorative design with semistructured interviews was used. MethodsThirteen former SNAs and 12 clinical supervisors (8 of whom were included in the final analysis) were recruited from 6 counties in Sweden. Participants were purposively recruited. Inclusion criterion for former SNAs was having completed the nurse anesthesia program in the fall of 2020 to spring 2022; and for nurse anesthetists, those who have experience in supervising SNAs. The interviews were analyzed with thematic analysis. FindingsThe analysis identified one theme and five subthemes. The theme was that student learning was in focus despite an ongoing pandemic. Every learning situation contributed, and learning was triggered by the challenges. Both the SNAs and the supervisors exhibited resilience by accepting the situation and striving to do their absolute best in a nonoptimal learning environment. Over time, learning and supervision returned to normal. ConclusionsDuring the pandemic, learning was ongoing despite stress, fear, and other challenging factors. Students’ learning appears to have been prioritized. The study highlights that nurse anesthetists and SNAs were resilient, resourceful, and able to find new ways to keep learning going.

A Brief History of Anesthesia in Somaliland.

A Brief History of Anesthesia in Somaliland.

Cognitive Competence and Curriculum Development in Nurse Anesthesia Education: A Pilot Study.

Advanced practice nursing in the United States is shifting toward doctoral certification, most commonly a Doctor of Nursing Practice degree. However, there is limited evidence that this transition improves clinical competence. The aim of this study was to determine whether modifications in a nurse anesthesia curriculum that transitioned from a Master of Nursing to a Doctor of Nursing Practice program were associated with improved cognitive performance using an oral examination. A prospective, comparative observational study of students from a single, university-based nurse anesthesia program. This study was a small-scale investigation (n = 22) that used a quantitative method to compare the performances of consecutive cohorts of Master of Nursing and Doctor of Nursing Practice nurse anesthesia students as rated by oral examinations designed to evaluate critical thinking skills and previously shown to demonstrate internal consistency and reliability. After completing an expanded curriculum, Doctor of Nursing Practice nurse anesthesia students performed significantly better than Master of Nursing students on oral examination, with improvements in cognitive domains previously identified as areas of underperformance by Master of Nursing students. Targeted curricular additions in a Doctor of Nursing Practice program correlated with improvements in nurse anesthesia student cognitive competence as measured by oral examination.

Ultrasound Guided Regional Anesthesia and Simulation

Problem: Literature regarding the number of iterations required for a nurse anesthetist graduate student to become proficient in ultrasound guided regional anesthesia is scare. Objectives: This pilot study aims to quantify the number of iterations and the amount of time required to reach a level of proficiency to identify the interscalene brachial plexus nerve bundle under ultrasound guidance. Design: A repeated measures design with a pretest-posttest methodology was used on a convenience sample of second year nurse anesthetist graduate students. A pretest was conducted followed by an educational component and five posttest iterations. The educational component included a lecture and hands on demonstrations on how to locate the interscalene brachial plexus nerve bundle. Each interations was analyzed for accuracy and timing. A posttest survey was given to the participants to assess student satisfaction. Results: The rate of accurate identifications of the interscalene brachial plexus nerve bundle increased from 16.67% during the pretest to 83.33% at the end of the fifth posttest iteration. An average of 1.83 iterations were required to accurately identify the interscalene brachial plexus nerve bundle. The average time taken to accurately identify the interscalene brachial plexus nerve bundle was 1 minute 19 seconds. The average time to first correct response was 1 minute 24 seconds. The average rate of accuracy for participants over six iterations was 53%. Eighty-three percent of participants strong agreed and 17% of participants agreed that they felt confident in their ability to perform the interscalene brachial plexus block. All participants agreed that the ultrasound guided regional anesthesia project was beneficial and provided knowledge of the anatomy of the interscalene brachial plexus nerve bundle. Validity of the survey and protocol was assessed by face validity. Significance: The project demonstrates a proof of concept of combining an educational presentation with repetitive simulation education in developing proficiency to identify the interscalene brachial plexus nerve bundle under ultrasound guidance. It also provides the nurse anesthesia program at the University of Buffalo evidence based information for future ultrasound guided regional anesthesia training activities. Lastly, it adds to the growing body of knowledge related to ultrasound guided regional anesthesia.

Peer Mentorship: Implementation of a Resident Registered Nurse Anesthetist Mentorship Program

Abstract Nurse anesthesia residents experience high levels of stress while being enrolled in a post-baccalaureate nurse anesthesia program. Elevated levels of stress have been proven to limit one’s ability to learn and commit new material to memory, all while inhibiting their academic and clinical performance. This study represents a quality improvement project that implements a Peer Mentorship Program (PMP) into a major University in the New England area of the United States. The study utilizes descriptive statistics to determine if implementation of a peer mentorship program can help to decrease nurse anesthesia resident’s stress, while simultaneously increasing academic and clinical performance. Data gathered by the investigators of this study was composed of a Critical Action Point Checklist (CAPC); a set of objectives that were meant to be completed by the participants in order to help run a successful mentorship program. Additional data was collected using a Peer Mentorship Reflection Questionnaire at the end of the study to receive feedback about the Peer Mentorship Program. 56% of participants agreed that the Peer Mentorship Program helped to decrease stress during the study and 83.4% of participants agreed that they would like to see the Peer Mentorship Program continue for future cohorts at their nurse anesthesia program. The findings of this study suggest that more Nurse Anesthesia Programs should work to incorporate a Peer Mentorship Program for their nurse anesthesia residents to help develop safe, high-quality anesthesia providers for the future.

Graduate Record Examination Scores as Predictors of First Time Success on the National Certification Examination in a Midwest Nurse Anesthesia Program

Graduate Record Examination Scores as Predictors of First Time Success on the National Certification Examination in a Midwest Nurse Anesthesia Program

Relationship Between Emotional Intelligence and Clinical Performance in Student Registered Nurse Anesthetists

Emotional intelligence (EI) includes skills such as recognizing, understanding, and managing emotions. This pilot study investigated the utility of the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 as a screening instrument in student registered nurse anesthetists by determining if EI predicted clinical performance. Scores from 11 participants enrolled in a single nurse anesthesia program were correlated with formative clinical evaluations. Relationships between EI and clinical performance were examined. Participants consistently met clinical performance objectives but were unable to use emotion to solve problems or to recognize others' emotions, suggesting that EI abilities could impact future student registered nurse anesthetist clinical performance.

Using complex adaptive systems theory to guide the transition to DNP nurse anesthesia education.

The opportunities and challenges when transitioning from a master's to DNP in nurse anesthesia education are complemented by using a complex adaptive system (CAS) theory to guide the curricula modifications. Major functional changes included reorganizing the curriculum to incorporate AACN DNP Essentials, COA competencies and integrating the scholarly work of a DNP improvement project. These changes were infused while balancing the intensive clinical requirements of a nurse anesthesia curriculum. Highlights in the DNP curriculum included the driving theory of complex systems, ethical values, leadership development, evidence-based practice and adaptation to emergent situations found in nurse anesthesia practice. Goals were to produce a DNP graduate that is more reliant on strategy and vision rather than only tasks or operations. Using the CAS framework enabled our program to transition and prepare DNP graduates to contribute to improved organizational effectiveness and understand the importance of leading change to positively impact patient outcomes.

Was student wrongly dismissed for academic reasons?

The plaintiff enrolled in the Nurse Anesthesia Program at the University of Alabama at Birmingham in 2014. Not long after she began a clinical rotation in August 2016, two evaluators wrote negative reviews of her performance.

Transgender Simulation Scenario Pilot Project

BackgroundTransgender people often experience inequities, discrimination, and violence within health care environments by ill-informed health care professionals. Simulation has been beneficial in increasing students’ knowledge about transgender health issues. MethodsA transgender simulation scenario was piloted with pairs of students completing an anesthesia preoperative interview with a transgender patient who presents for an emergent surgery. Thirty (42%) of graduate nursing students enrolled in a Doctor of Nursing Practice nurse anesthesia program voluntarily participated in a transgender pilot simulation. ResultsTwenty-eight of 30 participants (93%) completed a presimulation and postsimulation survey with the majority (68%) reporting after the simulation that they had ongoing feelings of incompetence related to the health care needs of transgender patients. ConclusionExpanded didactic lessons and simulation experiences that include transgender content can increase comfort levels for both patient and provider as we strive to shift the paradigm toward health care equity for all.

Nurse anesthesia student’s personality characteristics and academic performance: A big five personality model perspective

Purpose: The purpose of this correlational research was to assess the association between the Five Factor Model (FFM) of personality traits and the grade point average (GPA) of students enrolled in a nurse anesthesia program (NAP). This research was conducted to identify a more objective way to evaluate a prospective students’ personality that correlates with academic success in a NAP.Methods: The Program Directors of students enrolled in NAPs throughout the United States were randomly contacted to assist with the data collection. The FFM of personality traits inventory and question requesting the student to self-report their GPA were then forwarded to the student.Results: Upon completion, the data was analyzed using SPSS 22.0. The results demonstrated a significant correlation, indicating that the dimensions of personality were significantly related to GPA. The dimensions of personality accounted for 12% of the variance in GPA. An examination of individual regression coefficients revealed that the personality trait, conscientiousness, was significantly and positively related to GPA.Conclusions: Nurse anesthesia admission committees can use this personality inventory to better guide them in selecting candidates for their program. Used in conjunction with the more traditional admissions criteria; NAPs can be better positioned to select students more objectively that will be successful in their program, hence leading to lower attrition rates.

Did student's hasty dismissal violate her due process rights?

Angela Borrell became a graduate student in the nurse anesthesia program of Bloomsburg University in 2011. As part of her studies, she worked at the Geisinger Clinic.

Did student's hasty dismissal violate her due process rights?

Angela Borrell became a graduate student in the nurse anesthesia program of Bloomsburg University in 2011. As part of her studies, she worked at the Geisinger Clinic.

Students perceptions on pre-clinical experience in a front-loaded nurse anesthesia program

Objective: The purpose of the descriptive study was to identify the students’ perceptions regarding the benefits (extent and nature) they gained by participating in a 4-hour pre-clinical experience in their nurse anesthesia program. The program initiated a modification to the existing curriculum. Based on the modification, faculty queried the students to determine if the experience supported their learning and transition to clinical education. This initial effort serves as a foundation for future research for nurse anesthesia programs as well as curriculum revision. Methods: An online survey was used to collect data regarding the perception of the pre-clinical experience and identified changes that students made in their approach to learning. Additionally, anxiety and confidence was examined. A 21-item Likert scale style survey to explore the benefits student perceived following the 4-hour clinical training as well as any changes they made to their study practices and simulation laboratory time. Results: Multiple benefits were identified from participating in the pre-clinical experience. Nearly all the students acknowledged that the pre-clinical experience encouraged and motivated them to learn and study the didactic curriculum. All the students agreed that the pre-clinical experience not only helped to increase their confidence but also reduced their anxiety as they transitioned to the clinical year of the nurse anesthesia program. Conclusions: Reduced anxiety and greater confidence ease transition to clinical education. Pre-clinical experience improves preparation for clinical rotations by immersing students in the reality of the clinical environment. Students apply didactic knowledge to clinical practice and motivation to learn increases. The results of this research underscore the benefits of early clinical experience.

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review protocol

The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review protocol

Critical Thinking in Nurse Anesthesia Education: A Pilot Study

Critical thinking is pivotal for student success in health professions education. Knowing the critical thinking abilityof the learner helps educators tailor curriculum to enhance critical thinking. A quantitative comparative pilot studyassessed critical thinking ability for students at two distinct points in a nurse anesthesia program curriculum. Criticalthinking was examined using the Health Sciences Reasoning Test (HSRT) for students at the beginning and end ofthe first year of didactic instruction. This pilot study serves as a foundation for additional critical thinking studies.These study results may serve to help nurse anesthesia educators improve the learning process. Nurse anesthesiaeducators are in an important position to improve teaching and learning through classroom activities that fostercritical thinking.

The Effects of High-Fidelity Simulation on Salivary Cortisol Levels in SRNA Students: A Pilot Study

The use of clinical simulation in graduate level nursing education provides the opportunity for students to learn and apply theoretical practices of nursing care in a safe and controlled environment. It was postulated that laboratory simulation would mimic the stress levels of a real clinical situation as measured by the stress hormone cortisol. The purpose of this study was to determine whether high-fidelity simulation approximates the stress experienced by nurse anesthesia students in the operating room. Participants (n = 21) were recruited from an accredited nurse anesthesia program in the southern U.S. Saliva was collected for 3 days under controlled conditions for baseline data. Next, saliva was collected for 3 days: the day before, the day of, and the day after simulation. The same process was repeated for the first clinical day in the operating room. The participants acted as their own control. There was a significant (p < 0.05) increase in cortisol levels during laboratory simulation as compared to baseline values. Although levels of cortisol were higher during clinical time than baseline, this increase was not significant (p > 0.05), and levels were lower than levels during simulation. Laboratory simulation of patient scenarios raised the stress hormone cortisol level threefold above baseline levels in nurse anesthesia students, while actual clinical experience did not.

Impact of a Patient Safety Curriculum for Nurse Anesthesia Students

Patient safety has become an important aspect of national health care initiatives. The purpose of this evaluation was to measure the impact of a patient safety education series for students enrolled in a nurse anesthesia program. Baseline surveys that measured patient safety competencies across three domains, attitudes, skills and knowledge, were administered to the students. A patient safety education series was delivered to the cohort and the survey was then readministered. Mean scores were compared using independent samples t tests. Attitude scores did not change from baseline to posttest. Participants scored higher on posttest means for both the patient safety skills and knowledge domains. Incorporating patient safety content into the nurse anesthesia master's degree curriculum may enhance clinicians' skills and knowledge related to patient safety, and the addition of a patient safety curriculum is important during the formative education process.

Esmolol: A Unique Beta Adrenergic Antagonist

Since the introduction of propranolol in the 1970s, beta adrenergic antagonists have been used widely for cardiac and noncardiac disorders. The recent introduction of esmolol offers many advantages over other beta blockers. Included among them are rapid onset and elimination and beta selectivity. It has wide application in acute care settings.