Date of this Version

11-8-2024

Document Type

DNP Project

Abstract

Abstract

Background: Student Registered Nurse Anesthetists (SRNAs) work towards becoming a skillful anesthesia provider, which requires extensive rigorous training with didactic learning. Transitioning from ICU nurse to SRNA is challenging and requires clinical preparedness in anesthesia skills and knowledge. Combining learning with hands-on practice builds a foundation for proficiency. Regular simulation of foundational anesthesia skills enhances SRNAs' workflow, clinical abilities, and critical thinking. This quality improvement project aimed to optimize clinical training for first-year nurse anesthesia residents through Rapid Cycle Deliberate Practice (RCDP) versus boot camp simulation training methods.

Method: The researcher conducted a thorough search of PubMed, Cochrane, EMBASE, and CINAHL. Of 200 articles reviewed using the John Hopkins model, 15 met the criteria for this review. A pre- and post-survey qualitative study assessed. The project was developed in a significant level 1 trauma center, using an anonymous online platform for survey, virtual educational module delivery, and anonymous qualitative data collection. IRB-exempt status was obtained from the university. This project was successfully implemented in the current university curriculum, as evidenced by faculty and student anonymous post-surveys.

Results: Sixty-four anonymous qualitative surveys were sent to CRNAs at an acute care facility to assess knowledge of educational strategies and perceptions of nurse anesthesia education. Only 11 participants completed the survey (8% response rate). Pre-evaluation showed 73% of CRNAs rarely used simulation, reflecting past curricula. Post-survey data indicated increased awareness of simulation-based learning's importance for anesthesia residency. Limitations included a small sample size at one specific setting for a short time and lacking participation. The perceptions of graduates who did not experience simulation were optimistic that if experienced, the simulation would enhance cognitive thinking and decrease anxiety and imposter syndrome during educational studies. Forty-three percent felt that RCDT should be integrated into the anesthesia curriculum. Post-survey assessment of the implementation of boot camp and RCDT during the simulation of newly admitted NARs at the university revealed positive perceptions of learning, and 70% of students felt prepared and had more insight into the initial process than the prior cohort.

Discussion: Educational modalities such as RCDT and Boot Camp adopted in the nurse anesthesia curriculum revealed the effectiveness of reality-based training at the university. However, these positive trends suggest that simulation involvement has to be further enhanced, due to the perception of imposter syndrome still remains unresolved. The statistical analysis revealed that providers would have been satisfied with simulation-based education. Based on the statistical evidence, residents were well prepared for the clinical setting within the first year of training. Evidence shows that equipping residents with skills and confidence through simulation-based training is essential. Boot camp and RCDP methods improve NARs' performance, cognitive ability, and mental well-being during clinical rotations.

Conclusion: As the nurse anesthesia profession requires skill, research has found that RCDP and boot camp training methods help NARs better equip themselves for their clinical roles and the necessary skills and confidence to perform independently and competently in high-stakes environments. The educational module enhanced the anesthesia providers’ knowledge and approach to develop an effective training simulation-based training methods to build highly competent and confident nurse anesthetists.

Keywords: Rapid Cycle Deliberate Practice, Bootcamp, Simulation, Debriefing

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