Front-loading an Integrated Nurse Anesthesia Program: A Quality Improvement Project

The University of Michigan-Flint/Hurley Medical Center Anesthesia Program has successfully educated students in a fully integrated curriculum since 1991. Over the years, however, increased operating room efficiency has made gradual entry to clinical areas increasingly difficult for both students and instructors. Information collected from educators and students was used to design a curriculum intervention aimed at facilitating successful student transition into the clinical area. Literature Review: While the Council on Accreditation of Nurse Anesthesia Educational Programs sets minimum requirements for nurse anesthesia programs, programs are free to incorporate higher standards. Few studies evaluate the value of prerequisites or compare the success of front-loaded programs to those of an integrated design. The available information shows no significant difference in mean passing rates on the National Certification Examination based on program structure. The NBCRNA reports no statistical difference in student performance on the Self Evaluation Examination based on curriculum type. Results: The most dramatic differences in preparation between students from integrated programs and students from front-loaded programs appear during initial entry into clinical areas. In fall 2012, because UMF/HMC clinical instructors felt that first-year students should have higher knowledge levels and better technical skills when entering the clinical area the program added a four-week, pre-clinical period of intensive simulation and pharmacology training for new students. As a result, these students entered the clinical arena with significantly improved knowledge and technical skills. A pre-program preparatory web site, designed specifically for incoming students, will also serve to provide an improved foundation for this intensive training. Results: The curriculum change had a positive effect on clinical entry for students and clinical faculty. Students reported less anxiety upon entering clinical areas and clinical instructors noted a marked improvement in first-year student preparation, knowledge and clinical performance. Current students responded positively to the concept of a preparatory web site designed to fortify the foundational math and science knowledge levels of newly admitted students by channeling their enthusiasm during the interim months between program acceptance and the program's start date.Doctor of Anesthesia PracticeAnesthesia ProgramUniversity of Michigan-Flinthttps://deepblue.lib.umich.edu/bitstream/2027.42/143320/1/Fryzel.pd