High-fidelity simulation for continuing education in nurse anesthesia.

Simulation represents a true paradigm shift in teaching and learning that has revolutionized healthcare education. However, few continuing education opportunities for anesthesia providers exist using simulation of any type. This article explores the usefulness of high-fidelity simulation (HFS) as a valuable tool for continuing education and reports the results of a needs assessment conducted among 22 practicing nurse anesthetists. The questions related to their exposure to HFS and asked them to rank their experience with 11 anesthesia events. Next, respondents were asked to rank a similar list of anesthesia events that would be useful for continuing education using simulation. Of participants, 71% ranked advanced cardiac life support scenarios, anesthesia machine mishaps, and malignant hyperthermia as highly effective choices for using HFS. Eighty-one percent of participants identified that they envision simulation as a valuable tool to assess competency, but respondents had mixed written responses when asked if simulation should be used for recertification. This needs assessment represents a beginning, grassroots attempt to establish nurse anesthetists' perceptions related to using HFS as a tool for continuing education.

CRNA-physician collaboration in anesthesia.

The benefits of collaboration in healthcare have been linked positively with higher patient satisfaction, improved patient outcomes, enhanced nursing staff satisfaction, and decreased hospital costs. A sample of nurse anesthetists and anesthesiologists affiliated with postgraduate training programs in the state of Texas responded to a survey designed to gather attitudes toward physician-nurse collaboration using an adaptation of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Two-hundred seventy surveys were completed by 62 anesthesiologists and 208 nurse anesthetists. The mean for the total scores on attitudes toward collaboration for anesthesiologists was 44.4 (+/- SD 8.7) and 51.8 (+/- SD 2.7) for nurse anesthetists. Mean scores were consistently higher in the 4 subscales (showed stronger agreement) for nurse anesthetists than for anesthesiologists. No significant differences in attitudes were found between men and women for the total sample. However, the health discipline showed a statistically significant difference. These findings suggest that Certified Registered Nurse Anesthetists who deal with role conflict or unclear expectations as well as limited scope of practice may have increased job stress and dissatisfaction.