By Greg Peters, communications coordinator
School of Health Professions
Far away from the bright lights and often tense atmosphere of an actual operating room, students in the University of Kansas nurse anesthesia program hone their skills in the less-intimidating environment of a patient simulation surgical suite at Metropolitan Community College in Kansas City, Mo.
The instruments and equipment that fill the stark white operating room in the Virtual Hospital at MCC’s Health Science Institute are real. The buzzers and alarm bells are real. Even the operating room scenarios presented to the students are based on real clinical situations. The biggest difference between this experience and an actual operating room is that the students are working on high-fidelity manikins and not humans, so they are making life-and-death decisions but no harm is done.
“Being in charge for the first time in the simulation lab was a great way to start applying the skills and knowledge we had been learning about in class,” says Alexandria Doyle, a first-year student registered nurse anesthetist. “Reading from a book is one thing, but actually being hands-on is a great method of practice.”
The simulations, which are part of the nurse anesthesia curriculum, give students the practical experience of working with patients while allowing them the time and safety to make critical decisions without affecting human lives. There are currently 23 first-year SRNAs involved in the simulations as they begin three years of study working toward a doctor of nursing practice degree.
"We want to provide an active learning environment that includes hands-on and observation," says Shelley Barenklau, CRNA, DNP, a clinical assistant professor who leads the operating room experience.
Typically, the students work in groups of three or four during the operating room sessions, which last between one and two hours. Participants rotate into the primary role as nurse anesthetist, supporting health care team members and observers. Karri Arndt, CRNA, DNP, clinical assistant professor, worked directly in the operating room with the students during a recent novice simulation session while Barenklau controlled the manikin's voice, eyes and breathing from a location outside the operating room.
“Being in charge of the operating room for the first time in simulation was both intimidating and beneficial,” says second-year student Nick Linderer, SRNA. “Using the simulation manikin allowed for a greater sense of the ‘real thing,’ while maintaining safety while going through the growing pains of learning.”
One of the main goals of the simulation is to promote patient safety while allowing students to think critically and make key decisions – the kind of decisions they will confront in an actual operating room.
“Sometimes the ‘light bulb’ moment occurs during the simulation but often after the session,” says Barenklau. “Debriefing allows for both group- and self-reflection of the ‘experiential learning’ activity. Often we address a topic in simulation, and then the student observes a similar situation in clinical observation or training. Their clinical confidence is often boosted by simulation experiences and opportunities.”
By working in peer groups, students learn from both their classmates as well as the faculty.
“It’s nice to be able to bounce ideas off one another and help each other,” Doyle says. “There is still the added pressure of not wanting to look bad in front of your peers, but everyone is so understanding and is in the same boat.”
Additionally, the simulations help students build communication skills that will be important when they work with a variety of professionals on an interdisciplinary operating room team.
“Anesthesia is new to all of us and naturally there is apprehension about transitioning from the role of bedside intensive care unit nurse to anesthesia provider and all the associated responsibilities,” says Linderer. “Simulation was a great platform for easing the anxiety associated with taking on a new role. I know I felt much more confident about heading into anesthesia clinical after going through simulation training.”
Barenklau says simulation provides a safe learning environment where all team members can benefit from the experience.
“Errors and mistakes often become powerful learning tools,” Barenklau says. “Through post-simulation debriefing the group considers what and why an event occurred to help identify gaps and review what went well. Gaps may originate from lack of anesthesia knowledge, psychomotor skill, experience, or frame of mind at the time of the actual simulation scenario.”
Barenklau says students have a group of simulations during their first year in the program with additional more advanced simulations included throughout the curriculum. She adds students also do live clinical practicums at KU Medical Center and other outside affiliates as part of their curriculum.
“Our students have intensive care experience as registered nurses, so they readily transition to advanced assessment and hands-on skills while developing critical thinking skills vital to nurse anesthesia practice,” she says. “The goal is to transition at a pace that fosters student successes and ensures quality patient care.”
Nurse anesthesia is one of more than 25 academic programs offered by the University of Kansas School of Health Professions on the KU Medical Center campus in Kansas City, Kan. The School is recognized for its highly ranked educational programs as well as the significant research and clinical service it provides in support of the local community and the State of Kansas.