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Program of Nurse Anesthesia

PNA students use simulation to gain mastery in all aspects of anesthesia care.

The goal of the PNA’s simulation-based curriculum is for every technical process and relevant cognitive or interpersonal skill to become “second-nature.” This way, lessons in patient safety can be integrated into virtually every simulation experience.

Learning is enriched by the high level of expertise among the PNA faculty members, who are the acknowledged simulation experts at Samuel Merritt University (SMU). They expose their students to the learning techniques used at the Health Sciences Simulation Center (HSSC) during the students’ first semester and throughout their studies.

Scroll down or click on the links below for highlights of how simulation is used in the PNA Program:


Partial-Task Trainers ↑ 

Students in a laboratory session use task trainers
to practice airway management techniques
for thoracic anesthesia.

These functional anatomical models are used throughout the PNA curriculum, from the first foundational courses in basic airway management to advanced courses related to anesthesia subspecialties. SMU’s inventory of partial task trainers includes anatomically correct airway trainers and dexterity trainers to teach the skills of fiberoptic intubation. We also have the Blue Phantom™ central line training manikin for ultrasound and “blind” insertion; this manikin is used in advanced workshops for senior PNA students and anesthesia providers from the community. [More about Task Trainers . . . ]

Standardized Patients ↑ 

A standardized patient (SP) is an individual who is trained to act like a real patient in order to simulate a set of symptoms or problems. The PNA uses SPs primarily in the first semester advanced health assessment course, where students practice the history taking and physical examination skills required to complete preoperative assessments. SP simulation is also used to determine a student’s competence in preoperative assessments.

SPs are also used by the PNA in hybrid scenarios, that is, in combination with partial task trainers or manikin simulators. This format is used throughout the program curriculum, primarily to enhance students’ communication and other interpersonal skills. [More about Standardized Patients . . . ]

High-Fidelity Manikin-Based Simulation ↑ 

Student nurse anesthetists are coached
through their first general anesthesia induction.

To reinforce what they are learning in the rest of their studies, all PNA students spend regularly scheduled sessions in the HSSC immersed in complex scenarios that involve high-fidelity manikin-based simulation (HFMBS). These scenarios are designed to integrate the subject matter of PNA courses about pathophysiology and anesthesia principles with practical clinical application.

HFMBS is used in the first semester, prior to the clinical residency, to teach the safe induction of general anesthesia. Then, at the end of the first semester. HFMBS is used to assess whether a student has the basic competencies to progress to actual supervised patient care.

Another example of HFMBS comes during the second semester, which correlates with the beginning of the PNA clinical curriculum. In highly interactive scenarios in a simulated operating suite, students learn to address the disease processes common to surgical patients who have chronic conditions such as asthma, hypertension, coronary artery disease, diabetes or obesity. These scenarios are performed under the guidance of clinical CRNA preceptors who also teach in the real operating room environment. This idea is to give our student nurse anesthetists an opportunity to practice anesthetic management before they actually administer anesthesia care on real patients who may have the same chronic conditions and medical issues as their simulated patients. [More about High-Fidelity Manikin-Based Simulation[More about  . . . ]

Anesthesia Crisis/Crew Resource Management (ACRM) ↑ 

This type of high-fidelity patient simulation focuses on the prevention, amelioration, and resolution of critical incidents and crisis situations. It is the methodology that jump-started the use of simulation in the education of healthcare professionals.

ACRM session in progress.

ACRM training focuses on the professional’s application of the human factors that are known to be essential to safe patient care. These include task and resource management, situation awareness, teamwork, and complex problem solving and decision-making. Students participate in ACRM sessions twice in the last six months of the program curriculum as one indication of how well they have attainted all the PNA’s expected learning outcomes. SMU’s CRM curriculum template is also available to other academic disciplines.