Tag: clinical education

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#57 – Incivility in the Workplace – Joshua Lea, DNP, MBA, CRNA & Kelly Gallant, PhD, CRNA

Josh Lea, DNP, MBA, CRNA and Kelly Gallant, PhD, MSN, CRNA join me to discuss workplace incivility in anesthesia training. We discuss the role of precepting SRNAs and anesthesia residents, root causes and implications of incivility and processes for improving healthy work environments. 

Josh Lea, DNP, MBA, CRNA is a professor of anesthesia at Northeastern University’s Nurse Anesthesia Program and staff CRNA at Massachusetts General Hospital in Boston.  He serves on the board of the Anesthesia Patient Safety Foundation and focuses on burnout & creating healthy work environments as his area of research and publication. He has spoken extensively on the topics both nationally and internationally through his work with the Anesthesia Patient Safety Foundation and as a member of the American Association of Nurse Anesthetists (AANA) Health and Wellness Committee. 

Kelly Gallant, PhD, SRNA completed her anesthesia training at Northeastern University in Boston. She received her Bachelor’s degree from Northeastern in 2010 and spent 8 years working in the surgical intensive care unit as a Registered Nurse while researching pediatric pulmonary hypertension and caregiver reactions as part of her PhD, which she completed at Northeastern in 2017. Kelly then returned to school to study anesthesia completing her Master of Science at Northeastern in May 2020. Kelly was the fiscal year 2019 SRNA Representative to the AANA Health & Wellness Committee. and also contributed to episode #52 – SRNA Wellness in COVID-19 of Anesthesia Guidebook.

References:

Elmblad, R., Kodjebacheva, G., & Lebeck, L. (2014). Workplace Incivility Affecting CRNAs: A Study of Prevalence, Severity, and Consequences With Proposed Interventions. AANA Journal, 82(6), 437–445.

Katz, D., Blasius, K., Isaak, R., Lipps, J., Kushelev, M., Goldberg, A., Fastman, J., Marsh, B., & DeMaria, S. (2019). Exposure to incivility hinders clinical performance in a simulated operative crisis. BMJ Quality & Safety, 28(9), 750–757.

Neft, M., Hartgkidek, A., & Lea, J. (2017). Wellness milestone: The road to wellness: Paving the way toward a healthy work environment. AANA NewsBulletin.

Mahoney, C. B., Lea, J., Schumann, P., & Jillson, I. (2020). Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: Role of job characteristics and personality. AANA Journal, 88(1), 39-48.

Mahoney, C. B., Lea, J., Jillson, I., & Meeusen, V. (2014). Turnover of nurse anesthetists: The similarities and differences between countries. BioMed Central Ltd. 14(2).

Other Resources:

Do you want to learn from APSF about patient safety? Easy. Just subscribe to the APSF Newsletter for FREE and connect with APSF on Twitter, Facebook, and LinkedIn.

AANA Promoting a Culture of Safety and Healthy Work Environment: Practice Considerations PDF

AANA Webpage on Bullying, Disruptive Behavior and Workplace Incivility

AANA SRNA Wellness

Need Help? Not sure? Check out AANA Ask For Help website.


AANA Nurse Anesthesia Leadership Survival Guide PDF

Do you have more questions about workplace incivility? Feel free and contact Joshua Lea, DNP, MBA, CRNA at lea.joshua@gmail.com, Kelly Gallant, PhD, MSN, CRNA at gallant.k@husky.neu.edu or wellness@aana.com.  For concerns related to alcohol or other drugs, call the AANA Helpline at 1-800-654-5167 for 24/7 live confidential help.

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Anesthesia Education Clinical Tips

#22 – The Demo-Do Teaching Technique

“Tell me and I will forget. Show me and I will remember. Let me do and I will understand.” – Confucius

Demo-do teaching is all about “show me and I will remember.”

Demo-do is a simple process where educators outline what will be demonstrated, then demonstrate the process as it should be performed, then coach the learner through immediately practicing the technique.

Demonstration may seem like a silly thing for clinical preceptors to do with anesthesia learners. Too often, CRNAs & physician anesthesiologists expect learners to just know what to do – having completed the reading & studying ahead of time – and get to work practicing whatever skill is to be taught without getting the chance to see a demonstration. The demo-do process changes all that. By demonstrating skills, learners get to see what they’ve studied performed by an expert just prior to them being expected to perform the skill.

Check out the podcast to get the full run down on this technique that will enhance your clinical teaching and accelerate the time it takes for learners to master what you’re teaching them.

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency

#21 – Best Practices in Precepting with Obinna Odumodu, BSN, SRNA

Please follow the link below to complete the survey associated with this podcast for Obi’s research with the University of Saint Francis:

Effectiveness of a Nurse Anesthetist Preceptor Training Survey

https://www.surveymonkey.com/r/9M7VG92

Obinna Odumodu, BSN, SRNA is currently completing his doctorate in anesthesia at the University of Saint Francis in Fort Wayne, Indiana as of February 2021, when this podcast was published.  This podcast will review best practices in precepting and is being utilized as a teaching tool as part of Obi’s doctoral research.   Obi was motivated to create this podcast as a tool for helping SRNAs and CRNAs hone their skills as clinical educators.  To that end, we review the benefits of preceptor training, the qualities of effective preceptors and how to tailor approaches to teaching novices verses experienced anesthesia trainees.  We also touch on adult learning theory, how to create positive learning environments and give effective feedback.  Our hope is that this podcast will overcome the barriers of time consuming and costly preceptor training programs and give SRNAs & CRNAs some practical tools to improve their skills as clinical educators.  Like any clinical skill – whether it’s placing central lines & arterial lines or mastering an array of airway techniques, clinical education is not something you show up knowing how to do.  Being an effective preceptor is something you can get better at and if you’re working with any kind of learner, you owe it to those learners to think about and actually train on how to become a better educator.  Being an expert clinical provider does not mean you are an expert clinical educator.  It’s two skill sets.  Hopefully this podcast will help you develop as a clinical educator.  

Obinna Odumodu was born in Texas but at the age of 3, his parents moved back to Nigeria after completing their degrees at Texas A&M University College Station.  Obi grew up in Nigeria and when he was 19 years old, he returned to the United States where he completed a Bachelor’s degree in nursing at West Texas A&M University.  He worked as a critical care Registered Nurse for over a decade before returning to complete his DNP degree at the University of Saint Francis.  Obi is married to Josephine Odumodu and they have four boys.  Interestingly, Obi started training in Jujitsu with his boys when they were young and just prior to entering anesthesia school, Obi won a world jujitsu championship in 2017.  He plans to continue to train alongside his sons after completing anesthesia school later this year. 

References

Anthony, D., Anthony, D., Jerpbak, C., Margo, K., Power, D., Slatt, L., & Tarn, D. (2014). Do we pay our community preceptors? results from a cera clerkship directors’ survey. Family Medicine. https://pubmed.ncbi.nlm.nih.gov/24652633/

Ashurst, A. (2008). Career development: The preceptorship process. Nursing and Residential Care, 10(6), 307-309. https://doi.org/10.12968/nrec.2008.10.6.29440

Bain, L. (1996). Preceptorship: A review of the literature. Journal of Advanced Nursing, 24(1), 104-107. https://doi.org/10.1046/j.1365-2648.1996.15714.x

Bengtsson, M. &. (2015). Knowledge and skills needed to improve as preceptor: Development of a continuous professional development course – a qualitative study part I. BMC Nursing, 14, 51. https://doi.org/10.1186/s12912-015-0103-9.

Bonner, J. M., Greenbaum, R. L., & Mayer, D. M. (2016). My boss is morally disengaged: The role of ethical leadership in explaining the interactive effect of supervisor and employee moral disengagement on employee behaviors. Journal of Business Ethics, 137(4), 731-742. https://doi.org/10.1007/s10551-014-2366-6

Bowers, A. J. (2016). Quantitative research methods training in education leadership and administration preparation programs as disciplined inquiry for building school improvement capacity. Journal of Research on Leadership Education, 12(1), 72-96. https://doi.org/10.1177/1942775116659462

Cashin, A. J., & Newman, C. (2010). The evaluation of a 12-Month health service manager mentoring program in a corrections environment. Journal for Nurses in Staff Development (JNSD), 26(2), 56-63. https://doi.org/10.1097/nnd.0b013e3181d4789e

Easton, A. O. (2017). Development of an online, evidence-based CRNA Preceptor Training Tutorial (CPiTT): A quality improvement project. AANA Journal, 85(5). https://pubmed.ncbi.nlm.nih.gov/31566532/

Elisha, S., & Rutledge, D. (2011). Clinical education experiences: Perceptions of student registered nurse anesthetists. AANA Journal, 79(4 Supplement), S35. https://pubmed.ncbi.nlm.nih.gov/22403965/

Goldsmith, J. (2008). The code: standards of conduct, performance and ethics for nurses and midwives. https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-old-code-2008.pdf.

Hautala, K. T., Saylor, C. R., & O’Leary-Kelley, C. (2007). Nurses’ perceptions of stress and support in the preceptor role. Journal for Nurses in Professional Development, 23(2), 64-70. https://doi: 10.1097/01.NND.0000266611.78315.08.

Inayat-ur-Rehman, Hussain Shah, S. M., Bashir, Z., & Hussain, S. (2016). Relationship between dominance skills of school managers and teachers’ organizational citizenship behavior. Journal of Research & Reflections in Education (JRRE), 10(1), 28. http://prr.hec.gov.pk/jspui/bitstream/123456789/13004/1/Inayat_ur_Rehman_Education_2016_HSR_AIOU_01.02.2017.pdf

Jones, T., Goss, S., Weeks, B., Miura, H., Bassandeh, D., & Cheek, D. (2011). The effects of high-fidelity simulation on salivary cortisol levels in SRNA students: A pilot study. The Scientific World JOURNAL, 11, 86-92. https://doi.org/10.1100/tsw.2011.8

Jordan, J., Watcha, D., Cassella, C., Kaji, A. H., & Trivedi, S. (2019). Impact of a mentorship program on medical student burnout. AEM Education and Training, 3(3), 218-225. https://doi.org/10.1002/aet2.10354

Lalonde, M., & McGillis Hall, L. (2017). Preceptor characteristics and the socialization outcomes of new graduate nurses during a preceptorship programme. Nursing open, 4(1), 24-31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221437/

La, I. S., & Yun, E. K. (2019). Effects of trait anger and anger expression on job satisfaction and burnout in preceptor nurses and newly graduated nurses: A dyadic analysis. Asian nursing research, 13(4), 242-248 http:// doi: 10.1016/j.anr.2019.09.002.

Latessa, R., Beaty, N., Landis, S., Colvin, G., & Janes, C. (2007). The satisfaction, motivation, and future of community preceptors: The North Carolina experience. Academic Medicine, 82(7), 698-703. https://doi.org/10.1097/acm.0b013e318067483c

Lien, K., Chin, A., Helman, A., & Chan, T. M. (2018). A randomized comparative trial of the knowledge retention and usage conditions in undergraduate medical students using podcasts and blog posts. Cureus. https://doi.org/10.7759/cureus.2065

Man, M. (2016). Managers and organizational citizenship behavior. Scientific Bulletin, 21(1), 14-20. https://doi.org/10.1515/bsaft-2016-0031

Miesner, A. R., Lyons, W., & McLoughlin, A. (2017). Educating medical residents through podcasts developed by PharmD students. Currents in Pharmacy Teaching and Learning, 9(4), 683-688. https://doi.org/10.1016/j.cptl.2017.03.003

Mills, J., Francis, K., & Bonner, A. (2008). Getting to know a stranger—rural nurses’ experiences of mentoring: A grounded theory. International Journal of Nursing Studies, 45(4), 599-607. https://doi.org/10.1016/j.ijnurstu.2006.12.003.

Paul, C. R., Vercio, C., Tenney-Soeiro, R., Peltier, C., Ryan, M. S., Van Opstal, E. R., Alerte, A., Christy, C., Kantor, J. L., Mills, W. A., Patterson, P. B., Petershack, J., Wai, A., & Beck Dallaghan, G. L. (2020). The decline in community preceptor teaching activity. Academic Medicine, 95(2), 301-309. https://doi.org/10.1097/acm.0000000000002947

Peters, A. S., Schnaidt, K. N., Zivin, K., Rifas-Shiman, S. L., & Katz, H. P. (2009). How important is money as a reward for teaching? Academic Medicine, 84(1), 42-46. https://doi.org/10.1097/acm.0b013e318190109c

Phillips, J. M. (2006). Preparing preceptors through online education. Journal for Nurses in Staff Development (JNSD), 22(3), 150-156. https://doi.org/10.1097/00124645-200605000-00010

Price, A., Janssens, A., Woodley, A. L., Allwood, M., & Ford, T. (2019). Experiences of healthcare transitions for young people with attention deficit hyperactivity disorder: a systematic review of qualitative research. Child and Adolescent Mental Health, 24(2), 113-122. https://doi.org/10.1111/camh.12297

Ray W, &. D. (2016). The history of the nurse anesthesia profession. Journal of Clinical Anesthesia, 30, 51-58. doi:10.1016/j.jclinane.2015.11.005.

Ryan, M. L. (2018). Recruitment and retention of community preceptors. Pediatrics, 142(3). doi:10.1542/peds.2018-0673.

Sanford, P. G., & Tipton, P. H. (2016). Is nursing preceptor behavior changed by attending a preceptor class? Baylor University Medical Center Proceedings, 29(3), 277-279. https://doi.org/10.1080/08998280.2016.11929434

Scott-Herring, M., & Singh, C. S. (2017). A CRNA Preceptor Workshop to Increase Preceptor Satisfaction, Confidence, and Comfort: A Quality Improvement Project. AANA Journal 85(4):24–31. https://pubmed.ncbi.nlm.nih.gov/31566541/

Belding Schmitt, M., G Titler, M., A Herr, K., & Ardery, G. (2004). Challenges of web-based education in educating nurses about evidence-based acute pain management practices for older adults. The Journal of Continuing Education in Nursing, 35(3), 121-127. https://doi.org/10.3928/0022-0124-20040501-08

Scott-Herring, M., & Singh, S. (2017) A CRNA preceptor workshop to increase preceptor satisfaction, confidence, and comfort: a quality improvement project. AANA Journal, 85(4):24–31. https://pubmed.ncbi.nlm.nih.gov/31566541/

Sorensen, H. A., & Yankech, L. R. (2008). Precepting in the fast lane: Improving critical thinking in new graduate nurses. The Journal of Continuing Education in Nursing, 39(5), 208-216. https://doi.org/10.3928/00220124-20080501-07

Tan, K. F. (2011). A literature review of preceptorship: A model for the medical radiation sciences? Journal of Medical Imaging and Radiation Sciences, 42(1), 15-20. http://doi:10.1016/j.jmir.2010.08.004.

Schutt, M., & Stachowski, A. (2019). Development of an Online Preceptor Workshop for the DNP Nurse Anesthesia Program Recruitment and Retention. Retrieved from https://ubir.buffalo.edu/xmlui/handle/10477/81348

Merriam, S. B. (2001). The new update on adult learning theory (Ser. New directions for adult and continuing education, no. 89). Jossey-Bass.

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Anesthesia Education Clinical Tips Preparing for Grad School/Residency Wellness

#8 – How to master precepting with Will Cohen, MSN, CRNA

Today I’m joined by Will Cohen to talk about clinical precepting.  We discuss ways to create effective learning environments, how to expect excellence while being supportive and other tips for mastering the art of precepting.

Will created the Facebook page CRNA Preceptors and has become well known in the CRNA world for creating masterfully crafted deep dives on physiology & pharmacology to help CRNA preceptors train their resident SRNAs  

William Cohen is a CRNA who currently practices at two hospitals in the Kansas City metro area.  The first is the University of Kansas Health System which serves as the regional level 1 trauma & burn center.  The other is the Minimally Invasive Surgical Hospital, which focuses on bariatric and orthopedic surgeries and is staffed by a CRNA-only team proficient in multimodal, opioid sparing and ultrasound guided regional anesthesia techniques. 

Mr. Cohen graduated from the Our Lady of Lourdes Nurse Anesthesia Program with a Master’s degree, and had been in various clinical roles prior to entering the anesthesia environment.  He has provided patient care in the pre-hospital setting as an EMT and Paramedic in Ohio and New Jersey, as well as working as a trauma critical care nurse in Atlantic City. Throughout each phase of his career, William has always taken on preceptor roles and enjoys having learners in the clinical environment. 

William has a wide array of interests in healthcare, including precepting learners, human behavior during crisis and emergencies, airway management, opioid sparing anesthesia, and process improvement. Saving the best for last, William thrives on being a husband and father. His family loves to travel, as well as go mountain biking, skiing and experiencing whatever local foods and beers happen to be found along the way.

Chipas, A., Cordrey, D., Floyd, D., Grubbs, L., Miller, S., & Tyre, B. (2012). Stress: perceptions, manifestations, and coping mechanisms of student registered nurse anesthetists. AANA Journal, 80(4).

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