Cognitive Competence and Curriculum Development in Nurse Anesthesia Education: A Pilot Study

Background

Advanced practice nursing in the United States is shifting toward doctoral certification, most commonly a Doctor of Nursing Practice degree. However, there is limited evidence that this transition improves clinical competence.

Purpose

The aim of this study was to determine whether modifications in a nurse anesthesia curriculum that transitioned from a Master of Nursing to a Doctor of Nursing Practice program were associated with improved cognitive performance using an oral examination.

Design

A prospective, comparative observational study of students from a single, university-based nurse anesthesia program.

Methods

This study was a small-scale investigation (n = 22) that used a quantitative method to compare the performances of consecutive cohorts of Master of Nursing and Doctor of Nursing Practice nurse anesthesia students as rated by oral examinations designed to evaluate critical thinking skills and previously shown to demonstrate internal consistency and reliability.

Results

After completing an expanded curriculum, Doctor of Nursing Practice nurse anesthesia students performed significantly better than Master of Nursing students on oral examination, with improvements in cognitive domains previously identified as areas of underperformance by Master of Nursing students.

Conclusion

Targeted curricular additions in a Doctor of Nursing Practice program correlated with improvements in nurse anesthesia student cognitive competence as measured by oral examination.

Evaluation of an Interprofessional Oral Health Assessment Activity in Advanced Practice Nursing Education

The curriculum for nurse practitioner (NP) students often overlooks the assessment of the oral cavity. In recognition of this, the HEENT (head, eyes, ears, nose, and throat) assessment was expanded to HEENOT (head, ears, eyes, nose, oral, and throat) through integration of an interprofessional educational (IPE) activity developed for University of Colorado NP and dental students. The aim of this study was to assess NP students' perceptions of an IPE activity in which dental faculty and students taught NP students how to conduct an oral exam, recognize oral health pathology, and apply fluoride varnish. Afterwards, the NP students completed an evaluation survey focusing on their thoughts, comfort level, organization, and understanding of the activity. This IPE activity was repeated over four semesters from 2014 to 2017, and significant differences among the semesters were compared. All NP students in the four semesters participated in the activity and the survey: semester one N=25, semester two N=31, semester three N=43, and semester four N=25. In all semesters, NP students reported feeling more confident conducting oral health exams after completion of the IPE activity. Semester four students agreed more with the idea of interprofessional collaboration (OR: 0.103) and receiving educational information not learned elsewhere in the curriculum (OR: 0.134) compared to semester one students. Higher odds for the session being well organized and conducted in a suitable time were found for semester four compared to semester two (OR: 0.217). These comparisons reflect improvement in teaching methodologies over the four semesters and an overall increased confidence for NP students in performing an oral health assessment.

A Successful Model for Clinical Training in Child/Adolescent Cognitive Behavior Therapy for Graduate Psychiatric Advanced Practice Nursing Students

BACKGROUND

Graduate faculty in advanced practice nursing programs seek to provide clinical training in psychotherapy for psychiatric mental health nurse practitioner (PMHNP) students and prepare them for practice with patients across the lifespan, including children and adolescents.

OBJECTIVE

To develop a clinical training model for child/adolescent cognitive behavior therapy (CBT) that is adaptable to all graduate nursing programs including online, classroom, and blended programs.

DESIGN

Clinical training included a didactic 4-hour workshop and 7 small group practice sessions utilizing Creating Opportunities for Personal Empowerment (COPE), a manualized CBT program for teens. Students completed post-clinical training evaluations. Using qualitative design, responses to the open-ended questions were analyzed and common themes identified.

RESULTS

One hundred seven PMHNP students completed evaluations. Four themes emerged from the data: (a) therapeutic understanding of adapting CBT for children and adolescents, (b) therapeutic skills and techniques for use with children/adolescents, (c) improved level of confidence through participation in the CBT program, and (d) therapeutic benefits of being in a group.

CONCLUSIONS

Positive PMHNP student evaluations indicated that this clinical training model is feasible both online and face-to-face and acceptable for providing clinical training in CBT for children and adolescents.