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

Advances in Medical Education and Practice (06/19/23) Vol. 14 Swerdlow, Barry; Osborne-Smith, Lisa; Arditti, Douglas; et al.

A pilot study explored whether modifications to a nurse anesthesia curriculum that shifted from a Master of Nursing (MN) to a Doctor of Nursing Practice (DNP) program improved learners' cognitive skills. The researchers rated 22 participants in consecutive cohorts of MN and DNP programs with mock oral board examinations (MOBEs). The MN cohort include 10 learners who had completed 14 months of study, while the DNP cohort's 12 learners had finished 20 months and had less in-person high-fidelity simulation experiences due to the COVID-19 pandemic. All participants passed the MOBEs, though DNP students significantly outperformed MN students in the domain of Clinical Analysis and most domain subsets of Anesthesia Knowledge. DNP students also surpassed their MN counterparts in sub-domains including formulation of differential diagnoses, troubleshooting intraoperative problems and specifics of suitable preoperative evaluations. Neither cohort substantially outperformed the other in terms of appropriate choice of intraoperative monitors and anesthesia methodology, while their competence in the Communication domain was uniformly good. "The current investigation suggests that curricular modifications associated with a transition between these two programs of study within one institution can result in improved oral examination outcomes that assess student reasoning processes and correlate with enhanced clinical performance," the researchers observed. They suspect DNP training may be more effective for students "who not only 'know' data but also 'know how' to apply such data in clinical practice, and therefore support the ultimate goals of [advanced practice registered nurses] programs transitioning to doctoral practice models."

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