Jefferson DNP Nurse Anesthesia students get hands-on practice

The Impact of Simulation-Based Education Utilizing 3D-Printed Task Trainers to Improve Surgical Airway Preparedness

Students in the DNP-Nurse Anesthesia Program (jefferson.edu) at the Jefferson School of Nursing are practicing various difficult airway scenarios using the Emergency Cricothyrotomy (EC) procedure on 3D-printed tracheas.

BACKGROUND: Anesthesia providers are highly skilled at performing basic airway management but also must remain proficient in difficult airway scenarios requiring emergency cricothyrotomy (EC). Patients are at risk for adverse outcomes, which escalate over time if not managed effectively and efficiently by the provider (Kaiser, 2018).

However, the low incidence of emergency airway events, coupled with the high skill level requirement of an emergency cricothyrotomy, has resulted in decreased skill proficiency and self-confidence across anesthesia providers. EC also needs more presence in medical and nursing curricula, as demonstrated in a survey of anesthesia providers with less than five years of experience (Fayed et al., 2020).

As a result, it is essential to incorporate education and skills development into the anesthesia resident and nurse anesthesia curriculum. A literature review yielding 95 articles identified simulation-based education (SBE) as a valuable medium to increase provider knowledge, skills, and self-confidence related to EC (Alanazi et al., 2017).

Despite the literature, there currently needs to be more consensus on the best format of simulation education and data directly related to student nurse anesthetists (SRNAs). The project team utilized a pretest-posttest research design to evaluate the impact of education on the knowledge and confidence level of SRNAs to perform an EC.

The survey consisted of a 5-point Likert Scale and multiple-choice questions to assess knowledge and evaluate self-confidence. The intervention consisted of a live demonstration and an independent simulation using 3D-printed tracheas.

The Wilcoxon sign rank test and paired t-test were the primary statistical tests for data analysis. Limitations of the study involved using a small sample size and lack of generalizability.

Pictured Above: The "dragon skin" was made in different shades to be more inclusive.

Pictured Above: Jefferson DNP Nurse Anesthesia students (Hannah Sanders, Mina Youm, and Christine Goldman) receive hands-on practice performing the Emergency Cricothyrotomy (EC) procedure on 3D-printed tracheas at the Jefferson College of Nursing. Skin representing patients of different races ("dragon skin") was also made at Jefferson. Melker Emergency Cricothyrotomy Catheter kits were used to familiarize students with real equipment.

Pictured Above: Jefferson DNP Nurse Anesthesia Class of 2023 students practice the Emergency Cricothyrotomy (EC) procedure on 3D-printed tracheas after viewing an educational video on the procedure, indications, contraindications, and related information.

PROJECT GROUP (FULL LIST):

STUDENTS:

🔹Monica Sucharski, RN, BSN, SRNA

🔹Hannah Sanders, RN, BSN, SRNA

🔹Stefanie Yuen, RN, BSN, SRNA

FACULTY LEADS:

🔹Kristen Simmons, DNP, CRNA, CHSE

🔹Jacqueline Mainwaring, PhD, DNP, MS, CRNA, CNE

SIM LAB COORDINATOR:

🔹Maryanne Halligan, DNP, RN,CCRN-K, CHSE, CNML

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WATCH THESE JEFFERSON CRNAS IN ACTION!

Learn more about the Jefferson DNP Nurse Anesthesia Program here.

BLACK HISTORY MONTH: Dawn Bent’s hard work helped her overcome challenges to be a mentor for many

Dawn Bent, DNP, MSN, CRNA, didn’t choose to be a nurse anesthetist as much as the profession chose her.

She was working as an ICU nurse for eight years when one of the anesthesiologists that she worked with told her: “I think you would be a great nurse anesthetist.” She didn’t know what that was, and so he took her over to the operating room and let her see the profession in action. She still wasn’t convinced, but she didn’t forget. About a year or two later, she explored the profession again and decided to pursue the career path.

“I don’t know if I ever told him, but to this day I thank Dr. Stayer for introducing me to the profession,” said Bent, who works at the University of Pennsylvania and St. Christopher’s Hospital for Children.

Dawn Bent, DNP, MSN, CRNA

Today, Bent is a program director, a role she takes seriously for a number of reasons.

“There are so many challenges from an educational standpoint,” Bent says. “It is even more challenging as a director of color. I say that because we have such a diverse cohort of students on every level that giving them exactly what they ‘need and want’ can pose difficulty.

"I want to be an example to every student regardless of their background, but I know that students of color look up to me in a very different way. I want to make sure that I am being a great example to all of my students.”

Some of the students featured during PANA’s Black History Month commemoration have named Bent as their mentor. And, Bent has her own list of mentors, too. “It’s almost like, 'where do I begin here,'” she says.

The late Art Zwerling touched her education and clinical life so deeply. He was one of the best in the OR and she wanted to follow his lead at all times. She also can’t say enough for Maria Van Pelt (nee Magro), who is not only her friend but definitely always a text or phone call away. “She is so graceful in her approach and has the best poker face out there.” Bent says she learned so much from her.

With all this support, Bent’s greatest achievement thus far is her program director role and working with her associate director. This was not a role that she sought out and she was not even sure she would do it any justice, but they put together not only a team between the two of them, but also with their students and program administrator.

“The value of partnering with our students gives me such hope that in the future they will look at students as their partners so we can actively break the cycle of needing our students to be resilient,” Bent says. “Anesthesia education requires resiliency, but it also needs an environment of gentleness and tolerance to a degree. We were all students at one point.”

As a first generation Jamaican American, Bent’s family always stressed the importance of hard work, but she also recognizes that some from diverse backgrounds may work hard but are still not afforded opportunities. Her focus is continuing to be the face of hard work, mentorship and caring. There are a lot of talented Black Americans out there and some just need the platform in order to shine, she says.

As for what’s next? Bent hopes to continue to make a difference in the lives of students and grow the profession. Being a program director of color, she understands that students from diverse backgrounds — all of them — need an advocate and a mentor.

“I have had students reach out to me that do not go to my program and ask me lots of questions and ask me to mentor them,” she says. “I can’t help but say yes because there were people who invested in me when they really didn’t have to. Giving back means a lot. Working in partnerships with others who have the same heart for students is what I am looking to do.”

BLACK HISTORY MONTH: Tita’s long & winding road makes him a compass for others to follow

Tita Pale Ndognjem, DNAP, CRNA, says he never knew about Black History Month until he came to the United States. Yet, he’s the perfect example for why Americans pause every February to pay tribute to individuals like him.

Tita’s career began in his native country of Cameroon, and it took him through France, England, and now the United States. There were many challenges along the way. Learning the cultures, health-care systems, and specific attributes of each country has been a herculean task. Licensure procedures, socio-cultural and legal implications, and adapting to the environment of care are all very different as well.

However, Tita says, none of those compared to the challenges of anesthesia school, especially for a minority male in a majority white female profession, where he always has to earn the trust of his colleagues, patients, and mentors. The emergence of COVID-19 with the ensuing social and economic disruptions right at the beginning of anesthesia school made matters worse.

Still, Tita persevered. Among his achievements was graduating from the Excela Health School of Anesthesia in 2022 and then passing the NBCRNA certification exam at first trial. He is currently employed at the University of Maryland Capital Region Medical Center in Largo, Md.

From the very beginning, Tita chose the profession because of his passion and desire to provide service to others in need. He views his career as vocation and as a call to compassionate and dedicated service to his patients.

For that guidance, he has a number of mentors to thank: Nkam Mongwa; Dr. Edwin Aroke; Dr. Mike DeBroeck; Dr. Danielle Gray; Dr. Kelly Mallone; Dr. Sue Tranchine; Dr. Jessica Pool; Dr. Laura Wiggins; and Joe Herman, just to name a few.

“This list is endless because it truly takes a village to raise a child,” Tita said (African Proverb).

Beyond providing compassionate, quality, and evidenced-based anesthesia services to his patients, Tita also plans to continue his involvement with the American Association of Nurse Anesthetists (AANA), the Pennsylvania Association of Nurse Anesthetists (PANA), and the Association of Cameroonian Nurse Anesthetists in America (ACNAA) to give back to the profession by contributing financially, mentoring other nurses seeking admission in nurse anesthesia programs, and learning more knowledge and skills.

In other words, watch for him to help shape the future of the profession, which, in a way, is exactly what Black History Month is all about, as Tita now knows.

“It is a time to celebrate the contribution of people of African descent to the great American story, as well as the continuous search for equity, diversity, and representation of all the demographic strata of the American family,” Tita said. “It is a time to ponder on the specific issues that disproportionately affect people of African descent in America and make strides toward a more just and fair union.”

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