Untoward pathophysiological events: simulation as an experiential learning option to prepare anesthesia providers

Untoward pathophysiological conditions coupled with anesthesia delivery can lead to critical incidents. Anesthetists must be armed with a set of complex skills to respond effectively in acute situations. A survey of nurse anesthetists was conducted in which respondents were asked to report the frequency that they had experienced one of 24 select events in their practice in the last 60 days. They were asked to rank how meaningful it would be for graduate students to experience the same or a similar event in their training in order to be prepared for practice. Also, they were asked to rate, among 6 proposed curricular changes, those which would best address student learning needs. Seven events were identified as having occurred more than 13 times; hypertension, hypotension, bradycardia, acute hemorrhage, hypothermia, coronary constriction, and oliguria. The mean score for how important it was thought for students to experience untoward events in their training was 4.11, with a range of 3.54 for Addisonian crisis to 4.54 for experience in managing hypertension. Recommended curricular change scores ranged from a low of 3.33 for adding more theory in course work to 4.58 for adding simulator experience in the laboratory for critical events. This article identifies anesthetist learning needs from the practitioner's perspective and assists programs in adapting curricula accordingly. Overwhelmingly, respondents believe experiential learning is required to prepare anesthetists to manage untoward events. The rare occurrence of most critical events is a strong rationale for the use of simulator technology as the preferred method to address these learning needs.