Using Simulation Training to Reduce Skill Decay Among Certified Registered Nurse Anesthetists

Area of Science:

• Medical Education
• Simulation Training
• Anesthesiology

Background:

• Skill decay is a critical issue for certified registered nurse anesthetists (CRNAs), potentially leading to adverse outcomes.
• Low-dose, high-frequency (LDHF) simulation is a proposed method to counteract skill decay.
• A knowledge gap exists regarding the effectiveness of LDHF simulation for CRNAs, particularly concerning skill retention and confidence.

Purpose of the Study:

• To evaluate the effectiveness of LDHF simulation in mitigating skill decay for CRNAs.
• To assess the impact of LDHF simulation on CRNAs' proficiency and confidence in central venous catheter (CVC) insertion.
• To address the existing gap in the literature on LDHF simulation for CRNAs.

Main Methods:

• A quasi-experimental pretest-posttest follow-up design was employed.
• CRNAs underwent simulated refresher training for central venous catheter (CVC) insertion.
• Proficiency and confidence were measured using pretest and posttest evaluations, analyzed with the Wilcoxon signed rank test.

Main Results:

• CRNAs demonstrated a significant increase in CVC insertion proficiency, rising from 50% pretest to 94% posttest (p < .0001).
• Proficiency was retained at 91% six months after the training (p = .0109).
• No significant change was observed in CRNAs' confidence levels post-training (p = .4486).

Conclusions:

• LDHF simulation training is effective for improving and maintaining CVC insertion proficiency in CRNAs.
• This study validates the efficacy of LDHF simulation programs for CRNAs.
• The findings contribute to bridging the literature gap on LDHF simulation use among CRNAs.