Case-based instruction: An analysis of clinical curricula in nurse anesthesiology

• Main Author: McAuliffe, Maura Siobhan
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.1993
• Subjects: Anesthesia; Correlation analysis; Curricula; Health education; Higher education; Nursing
• ISBN: 9798208005996

This correlational study investigated relationships between graduate nurse anesthetists' perceptions of adequacy of preparation to function independently in the entry level role (dependent variable), and the following nurse anesthesiology student experiences (independent variables); (a) the number of clinical hours administering anesthesia, (b) the number of complex cases, (c) the number of complex experiences, (d) the number of high acuity patients, and (e) the total number of clinical cases. The conceptual framework used was Spiro's cognitive flexibility theory for advanced knowledge acquisition in ill-structured domains (Spiro, Coulson, Feltovish, & Anderson, 1988). Fifty-one graduates from seven programs of nurse anesthesiology completed the Nurse Anesthesiology Adequacy of Preparation Scale (NAAPS). The subjects mean scores on the NAAPS indicated that, overall, the graduates believed that they were at least adequately prepared to function independently in the professional setting. The Supervisors' perceptions of the graduates' preparation to function independently in the professional setting was slightly, but significantly, more positive than the graduates' perceptions. A multiple correlation (R$\sp2$), correlating all five independent variables simultaneously with the dependent variable was calculated. Two independent variables entered the equation (Multiple R.44, R$\sp2$.19). Total number of high acuity patients entered first (b$-$.37, F 4.16, p.04), followed by total number of cases (b.16 F change 6.19, p.01). These findings were not consistent with Spiro's theory, and suggest it is not simply a matter of supplying students with more cases that increases student learning, but supplying more cases of a certain type. Nearly all subjects reported that the most beneficial clinical learning experiences were those that allowed them (a) to participate actively in the planning and implementing of anesthetic care, (b) latitude in their learning experiences, and (c) opportunities to engage in critical thinking. Poor learning experiences were reported as those that (a) placed restrictions on the types of cases or experiences allowed, (b) limited student participation in decision making or, (c) lacked quality clinical instruction during cases. These findings support Spiro's theoretical statement that in advanced knowledge acquisition a wide variety of cases accompanied by active learner involvement, and guidance from expert mentors enhances learning.