Student Learning Objectives:
Upon completion of these courses, the student is expected to:
- Conduct a thorough and accurate preoperative assessment on all assigned patients.
- Derive a complete anesthetic care plan for all assigned patients using pertinent data gathered from the medical record and the patient interview.
- Prepare and organize all pertinent anesthesia related equipment and pharmacologic agents.
- Demonstrate proper care and use of all anesthesia related equipment.
- Practice in a manner that is protective of self, the patient and the environment.
- Safely and completely prepare all assigned patients for anesthesia and surgery
- Manage all aspects of the anesthetic care, from the preoperative area to the recovery area.
- Demonstrate professional behavior and appropriate interpersonal skills while engaged in clinical practice.
- Meet the individual site and specialty objectives.
- Demonstrate cultural competence when working with patients and members of the health care community.
Clinical Practicum Objectives
I. Preoperative evaluation and patient assessment
- Complies with institutional protocol for identifying the correct patient, procedure and surgical site.
- Completes and documents a physical assessment utilizing direct and indirect methods.
- Creates a trusting relationship with patients and staff that creates a therapeutic environment.
- Demonstrates sensitivity and respect for diverse populations.
- Demonstrates professional and effective communication patterns with patients and staff.
- Demonstrates knowledge of the intended surgical/therapeutic procedure and the related anesthetic implications.
II. Preparation of the anesthesia care plan
- Identifies and assesses pertinent data when considering the anesthetic regime. This includes, but is not limited to, anticipated surgical procedure, laboratory reports, x-ray reports, vital signs, history and physical findings, associated medical conditions and family history and previous anesthetic experience.
- Evaluates the patient's drug regime and anesthetic implications.
- Actively consults with clinical instructors as to the status of the patient and the selection of an individualized anesthetic care plan.
- Calculates and communicates a fluid plan for each patient.
- Calculates and communicates an estimated blood volume, allowable blood loss volume and the availability of blood products for each patient.
- Prepares an anesthesia care plan for every patient cared for and prepares at least one written patient care plan per day.
- Consults with clinical preceptor(s) in terms of evaluating the proposed plan versus the actual care delivered.
III. Selection, preparation, organization and care of equipment
- Selects, prepares and organizes equipment and supplies appropriate to procedure and anesthetic technique.
- Identifies locations of anesthesia equipment and supplies and ensures appropriate stock levels as necessary.
- Identifies locations of emergency equipment, supplies and pharmaceutical agents and ensures appropriate stock levels as necessary.
- Vocalizes and complies with institutional policy for equipment safety protocols in terms of preparation, use, cleaning and storage. Equipment examples include anesthesia delivery systems, vaporizers, patient monitoring devices, intravenous fluid and syringe pumps, blood warmers and fluid infusion devices.
IV. Preparation of the patient
- Identifies patients according to institutional protocol and documents the process.
- Identifies and documents site of surgery according to institutional protocol.
- Ensures and documents a legal informed consent for the administration of anesthesia.
- Uses patient focused methods of communication that recognize diversity and the individuality of each patient.
- Transports patients in a safe and respectful manner.
- Positions patients to optimize physiologic parameters, recognizing the safety and surgical implications of the patient's position and documents same.
- Initiates intravenous access and/or other required invasive monitoring devices.
- Manages appropriate fluid therapy regimes based on patient need.
- Prepares and initiates appropriate monitoring devices based on patient need.
- Prepares, selects and utilizes appropriate airway management devices.
- Documents all aspects of patient care.
- Ensures a safe environment by understanding, eliminating or reducing fire, electrical and environmental hazards in the anesthetizing location that may affect the patient, self, staff or the environment.
V. Induction of anesthesia
- Selects, prepares and utilizes appropriate airway management devices.
- Selects, prepares and utilizes appropriate induction agents.
- Assess patient reaction to induction and adjusts the process as necessary.
- Demonstrates comprehensive knowledge of all drugs utilized as part of the anesthetic, including anesthetic and ancillary preparations.
- Describes and recognizes the signs and stages of anesthesia.
- Effectively utilizes patient monitoring devices, including precordial stethoscope.
- Establishes and maintains a patent airway.
- Documents the patient reaction to induction, including drugs and airway devices.
- Recognizes and treats adverse reactions to induction, including the obstructed airway.
- Demonstrates knowledge of the difficult airway algorithm including the rapid sequence induction process.
VI. Maintenance of anesthesia
- Recognizes and intervenes when presented with an obstructed airway
- Utilizes and interprets all physiologic and mechanical monitoring devices.
- Demonstrates an understanding of, and strategies for, maintaining appropriate depth of anesthesia.
- Integrates surgical or therapeutic procedure progress with anesthesia plan.
- Records pertinent anesthetic and physiologic data as per institutional policy.
- Demonstrates comprehensive knowledge of all pharmacologic agents used or proposed to use.
- Assesses the patient's reaction to surgery and anesthesia and communicates the patient's status to the clinical instructor and surgeon as appropriate.
- Recognizes the need to change or adjust the anesthetic plan and consults with the clinical instructor.
- Skillfully inserts a nasogastric or orogastric tube when indicated.
- Describes the physiologic effects of controlled, assisted and spontaneous ventilation and utilizes the appropriate technique.
- Monitors the level of neuromuscular blockade and adjusts as necessary.
- Evaluates urine output and adjusts fluid plan as necessary.
- Utilizes institutional protocol when administering blood or blood products.
VII. Emergence from anesthesia
- Determines depth of anesthesia as necessary during emergence.
- Determines and prepares a post-operative pain control plan.
- Calculates, administers and evaluates the use of neuromuscular blockade reversals.
- Evaluates and maintains a patent airway.
- Uses appropriate suction techniques.
- Is prepared to treat a mechanical or physiologic obstructed airway.
- Assesses and is prepared to treat laryngospasm.
- Completes the documentation as per institutional policy.
VIII. Post operative assessment and care
- Safely transports patients to the appropriate post anesthesia care unit, utilizing monitors or supplemental oxygen as necessary and per institutional protocol.
- Delivers an accurate, complete report as to the patient's status.
- Completes a final patient assessment and determines the need for additional therapeutic interventions.
- Completes all required documentation.
- Decontaminates the anesthetizing location.
- Conducts and documents a post-anesthetic patient visit and relays the findings to the appropriate person.
IX. Professional behavior and relationships
- Describes the role and expectations of a student anesthesiologist assistant.
- Accepts responsibility for his/her relationships with patients and all other members of the health care team that demonstrates awareness of multicultural and social differences.
- Displays initiative, self-discipline and intellectual curiosity.
- Accepts constructive criticism and develops an action plan to address deficiencies.
- Demonstrates ethical behavior in all relationships.
- Acknowledges gaps in knowledge or techniques and develops an action plan to correct deficiencies.
- Accepts instruction from clinical instructors.
- Displays a willingness to perform all assigned duties.
- Displays confidence appropriate to the level of the student.
- Utilizes non anesthesia time in a productive manner.
- Seeks learning opportunities whenever possible.
- Complies with program policies, including attendance and record keeping.
- Complies with clinical site policies, including patient confidentiality, controlled substance use, documentation and others per clinical site.