Validating international CanMEDS‐based standards defining education and safe practice of nurse anesthetists

Abstract

AimTo investigate whether the CanMEDS‐based International Federation of Nurse Anesthetists’ Standards could adequately define the scope of practice and reliably be used to train and evaluate Swiss nurse anesthetists (NAs).BackgroundAlthough nurse anesthetists represent a majority of the global workforce in anesthesia, policies that define the scope of practice are frequently non‐existent. In low‐ and middle‐income countries, the lack of anesthesia providers with adequate training is a major challenge.IntroductionDespite stringent training requirements, the scope of practice of Swiss nurse anesthetists is actually not defined. Therefore, we surveyed and assessed whether nurse anesthetists felt that the professional competencies outlined in this framework were aligned with their clinical practice.MethodsA cross‐sectional survey investigated Swiss nurse anesthetists’ relevance ratings of 76 competencies of the International Federation of Nurse Anesthetists according to their professional practice. Cronbach's alpha coefficients were used to determine the internal consistency of the competencies, as well as factor analyses to assess construct validity of these competencies integrated into the CanMEDS roles model.ResultsParticipants rated the Standards overall as very relevant with high reliability. Factor analyses provided evidence of construct validity of these.DiscussionThe International Federation of Nurse Anesthetists' Standards of Practice provide a highly relevant framework and a valuable set of competencies for the scope of practice of Swiss nurse anesthetists, which enabled translation from global guides to local national standards.Conclusion and implication for nursing and health policyAdopted by low‐ and middle‐income countries or countries where national standards are non‐existent, this survey could introduce national and local policies at minimally acceptable standards of care for nurse anesthetists worldwide. The above standards have the potential to align education, outcomes and assessment of nurse anesthetists with the needs of national healthcare systems.

Psychometric Testing of a Structured Assessment Instrument for Non-technical Skills (NANTS-no) for Use in Clinical Supervision of Student Nurse Anesthetists

“…The CanMEDs framework has been recently adopted by the Norwegian Association of Nurse Anesthetists in an attempt to ensure high standards of safety and quality in clinical practice and the education of nurse anaesthetists. The seven competencies described in the framework (Figure 1) incorporate non-technical skills such as communication and situation awareness, task management, leadership and teamwork, as well as promoting the professional identity of the nurse anaesthetist (Herion, Egger, Greif, & Violato, 2019). The decision to adopt this framework for Norwegian nurse anaesthetists is in line with an international movement in health care education and clinical practice aimed at moving beyond competence, with excellence as an aspirational goal (O'Donnell, Cook, & Black, 2016;Smith, Glavin, & Greaves, 2011;Wong, 2012).…”

“…Flin et al (2008) define NTS as "cognitive, social and personal resource skills that complement technical skill, and contribute to safe and efficient task performance". Ensuring nurse anaesthetists have well-developed NTS, such as heightened situation awareness, optimal decision-making and task management, and open and effective communication is a prerequisite for excellent practice and providing high standards of safe anaesthesia care (Gaba, Howard, & Small, 1995;Herion et al, 2019;Larsson & Holmstrom, 2013;Rutherford, Flin, & Mitchell, 2012).…”

History of the Canadian Medical Education Journal

“…Many of them train graduate students at the Masters and PhD levels. [2][3][4][5][6][7][8][9][10] By 2007 my colleague, Dr. Tyrone Donnon, and I decided that we would lead the way to a new Canadian journal in medical education. We approached many of the major medical education organizations in Canada (the Association of Faculties of Medicine of Canada, the Canadian Association for Medical Education, the College of Family Physicians Canada, and the Royal College of Physicians and Surgeons of Canada, the Medical Council of Canada) and many of our colleagues at the major university centers.…”

Experiences using an instrument for non-technical skills in nurse anaesthesia education: a focus group study

“…Nurse anaesthesia education, scope of practice and potential for continuing professional development varies widely internationally [ 5 – 7 ]. In Norway, nurse anaesthetists are registered nurses, who have completed either a two-year masters’ degree or an eighteen-month post-registration program in nurse anaesthesia.…”

“…This requires high standards of competency and safety as advocated by the International Federation of Nurse Anesthetists (IFNA) [ 9 ]. It also demands a level of professionalism that encompasses recognizing and accepting responsibility for maintaining high levels of knowledge, skills, and professional values as well as an active commitment to self-appraisal and continuous professional development [ 5 , 9 ].…”