Errors in reasoning are the main causes of poor decision-making in clinical practice. To remedy this, many studies highlight the importance of supervising clinical reasoning during medical internships. Although decision-making is an ongoing process at all key moments of the perioperative period, there are no studies on the supervision of clinical reasoning during student nurse anesthetist internships. The objective of this study was to identify the characteristics of the supervision of clinical reasoning by anesthesia professionals with student nurse anesthetists.
A multicenter qualitative study was carried out using observations and individual interviews with five nurse anesthetists and five students.
Three themes are identified : the characteristics of the learner’s and supervisor’s posture ; the teaching methods used ; and the specificities of clinical reasoning.
The nurse anesthetists question clinical reasoning only when they detect difficulties in the student. However, no traceability is carried out. Students spontaneously verbalize their clinical reasoning when unexpected events occur.
The results will be used as a basis for a new tool for tracing learning during internships.
Les erreurs de raisonnement sont les principales causes de mauvaise prise de décision en clinique. Pour y remédier, de nombreuses études montrent l’importance de la supervision du raisonnement clinique pendant les stages en médecine. Bien que la prise de décision soit permanente lors de tous les moments clés de la période péri-opératoire, il n’existe aucune étude sur la supervision du raisonnement clinique durant les stages des étudiants infirmiers anesthésistes. L’objectif de cette étude est d’identifier les caractéristiques de la supervision du raisonnement clinique par les professionnels d’anesthésie auprès des étudiants infirmiers anesthésistes.
Une étude qualitative multicentrique a été réalisée à l’aide d’observations et d’entretiens individuels auprès de cinq infirmiers anesthésistes et cinq étudiants.
Les trois thèmes identifiés sont les caractéristiques de la posture de l’apprenant et du superviseur, les méthodes pédagogiques utilisées et les spécificités du raisonnement clinique.
Les infirmiers anesthésistes questionnent le raisonnement clinique uniquement quand ils détectent des difficultés chez l’étudiant ; cependant, aucune traçabilité n’est réalisée. Les étudiants verbalisent spontanément leur raisonnement clinique lors d’événements imprévus.
Les résultats serviront de base à un nouvel outil de traçabilité des apprentissages en stage.

Simulation is an integral part of the healthcare educational landscape and a key element in the future of graduate professional education. For the past three decades, simulation-based educational methodology has been gaining popularity in nurse anesthesia educational programs (NAEP). There is currently limited objective evidence documenting modalities used or educational outcomes addressed through simulation in NAEPs. In 2018, the American Association of Nurse Anesthesiology (AANA) established a Simulation Subcommittee of the AANA Education Committee and tasked the group with two primary goals: 1) to gain a better understanding of the current state of simulation education and 2) to review responses with regard to how NAEPs could best incorporate simulation elements within their curriculum to meet requirements while adhering to the guidelines of the Council on Accreditation of Nurse Anesthesia Educational Programs. A survey tool was developed and distributed to all programs to assess the utilization of simulation, available simulation resources, ongoing faculty development efforts, and barriers to use of this educational approach. Survey results indicated that simulation is valued as an effective method within NAEPs for a variety of teaching and learning activities and is utilized to support achievement of both technical and nontechnical learning outcomes for student registered nurse anesthetists.

Imposter phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high-performance or competitive environments. IP consequences include psychological distress, role underoptimization, and career dissatisfaction. As high-achieving advanced practice nurses in a profession often evaluated by peers, certified registered nurse anesthetists (CRNAs) are at risk for IP. Identifying impostorism early in the CRNA\'s career and adopting healthy management strategies can optimize the nurse anesthesiologist\'s healthcare role, lead to a more fulfilling career, and support personal wellness.

Entrustable professional activities (EPAs) are the tasks or responsibilities which can be entrusted to a learner competent in that task to allow for unsupervised practice. The concept of EPAs is well documented in medical education literature, but only recently in nursing education. A paucity of literature exists on the application of an EPA framework specifically in nurse anesthesia. Based on the successful application of EPAs in competency-based medical and nursing education, we are of the opinion that this framework may also be utilized in the transition to competency-based education for nurse anesthesia learners. Many certified registered nurse anesthetists clinical preceptors lack training in competency-based education and teaching. The concept of EPAs may assist clinical preceptors in the translation of competencies and performance evaluation of learners. EPAs are defined for the nurse anesthesia clinical education setting. Examples of EPAs specific to nurse anesthesia include anesthesia machine checks, intubation, invasive line placement, regional anesthesia blocks, and preoperative assessment. Criteria of EPAs, barriers to use, and concrete examples are provided. Deliberate use of the EPA framework by clinical preceptors may lead to a more effective evaluation of the learner, thus resulting in purposeful progression to competence.

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