? regarding CRNA programs

heartICU · Dec 4, 2004

My school is integrated; we started clinicals the first week of class. Some people say that front-loaded programs are better, because you learn a lot before you actually step into the OR, but I prefer integrated. Getting comfortable in the operating room environment is a big hurdle to overcome, and I like getting experience in the OR from day one. It allows you to actually apply what you have learned in class yesterday to the OR today. Just my opinion, others may disagree.

loisane · Dec 4, 2004

You ask a very interesting question, to which there is no clear answer. I think it would be a great topic for a research project, but it would not be any small task.

I think there are pros and cons to each approach. There is some logic to front loaded programs. You have all the academic background before applying it to actual clinical cases. This avoids the "we haven't had that in class" syndrome that is frustrating for both students and clinical educators. I also think some programs are attracted to this model because it seems administration might be easier. I have no direct knowledge, but it just seems if you have an entire cohort together for class, them send them off to clinicals all at the same time, that has to make day to day management a little smoother with less chance for confusion. It also allows for as many clinical sites as the program can handle, with less need to coordinate clinical scheduling needs. So my observation has been that students seem to have more choices for clinical sites with this model.

Integrated programs also have their strengths and weaknesses. You cannot avoid being assigned cases that you have not learned a thing about in the classroom yet. Later you may cover the classroom material, and never get another chance to go back and do that type of case. But SRNAs are all adult learners, and they tend to like to "do". So many students like the idea of getting in the OR right away. It is very difficult to take a RN who is used to running their tail off taking care of patients 8-12-16 hours a day, and sit them in a classroom all day, every day for months on end. That sounds like torture to alot of SRNAs. It has been my observation (although I may not see the whole picture) that integrated programs tend to use fewer clinical sites. It just seems logical that if you are coordinating all your clinical schedules with all your classroom schedules, that there is a lower number of clinical sites that you can realistically deal with.

These are the thoughts of an old, experienced CRNA who likes to muse abstractly. I leave it to the current or recent SRNAs to describe the nuts-and-bolt practical differences between the two types of programs. I have learned alot about this issue on this forum already, and always look forward to continued input on this.

loisane crna

apaisRN, RN, CRNA · Dec 4, 2004

When I interviewed at UNE, the director told us that studies have shown that graduates of integrated and front-loaded programs have equivalent competency at the end of their schooling.

I like the idea of an integrated program, but there seem to be more front-loaded ones and the thought of walking into an OR the first week is a bit scary.

versatile_kat · Dec 4, 2004

I attend a front-loaded program and have already seen the pros and cons of it (about to finish my first semester). One of the larger cons pertains to exams dealing with the anesthesia machine. We've never manipulated one and it was fairly difficult ascertaining the multiple valves (with multiple names) during the exam. It would have been much easier, IMO, had we been dealing with the gas machine on a weekly basis for the purpose of actually understanding and visualizing what we were reading.

However, this is probably the only instance where not being in clinicals right at the beginning is detrimental (and really only for testing purposes). We only have one more FULL semester of didactic before we're doing all clinicals (and we start going once a week halfway through next semester). I'll be glad when that starts! I think in the end I'll be glad I got all of the classwork out of the way in the beginning and focused on delivering the anethetics and doing hands on care for the greater majority of my schooling. Just my 2 cents!

apaisRN, RN, CRNA · Dec 4, 2004

I attend a front-loaded program and have already seen the pros and cons of it (about to finish my first semester). One of the larger cons pertains to exams dealing with the anesthesia machine. We've never manipulated one and it was fairly difficult ascertaining the multiple valves (with multiple names) during the exam. It would have been much easier, IMO, had we been dealing with the gas machine on a weekly basis for the purpose of actually understanding and visualizing what we were reading.

Did you not have a machine to play with? An old one in the nursing lab or something? No way I could learn a complex machine without handling one.

versatile_kat · Dec 4, 2004

apais ... we had an OLD machine, but the test was on the newer machines (Datex-Ohmeda), so a lot of the questions were geared toward's them and their vaporizers. Unfortunately, our simulation lab won't be finalized until the end of the spring semester ... too late for us. It's just one of those things that "pretend" machines tend not to make the entire picture very clear. But the exam is over and I'm happy with my grade!!! :)

apaisRN, RN, CRNA · Dec 4, 2004

But the exam is over and I'm happy with my grade!!! :)

That's all that matters!

charles-thor · Dec 4, 2004

Owning the intellectual material and being able to apply it clinically is what really matters - not grades. If you progress through school using grades as your endpoint, but forget the material 6 months later, then what have you accomplished?

blee1 · Dec 4, 2004

Thanks for all your input. Can you guys tell me which schools have integrated programs. I think I would like this type vs frontloaded and I want to do some early research on them...

apaisRN, RN, CRNA · Dec 4, 2004

Owning the intellectual material and being able to apply it clinically is what really matters - not grades. If you progress through school using grades as your endpoint, but forget the material 6 months later, then what have you accomplished?

Oh, come on. Of course learning the material is important. It's also important that the student feels she did her best and performed well. Why do people around here get so holier-than-thou?

heartICU · Dec 4, 2004

Thanks for all your input. Can you guys tell me which schools have integrated programs. I think I would like this type vs frontloaded and I want to do some early research on them...

Case Western Reserve has an integrated program. The programs starts off with two days per week clinical, and the rest is spent in class. Each semester the amount of clinical time increases and the class time decreases.