Recertification and Reentry to Practice for Nurse Anesthetists: Determining Core Competencies and Evaluating Performance via High-Fidelity Simulation Technology

Abstract

The National Board of Certification and Recertification for Nurse Anesthetists addressed a barrier to return to practice of uncertified practitioners by replacing required direct patient care experiences with high-fidelity simulation. Objectives The aims of this study were to: (a) validate a set of clinical activities for their relevance to reentry and determine if they could be replicated using simulation, (b) evaluate the content validity of an existing simulation scenario containing the proposed clinical activities and determine its substitutability for a clinical practicum, and (c) evaluate the validity of two methods to assess simulation performance. Methods A modified Delphi method incorporating an autonomous, anonymous, three-round online survey process using three unique expert certified registered nurse anesthetists groups was used to address each study aim. Results Twenty-seven clinical activities gained consensus as necessary to be assessed in the simulation. All 14 survey questions used to determine simulation content validity exceeded the minimum content validity index (CVI) value of 0.78, with a mean CVI of 0.99. The global rating scale CVI and the competency checklist CVI were 0.83 and 1.0, respectively. Conclusion The findings add to the existing literature supporting the utility of simulation for high-stakes provider assessment and certification.

Aiming for safer patient care: development of a needs-based anesthesia return-to-work program after a non-remedial leave of absence

“…Overall, respondents commented that the median duration of an LOA before requiring formal RTW updating should be 12 [6][7][8][9][10][11][12][13][14][15] months with a suggested median updating period of 7 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] days (Table 4). Respondents who had previously taken an LOA (compared with those who had not) thought that an RTW program should occur after a shorter absence from work (11 [6][7][8][9][10][11][12] vs 12 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]…”

“…1,7 In our survey, there were significant differences of opinion between respondents who had, or had not, taken an LOA. The LOA group thought that an RTW program should occur after a shorter absence from work (11 [6][7][8][9][10][11][12] vs 12 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] months) and be shorter (5 [3-12] vs 10 [5-26] days). This difference in viewpoint highlights the valuable perspective of those who have actually lived the experience of an LOA, providing essential guidance in this area.…”

“…Dans l'ensemble, les re´pondants e´taient d'accord pour dire que la dure´e d'un conge´ne´cessitant une mise a`jour officielle pour le retour au travail devrait eˆtre de 12 mois [6][7][8][9][10][11][12][13][14][15], avec une pe´riode me´diane de mise a`jour de 7 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] jours. Ceux qui avaient de´ja`pris un conge´estimaient que la mise a`jour devrait eˆtre organise´e apre`s une absence plus courte (11 [6][7][8][9][10][11][12] vs 12 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]…”

Assessing Competency: An Integrative Review of The Creighton Simulation Evaluation Instrument (C-SEI) and Creighton Competency Evaluation Instrument (C-CEI)

“…In addition to the C-CEI being used to evaluate nursing students, other healthcare professionals have utilized the C-CEI for competency evaluation of other disciplines Heyes et al (2018) . evaluated the validity and reliability of the C-CEI for nurse anesthetists that require recertification and reentry to practice.…”