Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

Dr. Clarence J. Biddle


Researchers have studied memory recall of crisis-oriented or emotional events in non-educational settings. However, within the health care field, there has been a limited study of the the concept of recall of crisis oriented or emotional events in& health care education. Crisis-oriented events such as natural disasters, acts of bioterroism, and industrial accidents, have been reported to impact memory. Patient safety is a primary focus in anesthesia education, appropriate crisis management is imperative to quality anesthesia care. Due to the critical nature of anesthesia delivery, there is a strong, constant need to develop methods that will enhance, support, and improve current anesthesia practices that impact patient safety. Educational methodologies used by both clinical and didactic instructors that will improve teaching effectiveness need to be investigated to ensure that patient safety content is being delivered to nurse anesthesia students in a manner consistent with the American Association of Nurse Anesthetists (AANAs) Council on Accreditation's COAs) standards of care. Utilizing a simulated anesthesia crisis situation, this study compared the differences in cognitive imprinting and application to practice between two content delivery methods, the written case study and patient safety vignettes, in nurse anesthesia students. The control group was given a written case study which is considered a traditional method of content delivery. The treatment groups studied vignettes, which are short, realistic, simulated audio-visual videos that demonstrate content to be relayed. The research hypothesis studied the use of anesthesia crisis oriented vignettes as an educational tool to impact memory recall, thus potentially improving application to clinical practice. Hypotheses for the study were: Hypothesis 1 (Hl): Student anesthetists exposed to audio-visual vignettes will exhibit superior clinical performance during simulated apparatus-related crisis events, evidenced by higher group mean demonstration scores, when compared to a matched group exposed to written case studies. Hypothesis 2 (H2): Student anesthetists exposed to audio-visual vignettes will exhibit superior recall of apparatus related material, evidenced by higher group mean post-test scores, when compared to a matched group exposed to written case studies. Using the paired samples t-test and analysis of variance procedure (ANOVA), statistical findings were evaluated for significance. The different teaching methodologies were represented in the abbreviation of the variables studied. Two different crisis oriented events were presented in vignette format, a malfunctioning unidirectional expiratory valve and a malfunctioning suctioning apparatus. Variables that were studied include: clinical performance during the anesthesia machine checkout process by recreating the stuck expiratory valve and malfunctioning suction apparatus scenarios. Statistically, mixed results were obtained. The impact that the stuck expiratory valve vignette had on student recall and clinical performance was found to be insignificant. The impact resulting from exposure to the non-functioning suction apparatus vignette was found to be significant for both student recall and clinical performance. Other recall and clinical performance measures related to the non- functioning suction apparatus were also found to be significant. Conclusions: In this research study, memory and clinical performance were impacted when the anesthesia provider incorporated the correct anesthesia apparatus checkout process and crisis management skills into their practice. This research demonstrated that under the conditions of this study, teaching methodology impacted some areas of clinical performance. Due to the small sample size and because the clinical performance measurements tools were newly designed for this particular study, findings from this study cannot be generalized to any other group or population. However, the findings from this study merit further investigation into the potential use of vignettes as an educational methodology to impact clinical practice and improve patient safety.


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