Overcoming the LMS repetition challenge for DNP anesthesia students

The journey to becoming a Doctor of Nursing Practice (DNP) in anesthesia is a demanding and transformative one. However, one aspect of this rigorous educational path that often goes unnoticed is the near monthly onboarding process required for clinical rotations, and the repetition of nearly identical Learning Module Systems (LMS) associated with that onboarding. It's a challenge that warrants attention and reform.

DNP anesthesia students endure a relentless cycle of onboarding for clinical rotations at new sites each month. This process, often facilitated through LMS, includes mandatory modules on topics like infection control, safety protocols, and facility-specific policies. While these modules are undoubtedly important for patient safety and compliance, the repetitive nature of the content and time commitment required for completion can often lead to reduced educational engagement. After anywhere from 8-20 hours of LMS every month, that are nearly identical to the previous month, I find it increasingly exhausting to dedicate the over 60hrs a week to anesthesia study and clinical practice.

Critics may argue that redundancy in onboarding is necessary to ensure consistent standards of care and patient safety. They might assert that even experienced clinicians benefit from revisiting these foundational topics regularly. However, it's important to acknowledge that DNP anesthesia students are not novices. They have completed rigorous didactic and clinical coursework, and their educational backgrounds should be taken into account.

To address this issue, I propose the implementation of a standardized national onboarding process for DNP anesthesia students, supported by the American Association of Nurse Anesthetists (AANA). This process would consist of an initial comprehensive onboarding experience, which covers core topics, available to students prior to their first semester of anesthesia study. Upon successful completion of this comprehensive onboarding, students would only be required to complete site-specific modules with each new clinical site. Such a policy would streamline the onboarding process, reduce redundancy, and better utilize students' time. This has been attempted with systems like Castle Branch in the past, but has fallen to the wayside and is no longer widely accepted by clinical sites. A national comprehensive onboarding would also allow educators to focus on enhancing the depth and breadth of clinical experiences, rather than repetitive onboarding paperwork.

With a standardized national onboarding process in place, DNP anesthesia students will experience a more efficient and focused transition when moving between clinical sites. It will also reduce the red tape and frequent delays in clinical site initiation as only site-specific modules would be required. Redundant modules will become a thing of the past, and the educational journey will become more tailored to individual needs. This change will improve the overall educational experience for students.

Advocate for Policy Change: DNP anesthesia programs, educators, and students should advocate for a policy change at the national level, engaging organizations like the AANA to champion this cause within the next year.

Collaborate with Clinical Sites: Collaborate with clinical sites to establish a standardized onboarding process that recognizes prior education and training, reducing the burden of repetitive modules.  This ongoing goal will require large upfront evaluation and annual assessment.

Evaluate and Adjust: Continuously assess the impact of the new onboarding policy on students' educational experiences and make necessary adjustments for improvement. This will prevent a reoccurrence of onboarding fatigue experienced by students.

In conclusion, the repetition of required learning modules in the onboarding process for DNP anesthesia students rotating at new clinical sites every month is a challenge that needs to be addressed. A policy-based solution, involving the national standardization of onboarding processes, will lead to a more efficient and effective educational experience. It's time to reimagine the onboarding journey for DNP anesthesia students and pave the way for a more focused and meaningful clinical education. As DNP anesthesia students, we have the power to make this change happen, and it's time to act.

Author: Sean Fricke, BSN, RN, CCRN, SRNA a Registered Nurse with over 7 years Cardiovascular ICU experience in hospital systems including, but not limited to, Vanderbilt, Cleveland Clinic, and University of Maryland Shock Trauma who is currently attending the Duke University Doctor of Nurse Anesthesia Program

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