The University of Evansville Selects Intelligent Ultrasound to Increase Student Learning Opportunities and Deliver Superior Patient Care

The University of Evansville’s Nurse Anesthesia Program has invested in Intelligent Ultrasound’s (IU) NeedleTrainer, BodyWorks Eve, HeartWorks and ORSIM to extend its simulation lab, increase student learning opportunities and ultimately improve patient care.

Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years. Certified Registered Nurse Anesthetists (CRNAs) are the primary providers of anesthesia care in rural America, enabling healthcare facilities in medically underserved areas, while helping to control escalating healthcare costs, through their efficiency.

The University of Evansville received accreditation for its Nurse Anesthesia program from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) in May 2021. Granted accreditation for the DNAP program in 2020, the University already had a simulation center for training purposes, but as its programs and number of students grew, so did the need for additional equipment.

Program Director, Dr Melissa Fitch, recognized the importance of expanding the simulation center and experiences for students, to both satisfy learning needs and prepare them for clinicals. So, the first time these students are stepping into the clinical arena, they are not performing or critically thinking through a skill for the first time, although it is the first time on a patient, they’ve done this before in simulation.

In addition to the newly accredited program, a change in nurse anesthesia training programs drove the need for simulators. The previous 2-year master’s program saw trainees taking care of patients in a clinical setting within weeks of their training beginning. Under the current doctoral degree most programs are front loaded with classroom type didactics.

Most programs are now about three years in length, and without simulation there is a huge disconnect if you have students who have been sitting at a desk learning for a year and there is no transition from didactic to clinical education. Simulation has become more important as these programs transition from classroom to clinic – ultimately, it’s all about patient care.

The search for simulation equipment was not “a straight road”, and the University carried out extensive research into options and trialled several systems before it led to IU through a recommendation from another educational facility.

According to Dr. Fitch, she and other faculty reached out to colleagues from another program and said, “hey we’re looking at a few different products here, what have you found to be successful? With significant investment going into the expansion, we wanted to make sure we were getting the right products for our students. Hands down, they recommended IU.”

When the University first contacted IU they were interested in NeedleTrainer. After an initial meeting they were introduced to the full portfolio of platforms for regional anesthesia and decided they needed “not just one, but all of them”.

The University chose to implement NeedleTrainer Plus, BodyWorks Eve, HeartWorks and ORSIM to grow its simulation center and help deliver its new program. Dr. Fitch states, “I am so excited to be able to offer this level of technology and educational experience to our students while we are still in the infancy of our program. Each of these products has its own place and time in our curriculum. Students are using the platforms across classes, and they’re being threaded throughout the program. Students are able to access the simulation center in the evenings and on weekends to hone their skills and increase their success levels in the clinical setting.”

NeedleTrainer has transformed how ultrasound guided needling (UGRA) and peripheral neve blocks are taught at the University.

“Before we had NeedleTrainer all we could do was lecture, put static images up on a screen, and hope that students would remember when they entered clinical rotations and were able to get their hands on regional equipment and ultrasounds. This year, we can scan ourselves or one of the students with NeedleTrainer’s built in ultrasound and using the colour overlays show the anatomy and how to get different views of a multitude of regional blocks.”

“Using NeedleTrainer, it makes sense for students. They walk into class to this big scary concept of peripheral nerve blocks and they think, I’m never going to do this. It’s too intimidating. By the end of the class, they’re so excited because they can identify the anatomy on the screen and then go back and practice on their classmates. It is a major confidence booster and has completely changed the way we are able to lecture.”

BodyWorks Eve is being used to simulate trauma at the University. Students are given a scenario to work through to evaluate the patient, for example whether Eve has any free fluid in the abdomen. They assess the severity of the injury and use that information to decide whether it will be a surgical case or medically managed, how they will administer the anesthetic, etc.

Using ultrasound and transoesophageal and transthoracic echo capabilities, HeartWorks is being used to visually inspect and detect heart abnormalities. Are the valves normal? Is the heart functioning and contracting normally? Helping students to assess what’s most appropriate for the scenario and how to best treat it – preparing them to deliver the best patient care – is the overarching goal.

ORSIM replaces the University’s previous advanced bronchoscopy and airway management training solution due to it being more durable and versatile when used on manikins.

From a student perspective, the benefits of using IU’s simulation platforms are numerous. They are now able to develop and practice key skills in a low stake simulation environment, so they can focus 100% on patient care when moving into clinical practice.

Dr. Fitch stated, “We want our students to step into the clinical setting with more confidence than they would if they had not had these strong simulation opportunities. Some practitioners are hesitant to utilize skills such as regional anesthesia or bronchoscopy due to a lack of familiarity. Using NeedleTrainer, BodyWorks, HeartWorks and ORSIM, our students can build their knowledge and confidence in the simulation lab.”

Feedback from the current cohort is positive with many students confirming they feel more comfortable with procedures being able to practice in a hands-on environment. In relation to ultrasound use, students can fine tune their probe manipulation skills to obtain the best view and optimize images.

Investment in the IU platforms is also benefitting teaching at the University. In relation to regional anesthesia and block classes, faculty have completely restructured their courses this year because of NeedleTrainer. Last year, content was delivered in PowerPoint in the classroom. This year, faculty utilized a more ‘flipped classroom’ approach with recorded lectures. Students watch these before coming into the class or lab. When they are on site, that time is predominantly used for simulation.

“Using NeedleTrainer, we have completely changed our approach to teaching regional anesthesia. It’s not that it’s more hands off, it’s just the hands on is literally hands on with practice of the skill, whereas the didactic portion they’re doing on their own in preparation for that simulation.”

Through this new teaching method and hands-on approach, Dr. Fitch, and other faculty, Dr. Matthew Harmon, Dr. Darlena Jones, and Wes Oliver, MSN, CRNA, are hopeful that students will be offered more opportunities for regional anesthesia in the clinical setting because they are able to demonstrate that they are ready for it. They understand the basics of ultrasound, where to place the probe, how to identify the anatomy and get the needle in plane.

The first cohort to use the new and improved sim lab and IU platforms is set to graduate in December 2023. With next year’s cohort increasing from 16 to 22 students, Dr. Fitch is confident in the program’s choice of platforms. “We took our time to ensure we were investing in the right simulation platforms for the University – that they would realize the right learning outcomes for our students. IU’s NeedleTrainer, BodyWorks and HeartWorks platforms, along with ORSIM, will allow us to effectively teach the simulation we need for our curriculum, allowing our newly qualified CRNAs to step confidently into clinical practice, providing the best care for their patients.”

For more information on IU’s platforms for nurse anesthesia, click the product links: NeedleTrainer, BodyWorks, HeartWorks, ORSIM.