Policy of MTSA Clinical Standards

Advancement of each student to the next higher level of anesthesia training and responsibility is made at semester intervals by the Progressions Committee. In order toTo be eligible to advance to the next higher level, the student must:
Meet all clinical objectives for the current level for advancement to the next level;
Successfully complete all assigned clinical affiliations;

• meet all clinical objectives for the current level for advancement to the next level,

• successfully complete all clinical affiliation assignments, and

• keep and maintain a current multi-state Tennessee RN license or Nurse Licensure Compact (NLC) or enhanced Nurse Licensure Compact (eNLC) license on file with MTSA during the entire program.

Keep and maintain a current multi-state Tennessee RN license or Nurse Licensure Compact (NLC) or enhanced Nurse Licensure Compact (eNLC) license on file with MTSA during the entire program. The student must possess a current RN license for any state in which he is assigned for clinical rotations. If a student’s RN license lapses for any reason, the student will immediately be removed from of his clinical rotationpractice. The student may not return to clinical rotationspractice until documentation of a current RN license is presented to MTSA. Any clinical dayspractice the student misses during this period must be made up prior to graduation, or the student may be extended in the program to compensate for these days. Any lapse in youra nursing license that results in the inability to perform clinical duties will result in clinical probation.

In addition, all students are required to have an annual influenza vaccine and submit vaccination documentation to MTSA the deadline in October published each year. If a medical condition exists that prohibits the student from receiving the vaccine, the student must present documentation from their primary care provider stating why the influenza vaccine is contraindicated.

Clinical grades will be recorded on the transcript. See Grading Policy for more information.

Clinical Supervision of Nurse Anesthetist Students

The following language is taken from the COA STANDARDS:

Supervision at clinical sites is limited to CRNAs and physician anesthesiologists who are institutionally credentialed to practice and immediately available for consultation. The clinical supervision ratio of students to instructor ensures patient safety by taking into consideration: the complexity of the anesthetic and/or surgical procedure, the student’s knowledge and ability, and the comorbidities associated with the patient. At no time does the number of students directly supervised by an individual clinical instructor exceed 2:1.

Clinical supervision of students must not exceed (1) 2 students to 1 CRNA, or (2) 2 students to 1 physician anesthesiologist, if no CRNA is involved. The CRNA and/or physician anesthesiologist are the only individual(s) with responsibility for anesthesia care of the patient, and have responsibilities including, but not limited to:, providing direct guidance to the student;, evaluating student performance;, and approving a student’s plan of care. There may be extenuating circumstances where supervision ratios may be exceeded for brief periods of time (e.g., lifethreateninglife-threatening situations); however, the program must demonstrate that this is a rare situation for which contingency plans are in place (e.g., additional CRNA or physician anesthesiologist called in, hospital diverts emergency cases to maximize patient safety). Clinical supervision must be consistent with the COA Standards (i.e., clinical oversight is the responsibility of a CRNA or physician anesthesiologist only). Students must be aware of these requirements and know who is supervising them in the clinical area.

The program restricts clinical supervision in nonanesthetizingnon-anesthetizing areas to credentialed experts who are authorized to assume responsibility for the student.

Clinical CareAnesthesia Management Plan Submission

Third Semester: ALL STUDENTSStudents should always complete a plan of care for each patient prior to beginning the case. Sometimes the anesthesia management plan will be written; however, at least a verbal anesthesia management plan should always be discussed with the clinical instructor before beginning the anesthetic. Written anesthesia management plans will be considered part of the clinical evaluation component for advising; they are required to complete carenot graded.

Students create written anesthesia management plans on each clinical day. Duringusing the third semesterMTSA Anesthesia Management Plan template provided.

If the student is aware of the first case for the next day, care plansthe basic anesthesia management plan aspects about the procedure and anesthetic should be submittedcompleted the day prior to the case, and the student should take the partially completed anesthesia management plan form to clinical to be available to present to the clinical faculty who will reviewinstructor. Then, the Care Plan for accuracy and completenessstudent can add the patient-specific data on the day of the case.

Fourth Semester: Each If the student is required to complete care plans on each clinicaldoesn’t know their case assignment until the day duringof clinical, the fourth semester. Thisentire anesthesia management plan should be an in-depth, detailed care plan presented to your clinical preceptor. Students may be required to complete additional care plans for cases they are unfamiliar withcompleted the day of the case.

Written Care Plan submissions may be reviewed by a CRNA and included• Semesters 3 – 5: Submit 10 anesthesia management plans per semester (total of 30 in the student's1st clinical year)

• Semesters 6 – 8: Submit 3 specialty anesthesia management plans per semester progress meeting and report.(total of 9 in 2nd clinical year)

Fifth Semester - Ninth Semester:Students should have at minimum a verbal care plan preparedmust upload written anesthesia management plans as external documents to the clinical case management system.

The deadline for all casessubmission is the last Thursday of Week 9 for each semester. Any unfamiliar procedure or anesthetic plan will require a written care plan. 

Clinical Grading

The penaltiesSee 5.4.108 Grading Policy (DNAP PD) and 5.4.102 Clinical Evaluation of Students for delinquent documentationinformation about clinical grading.

Senior Elective

MTSA recognizes that there are found underhospitals and anesthesia groups willing to give clinical instruction to students that cannot accommodate the Disciplinary Actionssection.

Endentire student body of Rotation Evaluations (Summative)

An EndMTSA. For this reason, the Senior Elective has been developed. Each student enrolled in the Practice Doctorate Program is required to participate in a Senior Elective during the last semester of Rotation Evaluationthe program.

A clinical affiliate agrees to have the position for a limited number of MTSA students. These facilities have the right to approve or deny student participation at the affiliation. MTSA reserves the right to limit the number of students in a Senior Elective at a site to prevent dilution of the clinical experience. Those requests made first, and those with hospitals already having contracts with MTSA, will be considered first. The cost of the Senior Elective is completedincluded in the tuition. All tuition and fees are set by the CRNAMTSA Board of trustees.

A list of facilities that have participated in MTSA’s “Senior Elective” program is available in the office of the Coordinator of Clinical Support. These are shared with students when the Coordinator of Clinical Support informs students of the Senior Elective processes and deadlines.

To be eligible for consideration for a Senior Elective of their choice, the student must meet the following criteria:

1. Maintain an overall 3.0 GPA

2. Above average clinical evaluations

3. Met or have the potential to meet all case requirements

4. No Progressions Committee action preventing student’s participation

5. Specific permission from the Progressions Committee if the student has been on probation for any cause during his time in the program

Students not meeting these criteria will be assigned at any one of the regular active affiliates, including those located in other states, or Anesthesiologist assignedat another senior elective affiliate with whom MTSA already has a current contract. In either of these cases, the student will be personally responsible for the entire cost of the Senior Elective, including any additional expenses, such as Clinicalhousing, travel, and non-NLC state RN licensure (if applicable). Any student who doesn’t adhere to the senior elective deadlines as stated via email from the Coordinator atof Clinical Support will be charged a fee if the clinical rotationstudent requests MTSA to try to secure a new site (or a site without an MTSA student in the past 3 years) within an abbreviated timeline.

MTSA is willing to develop a Senior Elective with any anesthesia group willing to offer specific clinical experience to students, and whose anesthesiologists and CRNAs are capable and desirous of becoming clinical instructors and are willing to enter into MTSA’s senior elective contract agreement. MTSA does not provide living accommodations for students, so the affiliate or student is expected to cover this expense. The student is responsible for identifying the Senior Elective site of their choice.

The contract must be in progress during the student’s Semester 6 at MTSA. All final paperwork must be submitted to MTSA by the end of March in Semester 7. Please see Coordinator of Clinical Faculty using feedback obtained from the clinical siteSupport for actual calendar date.