Learning from a nurse anesthetist perspective: a qualitative study.

This study explored the learning and problem-solving experiences of Certified Registered Nurse Anesthetists (CRNAs) using a qualitative case study design. Through interviewing and observation techniques, 5 expert CRNAs provided information on learning and problem solving in daily clinical practice. Data were analyzed using the Tesch 8-step model. Three themes emerged from the data. In their learning, expert CRNAs first desire to know the pharmacological, physiological, or pathophysiological ("basic") principles needed to understand clinical situations. Once they are comfortable with their grasp of the basic principles, CRNAs will then "try out" the new agent or technique in their clinical practice. As experiences accumulate, CRNAs create complex practice structures and demonstrate increased levels of confidence, comfort, and expertise in practice. In understanding how expert nurse anesthetists learn and develop, perhaps educators and students will be more able to identify and design learning activities that prepare students for competent and successful anesthesia practice.