Performance Standards

Program Academic and Technical Standards

Satisfactory Academic Progress

The School of Nurse Anesthesia is designed to integrate didactic and clinical learning experiences to optimize competency as an anesthesia provider.  Therefore, successful completion of every course is necessary to progress through the Program.

In order to meet the Council on Accreditation guidelines and to maintain our high standards, the School has established the following policy:  Anyone who receives an examination grade below 80%  is encouraged to make an appointment to meet with their academic advisor.  This is done to determine if there are any issues/problems with the student or course work, to provide appropriate counseling to the student, and to promote successful advancement through the program.

Students must successfully pass each clinical practicum course in order to advance to the next level.  Student success will be measured against the clinical objectives designed for each clinical practicum experience.  Grades will take into account clinical performance, clinical preceptor feedback, student self-evaluations and faculty insights.

Program Completion Timeline

Students are expected to complete 27 actual months in the program.

Student Progression

In addition to course grades and clinical or field evaluations, student progression is monitored through three processes: (1) regular instructor evaluation of assignments and performance; (2)  programmatic level review through regularly scheduled Comprehensive Student Reviews; and (3)  Student Development Committee (SDC) reviews as needed.  Comprehensive reviews are the responsibility of the full faculty of each program.  Each program also has an SDC, comprised of a minimum of three faculty members.   Program Directors cannot serve on the SDC, but membership can include faculty from other college programs.  The primary function of the SDC is to conduct reviews of student performance in order to assess whether a student can progress in a program, make a determination of student status, and make recommendations for action when a student has failed to maintain academic and professional standards, whether in class, clinical setting, or community.

A.  EVALUATION OF ASSIGNMENTS AND PERFORMANCE

The most sensitive and detailed assessment of student progress is that which is conducted on an everyday basis through the evaluation of assignments in the classroom and clinical performance. To enhance success, performance concerns should be addressed with the student by the instructor as soon as they arise and not held for mid-term reviews, or end-of term grades.  This may also lead to involvement of the student’s advisor and/or the SDC as determined by the       faculty member. (See II. D. for grade standards, and III. B.3.a.& b. for process)

B.  COMPREHENSIVE STUDENT REVIEW:

            At a pre-determined time or times in each semester, (but no later than mid-semester,) the   faculty of each program will conduct a comprehensive review of student performance.       Students’ standing will be noted as follows:  

            1.  Good Academic Standing: Students who meet the minimum standards and  requirements set by the program and UNE.  Students in good standing may continue to progress without restriction toward graduation.

             2. Probationary Standing:  Students who remain on probation as a result of a prior SDC Review.  Progress or concerns should be noted and discussed as needed at this time. 

3. Marginal Standing: Concerns have been previously noted but were not of sufficient consequence to merit probation. 

            4. New Concern(s) Identified:  Any concerns newly identified by the         Comprehensive Student Review may be referred for advising or to the SDC for        resolution.

a.  Referral for Advising:  When initial or minor concerns are first noted by a faculty member at or prior to the Comprehensive Student Review, , the respective faculty member will notify the student and the student's academic and/or field/clinical advisor(s) as appropriate to review the circumstances in person, and with the student.  The content and action steps determined at any such meeting will be documented and shared with the student in writing within two business days.  

b.  Referral to Student Development Committee:  If a resolution cannot be reached at the level of the advisor, or the concerns are substantial in nature, then the matter is referred to the SDC for a formal review.  Significant concerns may include academic performance (e.g. falling below a 3.0 GPA for semester or cumulative, C- or below in course, or “Fail” in a Pass/Fail course) or professional conduct. (See below.)

C.  STUDENT DEVELOPMENT COMMITTEE REVIEW

SDC reviews are intended to support students’ academic progression, and are required in cases where a student is failing to maintain academic standards in the classroom or field placement, is accused of engaging in professionally inappropriate behavior, or is accused of violating academic integrity.  An SDC review can be recommended by any faculty, including the student’s or Program Director(PD), or the faculty as a whole as an outcome of the Comprehensive Student Review.  In the event of an alleged breach of ethical conduct, any aggrieved or responsible party may request that an SDC Review be conducted.  Through the review process, the SDC is responsible for examining the concerns cited, evaluating their merits, determining student status, and recommending a course of action.

1. Responsibilities of the Committee Chair:

The SDC Chair is responsible for notifying all involved parties including the student when a formal SDC Review is required and the rationale for it.  When the rationale includes clinical or fieldwork concerns, every effort will be made to include the relevant parties from the clinical or fieldwork site in the meeting either in person, conference call or videoconference.

2. Responsibilities of the Committee:  

The SDC is responsible for:

a)   gathering all pertinent information relevant to the stated concerns         from all relevant parties, including the identified student, faculty,         advisors, preceptors or field instructors. 

b)         Determination of Student Status:

            i) Probation:  Probationary status allows a student to continue under certain specific criteria as determined by the SDC at a formal  review. Students placed on probation will receive a letter from the PD outlining the conditions of probation and the steps required to return to good standing.  Barring any exceptional circumstances, students who do not return to good standing within the specified                            time frame will be dismissed from the program. 

ii) Return to good standing: Once a student has successfully    completed the criteria specified in the SDC Review to the   satisfaction of the SDC, the Committee will inform the PD who   will send a letter to the student indicating return to good standing.

iii) Dismissal: Students may be dismissed for a variety of reasons, including but not limited to (1) unacceptable academic performance; ( 2) failure to remove probation status; or ( 3) a conduct violation.

c)         Recommending Actions steps:

            The SDC will develop and recommend a plan of action to be taken to  achieve stated outcomes, including the identification of responsible parties and expected dates of actions. This may include helping a student achieve educational objectives (e.g., remediation, use of the learning  assistance center);  employing  alternate pathways to achieve educational objectives (e.g. extending field work hours beyond normal expectations,   retaking a course); or specifying other terms for a student to remain in the  program.  The plan of action also describes the consequences for success(e.g. removal of probationary status) or failure to comply with or achieve the stated goals (e.g., probation, dismissal, or other.) 

d)         Timetable:  The SDC decision re student status and recommended action  steps are made within two (2) business days following the meeting(s) and   communicated to the program director in writing.  The PD reviews the report and seeks clarification if needed.  The PD then communicates the action steps to the student in writing within five (5) business days.

e)Scheduling:  To insure the greatest chance for a successful outcome, educational and conduct concerns should be identified as early as possible, and the SDC Review process initiated promptly.  Except in rare exceptions, this means a minimum of 2 weeks prior to the end of the current semester or term. 

3. Responsibilities of the Student:

The student is responsible for participating in the SDC Review process. This includes providing information as requested and playing an active role in the development of the action steps.

4. Responsibilities of the Program Director:

The PD has a unique role as a member of the faculty while also providing administrative oversight for all program functions.  In the case of SDC Reviews, the PD will review the determination of status by the SDC to ensure that policies have been followed and procedures implemented.  In the case that the PD believes that there are any potential concerns about the process, such as procedural irregularities or additional information that should be considered, the PD will communicate these concerns to the SDC for reconsideration.  The SDCs recommended action steps will be reviewed by the PD for logistical viability (faculty workload, support services, etc.).  The PD will then either approve the plan as is or recommend modifications to the SDC.  Following this step, the SDCs determination of status and recommended action steps will again be forwarded to the PD, who then communicates the outcome to the student. 

5. Responsibilities of the Associate Dean(s):

The Associate Dean(s) serves as a consultant to the SDC and PD re policies and procedures on an as needed basis. 

6. Student Appeals:

A student has the right to appeal to the Dean decisions affecting progression following the process outlined in the UNE Student Handbook

(PLEASE NOTE: There are  expedited review procedures for online programs, please refer to the appropriate program  Student Handbook for details)

C.  ADDITIONAL PROCEDURES

1.  Leave of Absence (LOA).  An LOA can be recommended by the Student Development Committee or be initiated as a student request.  Students who desire to request a leave of absence are encouraged to begin the process with a discussion with their Academic Advisor.  If a decision is made to proceed, a petition is completed by the student, signed by the Advisor, and submitted to the PD, who has final approval.  Leaves of absence can be requested for academic, medical or other personal reasons, and are ordinarily granted for a period not to exceed one year.   The petition form is available at: http://www.une.edu/registrar/upload/leaveabsence.pdf). 

            2. Withdrawal: Students wishing to withdraw for any circumstance must    complete the required University Withdrawal Form . Official withdrawal also        requires approval by the PD.

Appeals, Grievances, and Complaints Other Than Academic Progression

Occasionally, a student may have a grievance regarding another issue.  A student grievance with a faculty member should be addressed first directly with the faculty member.  If a student is not satisfied following this step, the student may request a review by contacting the PD.  The director has the discretion to address the concern directly, or to form a grievance committee.  Questions about procedural options should be directed to the PD.

Grievances or complaints about other aspects of the program may be brought to a faculty member or the PD by an individual student or through student class representatives.  If this does not successfully resolve the concern, a single student or a group of students may bring their complaint or grievance to the College Dean or other relevant administrative unit as per the guidelines in the UNE Student Handbook.

 

Ethical and Behavioral Standards

Failure to adhere to the Student Code of Conduct section of the University of New England Handbook or the Rules of Conduct while on Affiliation at Clinical Sites (see below) may result in a disciplinary sanction. Under these circumstances, the student will go before the SDC.  The SDC may do any or all of the following:

          1. recommend issuing a letter of concern or reprimand
          2. recommend disciplinary probation, which could result in a clinical probation as well 
          3. recommend dismissal from the Program

The SDC may consider any other behaviors in reaching a decision to make a recommendation to the Program Director for adverse actions. This includes actions outside the classroom or in the clinical rotation, which do not reflect well on the Program, profession or individuals.

Rules of Conduct while on Affiliation at Clinical Sites

Success in the Nurse Anesthesia Profession requires certain behavioral attributes including but not limited to personal commitment and hardiness, empathy, discipline, honesty, integrity, personal regard for others, the ability to work effectively with others in a team environment, and the ability to address a crisis or emergency situation in a composed manner.  Adherence to these attributes requires a high level of maturity and self-control, even in highly stressful situations.  During the clinical phase, students must conduct themselves in a highly professional manner consistent with the patient care responsibilities with which they will be entrusted.  Failure to adhere to these standards (noted below) or comply with the Clinical Rotation Policies will result in a disciplinary action ranging from a written warning to discharge from the program (depending upon the violation and the circumstances surrounding the offense).

  1. Creating or contributing to situations that jeopardize patient safety. 
  2. Students are expected to follow all policies in the Student Code of Conduct section of the University of New England Handbook.  Unethical behavior such as academic dishonesty, falsifying logs or medical records is considered a violation of the Program’s standards of conduct. 
  3. Respect the confidentiality of patients and fellow students.  One is not permitted to discuss any patients by name outside the clinical encounter situation.  Students should not discuss other students with preceptors.  For academic presentations, all identifying data , including name, initials, date of birth and facility where seen will be omitted.
  4. Unauthorized possession, use, copying, or distribution of hospital records or disclosure of information contained in such records to unauthorized persons.
  5. Use, distribution, or unauthorized possession of intoxicating beverages or drugs on hospital premises or reporting to work under the influence of intoxicants.
  6. Unauthorized absence from the Anesthesia Department during regularly scheduled clinical hours.
  7. Failure or refusal to follow instructions of a duly assigned preceptor including refusal to accept clinical assignment.
  8. Use of vile, intemperate or abusive language, or acting in a disrespectful manner to any employee, supervisor, patient, or visitor.
  9. Any disorderly conduct on hospital premises.
  10. Creating or contributing to unsanitary conditions.
  11. Theft, fraud, or unauthorized use of property belonging to the hospital, patient, or visitor.

Clinical Practicum Course Expectations

To successfully complete each clinical practicum course, students must achieve a grade of “pass.”    Details regarding clinical practicum expectations will be detailed in the Student Clinical Practicum Handbook and/or course syllabus.  Briefly speaking, clinical progression will be monitored during each clinical practicum.  If students are not meeting clinical objectives, they will be placed on Probation.   
  
If a student is placed on a 30- day Probationary Status, they will continue with the clinical objectives scheduled for that level.  The student will communicate with program faculty and clinical faculty to develop a remediation plan based on their clinical evaluations, clinical faculty feedback and/or program faculty findings.  The plan will include strategies for improvement of clinical performance. 

At the end of the 30-day Probation Status, the student’s performance will be re-evaluated by the program faculty. If they are successful, they will resume their clinical practicum at the same level their peers are at and return to good standing. If progress continues to be unsatisfactory, the student will receive a “fail” for the course and be dismissed from the program.    

Students may be placed on a second 30-day probation period for additional (newly identified) performance issues.  The process described above would apply for this as well.  Students are granted a maximum of two (2) probationary periods not to exceed 60 days total.  If additional (newly identified) performance issues continue to occur after a student has been granted (2) probationary periods, the student would be immediately dismissed.

Essential Technical Standards

Principles:
Nurse anesthesia education requires that accumulation of scientific knowledge be accompanied by the simultaneous acquisition of specific skills and professional attitudes and behavior. Nurse Anesthesia school faculties have a responsibility to society to matriculate and graduate the best prepared nurse anesthetists, and thus admission to this program has been offered to those who present the highest qualifications. The essential technical standards presented in this document are pre-requisite for matriculation, subsequent promotion from year to year, and ultimately graduation from the University of New England School of Nurse Anesthesia. These standards pertain to all matriculated students. All required courses in the curriculum are necessary in order to develop essential skills required to become a competent nurse anesthetist.

The faculty is committed to fostering relationships with its candidates that encourage human and professional growth. Its policies and procedures attempt to reflect this commitment to proactive and supportive communication.

Nonetheless, it is imperative that all candidates recognize that the primary responsibility for a successful nurse anesthesia education, both in and outside the classroom, rests with the individual. Candidates, including candidates with disabilities, must have the capacity to manage their lives and anticipate their own needs. The School has incomplete influence in helping students achieve these personal adaptations. Situations can arise in which a candidate’s behavior and attitudes resulting from a disability or other personal circumstances represent a secondary problem which impairs the candidate’s ability to meet the School’s standards, even after implementation of all reasonable accommodations have been made by the School.

The School’s obligation and mission is to provide an academic environment which allows candidates to master the intellectual and technical skills necessary to become competent in the safe conduct of anesthesia. It does this by providing a select group of experienced, graduate level nurses with the highest level of didactic education, simulation lab and clinical site experiences. Our graduates develop life-long scholarship, critical thinking skills and professionalism needed to become compassionate, patient-centered anesthesia providers in solo practice or within anesthesia care teams. Therefore, all applicants, regardless of disability, will be held to the same admission standards, with reasonable accommodations if needed.

Recommendations:

  1. No otherwise, qualified individual will be denied admission to the School of Nurse Anesthesia based solely upon a disabling condition.
  2. Candidates with disabilities applying to the School of Nurse Anesthesia will be expected to have achieved the same requirements as their non-disabled peers.
  3. Matriculation into the School of Nurse Anesthesia assumes certain levels of cognitive, emotional, and technical skills. Nurse anesthetist candidates with disabilities will be held to the same fundamental standards as their non-disabled peers. Reasonable accommodations will be provided to assist the candidates in learning, performing and satisfying the fundamental standards, so long as the candidate provides timely, comprehensive documentation establishing the candidate’s disability status and need for reasonable accommodation.
  4. Reasonable accommodations that facilitate candidate progress will be provided but only to the extent that such accommodation does not significantly interfere with the essential functions of the School of Nurse Anesthesia, fundamentally alter the program, or significantly affect the rights of other candidates.
  5. The School, under the law, is obligated to provide all reasonable accommodations that will eliminate or minimize the barriers disabled candidates may face in the process of successfully completing the requirements for graduation from the University of New England’s School of Nurse Anesthesia.

Abilities and Skills:
A candidate for this program must have abilities and skills of five varieties including observational skills; communication skills; fine and gross motor skills; intellectual skills: conceptual, integrative and quantitative abilities; and behavioral and social/emotional attributes.

I. Observational Skills
The candidate must be able to acquire a defined level of required information as presented through demonstration and experiences in the basic sciences and anesthesia courses including, but not limited to, information conveyed through gross anatomy labs and simulated anesthesia patient exercises. Furthermore, a candidate must be able to observe a patient accurately, at a distance, and close at hand, acquire information from written documents and visualize information as presented in radiographic images and patient monitors. The candidate must have visual and hearing acuity, including use of depth perception and peripheral vision; hearing normal and faint body sounds (blood pressure and heart sounds) and hearing auditory alarms on monitors and anesthesia delivery systems. Such observation and information acquisition necessitates the functional use of visual, auditory and somatic sensation while being enhanced by the functional use of other sensory modalities.

In any case where a candidate’s ability to observe or acquire information through these sensory modalities is compromised, the candidate must demonstrate alternative means and/or abilities to acquire and demonstrate the essential information without reliance upon another person’s interpretation of the information. The university will provide appropriate reasonable accommodations to foster the student’s ability to meet these standards, so long as the student registers with UNE Disability Services.
 
II. Communication Skills
The candidate must be able to effectively and efficiently communicate using verbal, written, and reading skills, in a manner that demonstrates sensitivity to patients, their families and all members of the health care team.  A candidate must be able to accurately elicit information, describe a patient’s change in mood, thought, activity and status. He or she must also demonstrate established communication skills using traditional or alternative reasonable means that do not substantially modify the standard.

III. Fine and Gross Motor Skills
The candidate must be able to, with or without the use of assistive devices, but without reliance on another person, to interpret x-ray and other graphic images and digital or analog representations of physiologic phenomenon (such as EKGs).

The ability to participate in basic diagnostic and therapeutic maneuvers and procedures (e.g. palpation, auscultation) is required. It is also essential for a candidate to possess the gross motor skills sufficient to provide a full range of safe and effective care to patients. These include the ability to move within confined spaces, reach above shoulders, bend, stoop, squat, stretch and to reach below the waist. Fine motor skills are necessary to perform psychomotor skills such as picking up objects, grasping, pinching with fingers (intubations, manipulating a syringe, starting IVs), twisting and squeezing.

Physical stamina sufficient to complete the rigorous course of didactic and clinical study is required. In addition, physical endurance and strength is a requirement in order to tolerate working an entire shift (including overtime or call), standing for long periods of time and sustaining repetitive movements (performing CPR, positive pressure ventilation, etc). Candidates must be able to provide hands-on patient care such as lifting, pushing and pulling excessive weight to position patients, pick up and carry children, ambulate patients and transfer anesthetized patients from stretchers and beds. When transporting patients to patient recovery areas, the candidate is required to move not only the patient's weight but also the heavy bed.
The candidate is required to carry heavy equipment and supplies, sit for long periods of time on stools with and without any back support, twist and turn to visualize monitors and the surgical field and possess the strength and flexibility to assist in the restraint of combative patients. In addition, the candidate must be able to move quickly to respond to emergencies. At all times the ability to administer care to patients in a safe manner is paramount.
 
IV. Intellectual Skills - Conceptual, Integrative and Quantitative Abilities
The candidate must be able to measure, calculate, reason, analyze and synthesize information in a timely fashion. In addition, the candidate must be able to comprehend three-dimensional relationships and to understand the spatial relationships of structure. Problem-solving, the critical skill demanded of nurse anesthetists, requires all of these intellectual abilities. These problem-solving skills must be able to be performed in a precisely limited time demanded by a given clinical setting. In addition, the candidate must be able to adapt readily to changing environments and deal with unexpected activities.

V. Behavioral and Social/Emotional Attributes
Candidates must possess the emotional health required for full utilization of their intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive and effective relationships with patients.
Candidates must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility and to learn to function in the face of uncertainties inherent in the clinical problems of patients. They must be able to measure, calculate, reason, analyze and synthesize information effectively in a precisely limited time demanded by a given clinical setting, while under stress, and in an environment in which other distractions may be present.
Compassion, integrity, concern for others, interpersonal skills, interest and motivation are all personal qualities that will be assessed during the admissions and educational processes.