74 J . R . Neal et al .: J Extra Corpor Technol 2024 , 56 , 71 – 76
Table 1 . Student level table .
Level 1 Student
Entry Level for all students – They are in the first week up to around week 3 – 5 . – Learning setup and priming ( need assistance from preceptor on this task perhaps ). – Still needing to complete observations of some surgeons and could do this as secondary cases ( might need to forgo clean up on the first case to accomplish this ).
– EPIC interaction is limited to simple tasks of basic buttons and documentation of items with help from preceptor ( EPIC should be the last item to have a student at this level focus on ).
– Assigned to normally straightforward CABGs , valve , cases over this level should be considered observational , or a case that will need a large amount of preceptor interaction . – Assistance from the preceptor in setup and tear down in the OR is needed . – If here for pediatric cases they can start those after week 2 .
Level 2 Students – This would be in the range of a week 4 / 6 to week 8 / 10 student . – Completed observations with all surgeons . – Full ability to setup and prime effectively ( may have a 630 start time instead of 600 start time at this point on Monday 700 start time ). – If here for pediatric cases then should be getting into the halfway point of pediatric cases needed . – EPIC interactions can increase to charting most of the timers , notifications , cardioplegia , and drug administration on CPB and I / O area after CPB .
– Assigned to straightforward and move difficult cases including LVAD insertions , redo cases with multiple procedures needed ( this may include hemi arch cases with a fair amount of assistance from the preceptor ).
– Some assistance with regard to OR setup and teardown .
Level 3 Students – This would be in the range of students over week 7 – 11 ( depending on pervious number of rotations ). – Full ability to setup with a 630 start time 700 on Mondays . – Finishing pediatric cases / observations . – Normally assigned two weeks of ICU time with ECMO and VAD patients . – Given a choice week to pick cases and work with the perfusionist assigned to that case ( if certain cases or preceptors are desired then discuss with the Program Director and charge perfusionist ). – Minimal or no assistance with regard to OR setup . – EPIC use during the case can be done with limited assistance from the preceptor ( perhaps some help with medication documentation )
( making sure that prime , checklists , staff , and billing are always the preceptor ’ s responsibility ).
– Cases may include most all cases and may include the most complex cases ( i . e ., total arch cases , TAA cases , and may include high-risk patients ( depending on the students ’ previous amount of experience ). Early rotation students might not make it to this level of case ability , but students close to graduation at Level 3 should be able to do complex cases with limited assistance from the preceptor .
our own content , thus saving resources while aligning with our institution ’ s medical center ’ s school . New preceptors at our institution also complete all previous years ’ training . We currently have five modules which include general handbook policy , self-reflection , making learning stick , learning preferences , and others . Previous studies in perfusion and allied health preceptor training have similar approaches with one study having 50 h of training and another study with five modules to complete [ 17 , 18 ]. An additional study showed the importance of giving nursing faculty the background and helpful implementation techniques of student-centered learning [ 19 ]. Another study had students give feedback on preceptors , which is something that we have not done at our institution [ 20 ]. Students do have an exit interview that is completed with the student and perfusion clinical program director .
Discussion
With student self-evaluation , preceptors get to see how students rate their skills and can coach those who too selfcritical . Preceptors can also guide those who are overconfident before graduating and becoming a practicing perfusionist . At our center , it is common for students during the first rotation to grade themselves lower than the preceptor does . Some students take a little time to acclimate to grading themselves . As students get closer to final rotations the areas of improvement become more detailed and focus on promoting the essence of a competent perfusionist .
Our goal of making improvements to the parameters and techniques that we use and offer to the students is to ultimately get them into a position where they will become lifelong reflective , evidence-based practicing clinicians . During the process of mastering the abilities to become a competent perfusionist , many experienced perfusionists used some of these techniques without fully understanding their names and the evidence behind them . By having a more formal process , it becomes a more easily reproducible and transferable process to help future perfusionists maximize their abilities to improve themselves and care for their patients .
While we do not have any publishable data showing this improvement since starting these student-centered practices , anecdotally the performance of students has improved over the course of their rotations more than what we have seen