Education has been demonstrated to be an effective deterrent for substance abuse. The American Nurses Association (ANA) recognized the need for education about addiction and in 1984 suggested that nursing schools add the topic to their curriculum. Since it is estimated that one of 10 certified registered nurse anesthetists (CRNAs) become addicted, this study was initiated to examine the graduate curriculum in nurse anesthesia programs.
A questionnaire was adapted and distributed to 98 program administrators from schools of nurse anesthesia throughout the United States in 1994. Fifty-six of the 98 program administrators responded, constituting a 57% response rate.
Program administrators from 48 programs reported an average of 22 full-time students and 14 full-time faculty. Program administrators reported that the topic of substance abuse was integrated in 82% of the schools and that only an average of 2.94 hours was dedicated to didactic learning and 1.4 hours to clinical substance abuse education. The lecture was the most common method used for teaching substance abuse, and the topic was usually integrated into an ethics or professional aspects course. The optimum method chosen by program administrators for introducing effective substance abuse education was “inviting impaired CRNA/MD speakers.”
Results of the questionnaire indicated that faculty were competent in only nine of the 27 items addressing faculty competence (competence was rated high in the “hard sciences“ such as physiology and pharmacology); faculty had more than a moderate interest in substance abuse education in 20 of the 27 items solicited; items in which faculty were perceived to have low interest were those including affective learning and reasoning; and faculty considered all 22 items relatively important in the last area of the questionnaire. All program administrators perceived that education was an important deterrent to substance abuse for nurse anesthetists.
Substance abuse curricula in schools of nurse anesthesia are fragmented and appear ineffective. Since the curriculum is underdeveloped, it should be expanded to include a progressive didactic and clinical course impacting both the cognitive and affective domains. In addition, the curriculum should also be spread throughout the entire course of graduate study to allow time for the student nurse anesthetist to process changes.