Published February 13, 2025
The University of Pittsburgh Schools of Nursing and Medicine have combined the efforts of their students and faculty to train anesthesia professionals in front of neck access (FONA) surgical airway management.
In 2022, Anna Breedlove (CRNA) and Emily Baldwin (CRNA) were University of Pittsburgh Doctor of Nursing Practice (DNP) students who focused on the rare but critical event where a patient’s airway is lost, and a surgical airway must be urgently performed. These students (now graduates from Pitt) worked with Pitt School of Medicine and Nursing faculty to facilitate workshops in which they would train practicing professionals to perform a front of neck scalpel incision technique, a skill that is crucial to both anesthesiologists and certified registered nurse anesthetists (CNRAs) when they encounter this situation in the field.
Charles Lin (MD, MSc), assistant professor in the School of Medicine, and John O’Donnell (DRPH, CRNA, CHSE, FSSH, FAANA, FAAN), professor and chair of the Department of Nurse Anesthesia and director of the Nurse Anesthesia Program at Pitt Nursing, identified a gap in surgical airway management training for anesthesia staff. Nursing faculty member Joseph Goode (PhD, CRNA) was then recruited to join the project given his expertise in airway management.
Surgical airway management is an important subject for all anesthesia airway providers to understand. Lin noted its importance for emergency medicine and said that while anesthesia providers receive training in this area, that training typically ends upon graduation.
The need for post-graduate education has led to the creation of a series of educational workshops involving Pitt DNP students who created PowerPoint presentations and other course materials to pilot the scalpel neck incision technique. The original workshop was held in 2022 and was funded by the UPMC Passavant Foundation as well as from a grant from the Society for Simulation in Healthcare (SSH).
A testing cohort of twenty anesthesia student providers were trained and evaluated in order to validate the course content and process. A new cohort of DNP students were recruited to follow Breedlove and Baldwin (Jessica Guan, Larry Sears, Ryan Caufield, Morgan Darling, Lauren Motolik, and David Gornall) with the plan to increase workshop efficiency, rigorously test educational methods, and offer the workshops, which were targeted to train teaching faculty, and eventually, practicing anesthesia staff at UPMC Passavant
Lin and O’Donnell later received funding from the UPMC Beckwith Foundation. The goal was to scale these workshops from UPMC Passavant to all UPMC hospitals. This year, a “train the trainer” workshop has been scheduled for spring at UPMC Passavant to expand the training across seven adult UPMC hospitals this summer. In the fall, the students will collect data on the effectiveness of the workshops with the aim of completing the work in 2026.
The three faculty leaders on this project have now worked closely with each other for the past three years recognizing that the need for close collaboration in developing and delivering these educational offerings required a team effort. They are especially proud that this project can serve as an exemplar for other projects in recognition that the field of anesthesia is unique and requires nurses and physicians working closely together to maximize outcomes.
“It’s a skill that both the nurse anesthetists and physicians need to know,” Lin said.
O’Donnell noted that Lin, who also holds a secondary appointment at the School of Nursing, “has a unique combination of clinical expertise and educational research interest that has fueled and supported the project.”
The interprofessional collaboration between Pitt students, faculty, and UPMC clinicians is helping to train staff at multiple hospital sites this year. Lin hopes the workshops can serve as a case model to help educators in other fields