The Juggling Act: SEE, Capstone, and the NCE, as per Dr. Charnelle Lewis, DNP, CRNA, Graduate, University of Buffalo Nurse Anesthesia Program

CRNA school requires a significant amount of self-determination and motivation.   There are many layers to school that include didactic work, clinical rotations, exams and a capstone project.

This 4-layer cake, as delicious as it sounds, is best eaten with small bites of each layer together.  It can be tempting to tackle it all at once, or even save a couple layers for the end. Savoring each bite, scheduling out time for each layer on a daily basis from the beginning, provides you with a satisfying dessert course throughout your doctorate program.

The SEE or self-evaluation exam is a voluntary examination that many schools require.  It is a 240-question exam that covers basic sciences, anesthesia equipment, general principles of anesthesia practice and anesthesia for surgical procedures and special populations.   

The NCE (national certification examination) is the real deal – the final board exam you must take (and pass) to become a CRNA.  The examination topics mirror that of the SEE, with a larger focus on general principles and anesthesia for surgical procedures and special populations.

From the beginning of my program, I began to take little chunks of that 4-layer CRNA cake.  Beginning with the basics, daily review of the materials helped me to stay on top of the didactic work, while simultaneously providing me with a framework for my upcoming clinical rotations and practice for my board exams.  

At the same time, I was constantly researching topics that piqued my interest that I would further explore as a potential DNP capstone project.  Each day I took a different focus.  Mondays were class and capstone project days, with Tuesday through Friday being clinical and prep days, and the weekends I did longer study sessions.

This “CRNA cake” can be broken down into these 4 layers: concentrate, rehearse, nurture and attestation.

C – concentrate.

I had to concentrate on what I needed to do that day, while still having a plan for the week, month and year.   At times it was easy to get ahead of myself, but make sure you sit down at the beginning of the program and plan what you’re going to tackle and when.

R – rehearse.

Rehearsing the information is key.  I’m not talking about rote, last-minute cramming memorization, but rehearsing or reviewing the information on a daily basis will allow you to store that memory long term.  Rehearsing also happens in clinical, when you’ll be verbally challenged with the information that you’ve learned in class.

N – nurture.

The nurturing comes when you take that information and encourage the growth of it.  I made it a point to go beyond knowing facts, but understanding the “why” behind what I was learning.  This “deeper” learning goes a long way to being able to not just know the information, but have the ability to apply it on a higher level.

A – attestation.

Attestation comes when you’re sitting for that exam and realize that because of your preparation, it feels “easy” to you.  Because you started early, utilized your time wisely and consistently built that knowledge through concentration, rehearsing and nurturing, you’re fully ready to attest with confidence that you can safely administer and manage a diversity of anesthesia cases.

Yes, you can have your cake, and eat it too.