Policy of MTSA Clinical Standards

Policy Number: 
12/20/16, 5/15/18, 10/20, 9/20/2022
12/20/16, 5/15/18, 10/20, 11/20, 9/21, 4/19/2022, 9/20/2022 pending BOT approval

Advancement of each student to the next higher level of anesthesia training and responsibility is made at semester intervals by the Progressions Committee. In order to be eligible to advance to the next higher level, the student must:
Meet all clinical objectives for the current level for advancement to the next level;
Successfully complete all assigned clinical affiliations;

Keep and maintain a current multi-state Tennessee RN license or Nurse Licensure Compact (NLC) or enhanced Nurse Licensure Compact (eNLC) license on file with MTSA during the entire program. The student must possess a current RN license for any state in which he is assigned for clinical rotations. If a student’s RN license lapses for any reason, the student will immediately be removed from of his clinical rotation. The student may not return to clinical rotations until documentation of a current RN license is presented to MTSA. Any clinical days the student misses during this period must be made up prior to graduation or the student may be extended in the program to compensate for these days. Any lapse in your nursing license that results in the inability to perform clinical duties will result in clinical probation. 

In addition, all students are required to have an annual influenza vaccine. If a medical condition exists that prohibits the student from receiving the vaccine, the student must present documentation from their primary care provider stating why the influenza vaccine is contraindicated.

Clinical grades will be recorded on the transcript under Clinical Performance. They will be recorded as GS (Good Standing) or Prob/C (Probation Clinical) and accompanied by the letter grade earned, as described above, for that semester (see Grading Policy, Clinical Grade).

Clinical Supervision of Nurse Anesthetist Students

Supervision of the MTSA nurse anesthesia students in any clinical facility is restricted to anesthesiologists and CRNAs, who are immediately available in all clinical areas, and in any non- anesthetizing areas where students may be involved in the care of patients. Supervision does not exceed the ratio of two nurse anesthesia students to one anesthesiologist or one CRNA. At no time are resident physicians or graduate registered nurse anesthetists the sole agents responsible for the student. The supervision ratio is determined by the level of the student, complexity of the case, anesthetic, procedure, and experience of the instructor.

Clinical Care Plan Submission

Third Semester: ALL STUDENTS are required to complete care plans on each clinical day. During the third semester, care plans should be submitted to the clinical faculty who will review the Care Plan for accuracy and completeness.

Fourth Semester: Each student is required to complete care plans on each clinical day during the fourth semester. This should be an in-depth, detailed care plan presented to your clinical preceptor. Students may be required to complete additional care plans for cases they are unfamiliar with.   

Written Care Plan submissions may be reviewed by a CRNA and included in the student's semester progress meeting and report.

Fifth Semester - Ninth Semester: Students should have at minimum a verbal care plan prepared for all cases.  Any unfamiliar procedure or anesthetic plan will require a written care plan.  

Clinical Grading

The penalties for delinquent documentation are found under the Disciplinary Actions section.


End of Rotation Evaluations: Summative



Clinical Evaluation Reports: Formative



Comment Cards


Sentinel Events


Yellow Card

Up to 8% deduction each


Red Card / Safety Concern

Up to 16% deduction each




Green Card

Up to 2% addition each


Case Number & Anesthesia Time Thresholds



Student Evaluation of Clinical Sites



Clinical Self-Assessment Tool


End of Rotation Evaluations (Summative)

An End of Rotation Evaluation is completed by the CRNA or Anesthesiologist assigned as Clinical Coordinator at the clinical rotation site or by the Clinical Faculty using feedback obtained from the clinical site.