Diverse and Specialized Clinical Sites

Crestwood Medical Center

Crestwood Medical Center, a 180-bed hospital in Huntsville, Alabama, has recently joined the MTSA Fellowship. Partnering with SportsMED, a prominent orthopedic group, Crestwood provides extensive experience in ambulatory surgeries, particularly for orthopedic and ortho-spine cases. The site is coordinated by Rachel Foy, CRNA, and John Martin, CRNA, both of whom are current Fellows. CRNAs at Crestwood perform a wide range of regional blocks, significantly enhancing their practical skills. “Recently, a Fellow performed more than 80 regional blocks in his five days with us,” said Foy. “We are excited to have Fellows here to share our enthusiasm for what we’re doing because it’s truly a game-changer for this area.”

Norton Hospital

Norton Hospital in Louisville, Kentucky, provides Fellows with the opportunity to enhance their skillset with truncal blocks. Coordinators Ben Sampedro, CRNA, and Evan Reagan, CRNA, both graduates of the Fellowship, ensure that Fellows receive tailored experiences to refine their techniques in regional anesthesia.

The anesthesia group’s approach to pain management has evolved significantly over the years, shifting from traditional opioid-based monotherapy to multimodal, opioid-sparing techniques, and in some cases, completely opioid-free methods. Fellows gain invaluable experience with truncal blocks primarily through their association with the Leatherman Spine group. Additionally, they handle a diverse range of cases, including orthopedics, breast surgeries, and surgical oncology, further broadening their clinical expertise.

“Fellows rotating at Norton are typically focused on enhancing their expertise in truncal blocks,” Sampedro explained. “Our goal is to customize the experience for each Fellow, ensuring they become highly proficient in patient assessment, identifying suitable candidates for these blocks, accurately placing the transducer to identify the appropriate target anatomy, and refining their needling techniques.”

“One thing we hear repeatedly is how challenging truncal blocks can be,” Reagan said. “Many CRNAs are accustomed to more superficial blocks in the upper or lower extremities. Our approach involves creating a mental checklist for them to consistently identify this challenging anatomy. It’s incredibly rewarding to hear that Fellows who rotate at Norton can successfully integrate what they’ve learned into their own clinical practice.”

SSM Health Bone & Joint Hospital at St. Anthony

Oklahoma City’s SSM Health Bone & Joint Hospital at St. Anthony was the Fellowship’s inaugural clinical site. The 100-bed orthopedic specialty hospital offers a comprehensive range of services, from sports medicine to various surgical interventions. Patrick Myer, DNAP, CRNA, is the Chief CRNA at the hospital as well as the clinical coordinator. He completed the Fellowship in 2018 as part of the first cohort.

While building confidence in regional techniques is a key element of the Fellowship, Myer emphasized that it goes beyond learning to perform blocks: “The Fellowship teaches you how to comprehensively manage acute surgical pain from the preoperative phase through the extended postoperative recovery period, ensuring effective pain management well beyond the immediate perioperative phase. My goal for Fellows is to demonstrate the full scope of our practice, showing them how to set up and run an acute pain service from the ground up.”

Additional Clinical Sites

MTSA’s Fellowship also includes partnerships with:

• Crystal Clinic Orthopaedic Center, Cleveland, Ohio
• Fairchild Medical Center, Yreka, California
• Horizon Health, Paris, Illinois
• Republic Pain Specialists, Bryan, Texas

About the Fellowship

Led by director Christian R. Falyar, DNAP, CRNA, FAANA, and assistant director Nicolette B. Hooge (above left), DNP, MBA, CRNA, MTSA’s Fellowship comprises a comprehensive 12-month curriculum designed to enhance a CRNA’s regional anesthesia skills and provide the tools necessary to incorporate an acute pain service into their practice. The curriculum combines online education, live synchronous events with expert faculty, on-campus hands-on cadaveric intensives, and clinical rotations, ensuring a well-rounded and in-depth educational experience.

Fellows participate in two intensive week-long clinical rotations, where they become integral members of a pain service team, learning directly from Fellowship-trained clinicians. These rotations are packed with hands-on experiences, from assessing patients for regional anesthesia opportunities and performing complex blocks to managing patients in the PACU and rounding on previous surgical cases. This comprehensive training equips Fellows with the skills to revolutionize pain management practices. Graduates take the knowledge and techniques learned from these rotations back to their home practices, where they often become trailblazers, spreading innovative techniques and significantly enhancing patient care.

“One of the key advantages of the Fellowship is the lasting relationships Fellows build with other CRNAs across the country, who serve as invaluable clinical resources long after completion. This network allows them to consult with fellow CRNAs, ask questions, and continuously enhance their practice,” Hooge said.

Preparation and Enrollment

Candidates interested in the Fellowship are required to have experience performing blocks in practice and a foundational understanding of basic regional blocks. To help prepare candidates, MTSA offers the Regional Anesthesia Foundations Class, a 15-week comprehensive course covering essential regional anesthesia techniques, which are reinforced with a cadaveric workshop at the end of the class. This course ensures that candidates have the necessary background and skills to succeed in the Fellowship.

Jennifer Squibbs, CRNA at Crystal Clinic and recent graduate of the class, praised the Fellowship for its beneficial instruction and significant impact on her practice. “The learning and programming at MTSA leads our industry in excellence and performance,” she said.

The application period for MTSA’s next Acute Surgical Pain Management Fellowship cohort will open in late 2024. For more information, visit www.mtsa.edu/fellowship.