AANA Code1046984
Credits3.0 CE
PageSubscriber instructions
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Subscriber Instructions

Physiological Awareness in Clinical Practice · 3.0 MAC Ed CE Credits

Please read these instructions before starting the activity. They describe how the activity works, what is required to earn credit, and the disclosures for this program.

How this activity works

This is a self-paced online continuing education activity hosted at pausality.health/ce. You will need a current web browser and an internet connection sufficient for streaming audio. The guided breathing practice sessions are completed in the Pausality companion app on an iPhone (iOS 18 or later); an audio-only mode is available without biometric hardware.

The activity is delivered in three tiers completed in sequence — Foundation, Awareness, then Mastery. Within each tier you complete a didactic reading, then that tier's seven guided breathing practice sessions (each completed three times), and then the tier's check-in. After all three tiers you complete a cumulative Final Knowledge Check and the learner assessment and program evaluation. The components, in order:

  1. Learning activity — the three tier didactic readings and the guided breathing practice sessions:
    • Foundation reading: "The Mechanics of Slow Breathing: Diaphragm, Baroreflex, and Vagal Tone," followed by the seven Foundation breathing sessions, each completed three times.
    • Awareness reading: "Interoception as a Trainable Variable: Reading the Body and the Data Together," followed by the seven Awareness breathing sessions, each completed three times.
    • Mastery reading: "State Transitions, Co-Regulation, and Building a Personal Protocol," followed by the seven Mastery breathing sessions, each completed three times.
  2. Knowledge checks — a tier check-in at the end of the Foundation, Awareness, and Mastery tiers, followed by a cumulative Final Knowledge Check drawn from all three tiers.
  3. Learner assessment and program evaluation.

A tier's check-in remains locked until that tier's reading is complete and its seven practice sessions have each been completed three times. The Final Knowledge Check remains locked until all three tier check-ins are passed.

To receive credit

To receive credit, participants must (1) review the target audience, learning objectives, and disclosure statements below, (2) complete the educational activity online, and (3) pass the Final Knowledge Check and complete the learner assessment and program evaluation.

It is estimated that this activity takes approximately 3 hours to complete. To receive 3.0 MAC Ed CE Credits, the learner must achieve a minimum score of 80% on the Final Knowledge Check. Up to 3 attempts are permitted; the question set varies on each attempt.

The certificate of completion is available for download once all requirements have been met. It is stored in your account and can be re-downloaded on demand at any time.

Target audience

Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs).

Disclosures

Somnistics Research Labs, Inc. is the continuing education provider for this activity and develops the Pausality application used for the practice component of the course. Content was reviewed to be free of commercial bias.

Program description

The purpose of this activity is to educate CRNAs and SRNAs on interoceptive self-awareness and evidence-graded breathing techniques that can be applied during the brief clinical transitions ("Gap Moments") of anesthesia practice, and on interpreting biometric feedback to evaluate physiological response to a practiced protocol.

Learning objectives

At the conclusion of this activity, participants will be able to:

Foundation tier

  1. Describe the role of diaphragmatic engagement in vagal pathway activity, including the mechanism by which paced diaphragmatic breathing stimulates vagal afferents.
  2. Identify the autonomic effects of paced breathing patterns at 5–6 breaths per minute, including the baroreflex resonance pattern documented in the breathing-research literature.
  3. Apply at least three Foundation breathing techniques (diaphragmatic, box breathing, resonant breathing, pursed-lip exhalation, equal breathing) to specific clinical Gap Moments in the learner’s own practice.

Awareness tier

  1. Describe interoceptive awareness as the trainable variable underlying breath-based practices, including the relationship between sustained attention to interoceptive signals and the same attentional networks recruited for clinical vigilance.
  2. Apply extended-exhalation patterns (1:2 ratio) and breath-counting practices to specific clinical contexts, citing the parasympathetic-engagement evidence base for the extended exhale.
  3. Evaluate the role of attention and movement integration in sustained breath practice, including breath walking as a Gap Moment application between back-to-back cases.

Mastery tier

  1. Apply advanced breath patterns to specific high-pressure clinical contexts (emergency, fatigue, transition), including the safety contraindications associated with breath-hold practices.
  2. Demonstrate state-transition sequences across multiple breath patterns, including the multi-phase protocol that closes the curriculum.
  3. Construct a personal breathing practice plan with specific Gap Moment applications across the learner’s own clinical shift structure.
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