This is the fifth clinical practicum course that continues to challenge students to perform at a competent level as rotations in the anesthesia subspecialties of pediatrics, obstetrics, cardiovascular, and neurosurgery, as well as complex general surgical procedures, continue as per the requirements of the Council on Accreditation of Nurse Anesthesia Educational Programs. Expectations for independent decision-making and refined cognitive and technical skills continue to increase. Student clinical performance will be continually evaluated, and students will be appraised of their progress. Formative evaluations by the clinical preceptor, summative evaluations by CRNA faculty, and self-reflective evaluations by the student will direct and document the maintenance of competent skills in this course. Conferences and journal club are included which will require the student to present case studies and research articles. Students will have another opportunity for hands-on simulated experiences to refine their clinical skills. Prerequisite: DNPA-783