What keeps some program directors in their, positions so long? An examination of job longevity among anesthesia program directors

The turnover rate of nurse anesthesia faculty has been monitored by the Council on Accreditation of Nurse Anesthesia Educational Programs for a number of years. In 2005, the turnover rate remained high, at 22%, indicating a problem with faculty retention. This article reports the results of a study in which 25 long-time nurse anesthesia program directors were interviewed to gain insights into faculty retention. The interviews revealed reasons for becoming an anesthesia educator, positive and negative aspects of the job, changes over time, and reasons for longevity in their positions.     

TheNational Commission on Nurse Anesthesia Education 10 years later--Part 1: The commission years (1989-1994)

The significant decrease in the number of anesthesia providers during the late 1980s prompted American Association of Nurse Anesthetists (AANA) leaders to establish the National Commission on Nurse Anesthesia Education (NCNAE). The NCNAE was charged with scrutinizing all aspects of nurse anesthesia educational programs and developing strategies to reverse the critical shortage of nurse anesthetists. The tactics outlined by the commissioners were implemented, and they resulted in an increase of annual nurse anesthesia program graduates. Although there has been continued realization of NCNAE strategies, 10 years later the critical shortage of CRNAs has resurfaced. This 2-part article describes the commission years, the years that followed, and the current status of Certified Registered Nurse Anesthetist (CRNA) manpower.     

Faculty positions as a career choice for professionals--Part I

This article is the first part of a two-part series designed to give the readers an overview of the study, "Faculty Positions as a Career Choice for Professionals." This nationwide study, requested by the AANA Education Committee, investigated the questions, "Why do professionals enter faculty positions?" and "Why do CRNAs with graduate degrees choose to become or choose not to become educators?" An attempt was made to answer these questions by studying demographic, life cycle and certain intrinsic and extrinsic factors of graduate-prepared CRNAs, nursing education faculty, higher education faculty (other than nursing and nurse anesthesia), and nursing service personnel. The authors reviewed the methodology and the results as they applied to the demographic data. The results showed that CRNA faculty were older than practicing CRNAs. Twenty-five percent of the CRNAs had degrees in nurse anesthesia, 16% in education, 13% in nursing, 6% in biology, and 40% in a variety of other disciplines. Sixty-five percent had undergraduate degrees in nursing and 7% in nurse anesthesia. CRNA faculty salaries and practicing CRNA salaries were comparable. The information was presented by the authors at the Assembly of School Faculty Meeting, February 21-24, 1991 in Tampa, Florida. It is hoped that this study will assist nurse anesthesia programs, universities and colleges in their recruitment activities for faculty.     

Perceptions of CRNAs: current and future roles--Part II

The purpose of this study was twofold. First, to identify current roles and future role perceptions for Certified Registered Nurse Anesthetists (CRNAs) using the delphi methodology. Second, to analyze the level of agreement or disagreement of anesthesiologists and CRNAs with the identified roles. A survey instrument was developed using the delphi methodology which involved five CRNAs and five anesthesiologists. The instruments with a dimensional rating scale were labeled "Current Roles for CRNAs" and "Future Role Perceptions for CRNAs." The former instrument contained 26 items and the latter contained 28 items. Participants in this study were randomly selected from the active memberships of the American Association of Nurse Anesthetists and the American Society of Anesthesiologists. Usable responses were obtained from 369 of the 684 CRNAs and 354 of the 1,400 anesthesiologists. Analysis of the data revealed there were significant differences between the two professions on all roles. There was evidence of extreme polarity on roles relating to expanded practice, independent practice, the role of CRNAs on the anesthesia care team, and nontraditional practice settings. CRNAs differed from anesthesiologists in their role as nurse anesthesia educators. Anesthesiologists who worked with CRNAs were influenced in their support of CRNA roles, except for roles in independent and expanded practice, and responded differently from anesthesiologists who did not work with CRNAs. The conclusions were as follows: 1. CRNAs and anesthesiologists differ in support for expanded practice in both current and future perceptions. 2. CRNAs and anesthesiologists differ on the issue of independent practice. 3. The perception of anesthesiologists relative to the anesthesia care team appeared to be influenced by a working relationship with CRNAs.(ABSTRACT TRUNCATED AT 250 WORDS)     

Compensation for teaching in critical care

OBJECTIVES: To determine the financial or nonclinical time critical care program directors or teaching faculty members receive as compensation for their educational activities. To compare compensation types and amounts among critical care specialties and between university vs. nonuniversity sponsoring institutions. DATA SOURCES AND EXTRACTION: Survey returns (46%) from critical care fellowship directors listed in the American Medical Association Graduate Medical Education Directory. Information was stratified according to fellowship specialty and type of sponsoring hospital and compared by chi-square analysis and the Kruskal-Wallis test. CONCLUSIONS: Most program directors (77%) and faculty (82%) receive no specified compensation for education-related activities. Multidisciplinary programs are more likely to compensate faculty members than other specialty-specific programs (p = .006). Most programs sponsored by university or military/federal hospitals do not provide specified compensation (79% and 100%, respectively). Overall, community hospital-based programs provide a greater percentage of compensation to directors and faculty than university programs (for directors, p = .02; odds ratio, 3.85; for faculty, p = .001; odds ratio, 8.4). When compensation is specified, it is most often financial and it averages 18% of the salary (range, 5% to 100%) for directors and 19% of the salary for faculty (range, 5% to 50%). When reduced clinical time is provided (5% of program directors, 2% of faculty), it averages 13% (range, 8% to 18%) for directors and 18% (range, 10% to 25%) for faculty. Alternative methods for assigning educational compensation are discussed.     

Studies support removing CRNA supervision rule to maximize anesthesia workforce and ensure patient access to care

Recent research reaffirms that Certified Registered Nurse Anesthetists (CRNAs) are critical to the delivery of anesthesia in the United States and argues persuasively for the removal of barriers-including supervision requirements--that prevent CRNAs and other advanced practice registered nurses (APRNs) from practicing to the full extent of their education and training. As we as a nation strive to make healthcare accessible, ever safer, and affordable, the health system must use anesthesia professionals as efficiently as possible. Repealing the federal Medicare physician supervision requirement for nurse anesthetists is an important step toward achieving this goal.     

A comparison of nurse anesthesia practice types.

The present study examined the differences between anesthesia care team (ACT) and non-ACT practice types. Six practice variables were analyzed. We prepared and distributed a 13-item questionnaire to 1,000 practicing Certified Registered Nurse Anesthetists (CRNAs) with a 44.4% response rate. Data analysis revealed that nurse anesthetists in ACT practices had fewer years of experience and were younger than non-ACT nurse anesthetists (alpha = 0.05). Also, a significantly greater percentage of ACT nurse anesthetists were female, held master-level degrees, and practiced in urban and metropolitan locations. This also was true for placement of laryngeal mask airways and arterial lines, and in providing anesthesia for cardiopulmonary bypass, pediatric, intracranial, and trauma cases. However, a significantly greater percentage of non-ACT nurse anesthetists placed epidurals and central lines and were involved in pain management and critical care consultations. Income was significantly greater for non-ACT nurse anesthetists as well, but they worked more hours per week on average. Lastly, evaluation of employment arrangements showed that more than 91% (n = 361) of ACT nurse anesthetists were employees, and only 4% (n = 17) were self-employed. However, only 49% (n = 24) of non-ACT nurse anesthetists were employees, and almost 43% (n = 21) were self-employed. The present study demonstrates that significant differences exist between the 2 nurse anesthesia practice types examined. As nurse anesthesia practice arrangements continue to change and fewer CRNAs are hospital employed, each nurse anesthetist must be aware of current practice trends and understand the alternatives.     

Blended roles: preparing the advanced practice nurse educator/clinician with a web-based nurse educator certificate program

Changing demographics, a nursing shortage, and various societal changes underscore the need for nurse educators and new nurse educator programs. This article describes a Web-based nurse educator program designed to prepare advanced practice nurses for faculty roles while simultaneously preparing them as clinicians. Guided by adult education theory and self-directed learning theory, the Web-based Nurse Educator Certificate (four Web-based nurse educator courses including a teaching practicum) has been developed and offered to clinical master's and postmaster's students. This article also describes student work with mentors, interactive Web-based teaching strategies, portfolios, graduate competencies, and initial evaluative data. In the first two years of the program, 48 students have taken at least one course in the Nurse Educator Certificate program and eight students have completed it. A Web-based nurse educator certificate program, as part of a clinical master's or postmaster's program, has the potential to help meet the faculty shortage.     

Faculty discernment of student registered nurse anesthetist's personality characteristics that contribute to safe and unsafe nurse anesthesia practice: metrics of excellence

A review of the literature revealed that nurse anesthesia educational program (NAEP) faculty members perceive certain personality characteristics and clinical awareness as the most important traits needed for clinical success in an NAEP. Clinical success in an NAEP is equated with safe nurse anesthesia practice. The purpose of this study is for NAEP academic faculty and expert Certified Registered Nurse Anesthetist (CRNA) clinical faculty to discern which of the 63 intrapersonal and 15 interpersonal characteristics that student registered nurse anesthetists (SRNAs) exhibit contribute to safe or unsafe nurse anesthesia practice. A pilot study of expert CRNA clinical faculty (n = 10) was undertaken, followed by a prospective randomized survey of NAEP academic faculty (n = 25). The results were analyzed and determined that 17 intrapersonal and 4 interpersonal characteristics are beneficial for safe nurse anesthesia practice, whereas 20 intrapersonal and 3 interpersonal characteristics portend unsafe nurse anesthesia practice. This information can be used to predict clinical performance, develop more stringent NAEP admission processes in the form of a checklist or test, provide an outline for clinical evaluation, help create a tool to educate novice CRNA clinical faculty, and furnish a strategy for the remediation of unsuccessful of SRNAs.     

Report of the National Commission on Nurse Anesthesia Education. Current and future perspectives regarding the framework for nurse anesthesia education: nurse anesthesia curriculum in the College of Pharmacy and Allied Health Professions, Wayne State University.

The nurse anesthesia educational program at Wayne State University, Detroit, is one of four allied health programs that offers a master's degree from the College of Pharmacy and Allied Health Professions. The program itself is housed in a teaching hospital, where CRNAs control and deliver the coursework. Advantages and limitations of this arrangement are analyzed and discussed.     

Correlates of university nurse faculty publication productivity

The purpose of this study was to identify factors which may be important in the publication productivity of university nurse faculty. Two central research questions were addressed: 1) What relationship exists between selected professional, educational, and career variables and the publication productivity of university nurse faculty members? 2) What is the typical publication productivity profile of university nurse faculty? The population consisted of 422 full-time tenure tract nurse faculty teaching in seven nursing schools that offered baccalaureate, master's and doctoral programs and were located in public Research Universities I. All data were obtained through the use of a questionnaire. Completed questionnaires were received from 80 percent of the respondents. Faculty not meeting the criteria for the study and all instructors were eliminated from analysis. Data were ultimately analyzed for 261 subjects. Thirty-two variables were found to have a significant relationship to faculty publication productivity. Eleven of these variables (highest degree, years since first master's, age, rank, teaching responsibilities, time spent teaching, time spent in research, hours of clinical instruction, teaching and research preferences, journals received, beliefs about the desirable relationship between publication and promotion and tenure) and five motivational variables were included in a regression analysis. These 16 variables grouped into three clusters, accounted for .4845 percent of the total variation in university nurse faculty publication productivity. Current job socialization factors and motivational factors accounted for a significant amount of variation in faculty publication productivity even when highest degree, years since first master's, age, and rank were controlled.     

A model for utilization of academic resources: the Philadelphia area nurse anesthesia educational programs' shared curriculum consortium

Educational consortiums possess significant academic and financial benefits. A faculty shortage has had an impact on subspecialty educational programs including nurse anesthesia. This column describes a collaborative "consortium" model of 3 individual nurse anesthesia educational programs located in the Philadelphia, Pennsylvania, area. The Philadelphia Area Nurse Anesthesia Educational Programs' Shared Curriculum Consortium provides high quality, didactic education; decreased overall program administrative costs; and offers each participating program the ability to explore opportunities for continued growth.     

Faculty practice: how it enhances teaching.

This article is a presentation of the two authors' views on faculty practice and how both have operationalized the practice option. Both describe how the practice option has positively affected their teaching and their students' learning in a university baccalaureate nursing program located in the midwestern United States. The authors are full-time, master's prepared faculty members who have been in the faculty practice track for 2 years. Both teach in the junior year of a 4-year baccalaureate program. The first author (D.M.G.) is a staff nurse who works in a community hospital and serves on the hospital's clinical nursing research committee. The second author (C.R.S.) is a clinical research nurse coordinator who performs and manages pharmaceutical trials at multiple inpatient and outpatient locations. In this article, the authors examine faculty practice in general and the various models currently used. In addition, they explain their individual academic positions, the duties and responsibilities accompanying each of their practice roles, and the integration of those practice experiences into their clinical and classroom learning.     

The Flipped Classroom in Nursing: The Nurse Educators' Experience

BackgroundNurse educators are being called to transform the classroom through engaging teaching methodologies, such as the flipped classroom. However, a gap in the scientific knowledge exists explaining the experience of faculty using the flipped classroom model and its efficacy.MethodA qualitative study was conducted with associate degree faculty to answer what is the experience of nurse faculty who have incorporated the flipped classroom into their courses?ResultsAnalysis of the data identified five generalized categories.ConclusionThe study provided new insight into faculty transformation.     

Learning from a nurse anesthetist perspective: a qualitative study.

This study explored the learning and problem-solving experiences of Certified Registered Nurse Anesthetists (CRNAs) using a qualitative case study design. Through interviewing and observation techniques, 5 expert CRNAs provided information on learning and problem solving in daily clinical practice. Data were analyzed using the Tesch 8-step model. Three themes emerged from the data. In their learning, expert CRNAs first desire to know the pharmacological, physiological, or pathophysiological ("basic") principles needed to understand clinical situations. Once they are comfortable with their grasp of the basic principles, CRNAs will then "try out" the new agent or technique in their clinical practice. As experiences accumulate, CRNAs create complex practice structures and demonstrate increased levels of confidence, comfort, and expertise in practice. In understanding how expert nurse anesthetists learn and develop, perhaps educators and students will be more able to identify and design learning activities that prepare students for competent and successful anesthesia practice.     

The National Commission on Nurse Anesthesia Education 10 years later--Part 2: Years following the commission (1994 to present)

In 1989, the National Commission on Nurse Anesthesia Education was implemented to reverse a severe shortage of CRNAs. The Commission, charged with scrutinizing all aspects of nurse anesthesia educational programs, developed 8 goals with corresponding strategies that were used by the Commission Implementation Task Force to actualize its charge. These goals and strategies contributed to an increase of annual graduates from nurse anesthesia programs and the development of 10 new programs. These activities were documented in Part 1 of this article, which appeared in the October 2001 AANA Journal. Following completion of the 3-year project, the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) and the AANA Education Committee began carrying out the final recommendations made by the Commission. Part 2 addresses the accomplishments of the Education Committee and COA in implementing the recommendations of the Commission, discusses current status of educational programs and CRNA manpower, and identifies roles for both educators and practitioners in protecting the future of the profession.     

Optimizing the student learning environment: A framework to select faculty for teaching courses

Nurse educators must provide high quality student education and demonstrate foundational competencies to fulfill the academic role. Reports on nursing and health care underscore the importance of nurse educators' clinical expertise and educational preparation in teaching; yet, a framework to framework faculty selection and preparation to teach courses does not exist. The purpose of this article is to describe an innovative Faculty-Course Selection Framework (FCSF) for nursing education and discuss two practical examples of application in one school of nursing. The FCSF describes student, organizational, and faculty elements for consideration in determining faculty-course assignment. The fundamental units of the framework include workload needs, credentials, skills, content interest, individual attributes, and commitment. The FCSF equips nursing program administrators and directors to cultivate a highly functioning faculty team that can achieve pedagogical, subject, social, and organizational competence to practice the nurse educator role skillfully and artistically and optimize the student learning environment.