Report from the Field – MoANA meeting

I just finished presenting (on Sunday, 10/23/2011) the NBCRNA CPC program to the Missouri Association of Nurse Anesthetists.  This is my report.  I am sending a copy of the report simultaneously to the NBCRNA, the AANA BOD, and the AANA members’ only listservs.  Much of this report was copied from my previous Illinois meeting report, with the numbers and some editorial comments changed to reflect what occurred in Missouri.

I was invited to speak at the end of the Business meeting by Sally Poepsel, CRNA MoANA President along with Bernadette Henrichs, CRNA, PhD, AANA Region 4 Director.  We were given 45 minutes, after President Poepsel graciously revved up and shortened their business meeting to accommodate discussion of the NBCRNA proposal.  I want to thank the Missouri Association for their generosity in granting us this time.

The Presentation

As soon as the Business meeting agenda was done, Dr. Henrichs and I set up our show.  As I pointed out in my last report, the NBCRNA had given me a very well-done and professional-looking slide presentation to present to the audience, as well as a 22-minute video that pretty much goes over all of the slides in the presentation.  Due to our limited time, I opted to show only about 20 of those slides and did not show the video.  I emphasized the parts of the proposed CPC and also highlighted the evidence supporting the change.

As in did in my Illinois presentation, I began the session by opening up PollEverywhere.com and asking the audience to respond to the following question:

“Do CRNAs need to improve their certification process?”

I explained that I would be asking them the same question again once my presentation was over.

Here is the response, before my presentation, to the question, “Do CRNAs need to improve their certification process?”:

As it was in Illinois, we started out with a clear majority supporting change.

I then began my lecture.  I began by giving an introduction of my own devising, discussing the societal/consumer forces at work – that we were late to the game, that this wasn’t just our colleagues asking for us to change- it was our patients (or at least those who advocate for them) that were demanding it.  I then went on to use the slides and cover the important points- the main elements of the program, how it was researched and benchmarked and discussed in focus groups, etc.

Poll Questions

After I finished my presentation, I asked the group to answer my question again.  Here are the numbers I got in my second attempt, post-lecture:

Response after my presentation to the question, “Do CRNAs need to improve their certification process?”:

The change was quite dramatic.  We went from 57% in favor of improvement to 81%.  Those for the status quo were only 19%.  Also note the number – we still had 84 respondents.

I then followed up with some other questions that I thought would be useful for the NBCRNA as they grapple with this vital issue.

What aspect of the program most concerns you?

Obviously, the part of the program that most troubles CRNAs is the exam.  They are very concerned about it.  During the question and answer period afterwards, a CRNA got up and said that she was convinced that the exam would include very specific questions about cardiovascular or neuro or OB anesthesia, and that she was not and could not be prepared to answer them.

Dr. Henrichs and I and others in the audience tried to reassure her that the proposed re-certification exam would bear little resemblance to the initial certification exam – that the goals of the exam were far different.

Next, I wanted to measure the mood of the audience with respect to the proposed plan.  This question was one of two- the first to garner the support for the plan as presented, the second was asked to see what support would be there if the plan were modified.  I told the audience in the second question to vote as if the plan had been modified “the way you want it”.  Here is the response to the first question:

Do you support the NBCRNA program as presented?

I then asked this as a follow-up:

Do you support the NBCRNA program if modified?

93% would support the plan if modified.

Questions and Comments from the Audience

As opposed to my previous experience in Illinois, the audience seemed far more accepting of the proposal, as there was not nearly the number of people getting up to the microphone to ask questions. However, in addition to the concerns brought up about the content of the exam, there was one member who got up to express his concern about grandfathering – he offered that perhaps the way to do that would be to allow those certified before the grandfathering date to take the test as a “self-assessment”.

Other questions and comments reflected the general tone of concern, and all were encouraged to register their comments with the NBCRNA before the November 14^th deadline.

Summary

In summary, I want to again thank the NBCRNA for their boldness in allowing me to present.  They did so even after I specifically told them that I would not sign any confidentiality agreement, and that I would present the information exactly as I saw fit.  I also stated that I would share my report with them simultaneously with all of you.  They trusted me, and I hope they do not feel I betrayed their trust.

I take full responsibility for my conduct of the session and for this report, and I hope it helps further the cause of improving our certification process.  I believe, as the great majority of the CRNAs present at this meeting believed, that we have to move forward, and that the NBCRNA needs to listen closely to the comments presented to them and then modify the program based on those comments- but that in the end they must come forward with a new certification process.

—

Dan Simonson, CRNA, MHPA