An Overview of the
Anesthesiologist
Assistant: What the
CRNA Should Know
Heather Baglio, RN, BSN, SRNA
Jessica Hammond, RN, BSN, SRNA
Objectives
• Explain the historical development of the Anesthesiologist
Assistant (AA) profession
• Define the scope and standards of practice for AAs
• Discuss specific legalities of the AAs practice
• Discuss the AAs educational background, curricula, program
accreditation, certification and continuing education
• Differentiate the role of the CRNA and AA in the healthcare
setting.
History
Joachim S. Gravenstein
John E. Steinhaus
Perry P. Volpitto
Facts and Figures
WHO ARE THEY??
HOW MANY ARE THERE??
By the Numbers…
In the Workforce
Anesthesiologist and
Residents
CRNA
AA
ACT Model
Anesthesiologist
Resident
Physician
CRNA
AA
Educational Background
Admission Requirements
• Bachelor’s degree
• Science and math pre-requisites
• MCAT/GRE
• Clinical shadowing experience (8 hrs)
• Personal Interview
Program of Study
• Master’s Degree Programs
• 24-28 months
• 56-132 didactic hours
• Clinical hour requirements 2000-2500
hours
• Minimum of 600 cases (avg ~ 800)
• All sub- specialties of anesthesia
CRNA vs. AA
Education
Accreditation and Certification
Governing Entities/Professional
Organizations
Scope
Supervision
Legalities
Prescriptive Authority
Anesthesiologist to AA Ratio
Location of Practice
Supervision and Practice Jurisdiction
CRNA
AA
Patient Safety: What the
Literature Says…
Evidence Supporting
AAs
Evidence Supporting
CRNAs
• University Hospital
Quality Assurance
• Kentucky Legislative
Research
Commission
• Dulisse & Cromwell
(2010)
• Needleman &
Minnick (2009)
• Pine, Holt & Lou
(2003)
• Simonson, Ahern &
Hendryx (2007)
“Opinions have caused more ills
than the plague or earthquakes on
this little globe of ours.”
-Voltaire
The Future
References
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The American Academy of Anesthesiologist Assistants. (2012). Retrieved from http://www.anesthetist.org
American Academy of Anesthesiologist Assistants. (2006, March 31). Statement on the anesthesia care team
model. Retrieved from http://www.anesthetist.org/practicestatements/ACT_Position_Statement.pdf
American Academy of Anesthesiologist Assistants. (n.d.) AAAA statement on clinical doctorate degrees. Retrieved
from http://www.anesthetist.org/practicestatements/Statement_on_Clinical_Doctorate_Degrees.pdf
American Academy of Anesthesiologist Assistants. (2011, February). Comparison of AAs and CRNAs education and
practice. Retrieved from http://www.anesthetist.org/lobby/Comparison_of_AAs_and_CRNAs_Education.pdf
American Association of Nurse Anesthetists (2012). Anesthesia assistant tool kit. Retrieved from
http://www.aana.com
Berry, A.J., Odom, S.H. (2003). Assuring competency of anesthesiologist assistants: Education program
accreditation and graduate certification. ASA Newsletter, 67(3), 9-10. Retrieved from http://www.asahq.org/ForMembers/Publications-and-Research/Periodicals/ASA-Newsletter.aspx?year=2012&ypp=5
Case Western Reserve University. (2010). Anesthesia program: Program overview. Retrieved from
http://casemed.case.edu/anesthesiaprogram/program/
Commission on Accreditation of Allied Health Education Programs. (n.d.) Anesthesiologist assistant. Retrieved
from http://www.caahep.org/Content.aspx?ID=2
Commission on Accreditation of Allied Health Education Programs. (2004). Standards and guidelines for the
accreditation of educational programs in anesthesiologist assistant. Retrieved from
http://www.anesthesiaprogram.com/pdfs/AA_Standards.pdf
Daugherty, L., Fonseca R., Kumar, K.B., Michaud, P. (2010). An analysis of the labor markets for anesthesiology.
Santa Monica, CA: RAND Corporation. Retrieved from http://www.rand.org
Dulisse, B., & Cromwell, J. (2010). No harm found when nurse anesthetists work without supervision by physicians.
Health Affairs, 29(8), 1469-1475.
doi: 10.1377/hlthaff.2008.0966
Emory University. (2013). Master of science program in anesthesiology. Retrieved from
http://med.emory.edu/aa_program/
Georgia Association of Nurse Anesthetists. (2012). Fact sheet about AAs. Retrieved from http://www.gana.org
Gravenstein, J.S., Steinhaus, J.E., & Volpitto, P.P. (1970). Analysis of manpower in anesthesiology. Anesthesiology,
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Gunn, I.P. (2000). Rural health care and the nurse anesthetist. CRNA, 11(2), 77-86. doi:10.1053/CRNA.2000.8004
Institute of Medicine. (2011, June). Relieving pain in America: A blueprint for transforming prevention, care,
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References
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Legislative Research Commission. (2007, February). A study of anesthesiologist assistants (Research Report No.
337). Retrieved from https://www.asahq.org/For-Members/Advocacy/State-Legislative-and-RegulatoryIssues/~/media/For%20Members/Advocacy/State%20Issues/AA%20Study%20Report%20337.ashx
Mackey, D.C. (2003). Anesthesiologist assistants: A new direction for the anesthesia care team begins to accelerate
(finally!). ASA Newsletter, 67(3), 4. Retrieved from http://www.asahq.org/For-Members/Publications-andResearch/Periodicals/ASA-Newsletter.aspx?year=2012&ypp=5
Nagelhout, J. J. & Zaglaniczny, K. L. (Eds.). (2009). Nurse Anesthesia (4th Ed.). Philadelphia: Saunders.
National Commission for Certification of Anesthesiologist Assistant. (n.d.). National Commission for Certification of
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Needleman, J., Minnick, A.F. (2009). Anesthesia provider model, hospital resources, and maternal outcomes.
Health Services Research, 44(2), 464-482. doi:10.1111/j.1475-6773.2008.00919.x
Nova Southeastern University. (n.d.) Anesthesiologist assistant: Program overview. Retrieved from
http://www.nova.edu/chcs/healthsciences/anesthesia/fort_lauderdale/index.html
Pine, M., Holt, K.D., Lou, Y.B. (2003). Surgical mortality and type of anesthesia provider. AANA Journal, 71(2), 109116. Retrieved from
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Simonson, D.C., Ahern, M.M., Hendryx, M.S. (2007). Anesthesia staffing and anesthetic complications during
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