Objectives of Presentation

2. Objectives of Presentation • Review mission and function of NBCRNA. • Differentiate between NBCRNA and AANA. • Describe composition of NBCRNA. • Discuss the NBCRNA Certification Program. • Review the NBCRNA Recertification Program. • Discuss future of recertification.

4. Importance of Credentialing • Function to protect and benefit the public • Provide assurance to public that individuals have met predetermined qualifications for providing nurse anesthesia services

5. Evolution of Credentialing 1967 • AANA began to study the relationships of continuing education, recertification, and professional competence. 1969 • The AANA EC implemented a voluntary continuing education program for nurse anesthetists. March 11 2010 Program Administrator Orientation

6. Evolution of Credentialing of Nurse Anesthetists • 1945: Qualifying Examination • 1976: Council on Certification (CCNA) • 1978: Mandatory CE Program • 1978: Council on Recertification (COR) • 1996: Computerized Adaptive Testing begun • 2007: NBCRNA • Merging of COR and CCNA

7. Council Certification of Nurse Anesthetists (CCNA) • Formulate and adopt requirements for eligibility for admission to the NCE and for the certification of nurse anesthetists • Formulate , adopt and administer the NCE to registered nurse anesthetists who have met requirements for exam • Evaluate performance of exam • Grant initial certification to those who pass NCE

8. Council on Recertification (COR) • Recertify qualified CRNAs every two years • Formulate and adopt criteria for eligibility for recertification • Formulate and adopt criteria for approval of CE programs and offerings  • Develop and maintain a mechanism for the investigation of allegations • Make recommendations to interested individuals based on stated purposes

9. NBCRNA Structure

10. Relationship • Professional and business relationship • Services and Recognition Agreements • Share Resources (HR, Finance, IS) • Key elements: • Autonomy • Credentialing of nurse anesthetists • Meetings of Leadership

11. Why do some members think NBCRNA and AANA are the same? • NBCRNA is a customer of AANA • NBCRNA rents office space in the AANA building • CEs are required for recertification by NBCRNA • CEs are sent to AANA 222 South Prospect Ave Park Ridge, IL

12. NBCRNA Composition • CRNA Practitioners • CRNA Educators • Public Member • Board Certified Anesthesiologist • Board Certified Surgeon

13. Current NBCRNA Leadership • President • Jackie Fortenberry CRNA, BA • Vice President • Mary Anne Krogh CRNA, MS • Secretary Treasurer • Michael Rieker CRNA, DNP • Staff • Karen Plaus, PhD, CRNA, FAAN Executive Director • Tim Muckle PhD, Director of Testing

14. Basic Certification Requirements • Comply with all state requirements for RN licensure • Complete a nurse anesthesia educational program accredited by the Council on Accreditation (COA)

15. Requirements for National Certification Examination • Complete and accurate examination application form • Official notarized transcript of the student record • Copy of a current valid RN license • Authentication of Applicant Identity Form • Signed • Notarized • Passport or digitalized photo taken within 6 mo • Certified check or money order

16. National Certification Examination • Variable length, CAT • Year round • Minimum of 100 questions/max 170 • 70 content questions • 30 pre test questions • 3 hour time limit

17. Alternative Item Types Multiple Correct Response Short answer / calculation question Graphics MCR Question Drag and Drop Hotspot Graphics/Video

18. Multiple Correct Response Multiple Correct Response

19. Calculation/fill-in Calculated numeric

20. Matching/ordering Matching/Ordering

21. Hot spot Hot Spot Questions • In the figure below, click on the area of the arm where peripheral nerve stimulator electrodes should be placed to demonstrate thumb twitch via the adductor pollicis muscle. X

22. Video enhanced

23. NCE Results • Candidates notified of preliminary pass/fail upon completion of exam beginning in 2009 • Formal notification sent via mail once score verified

24. Pass/Fail Notification

25. PASS RATE OVER TIME

26. What if NCE Exam is Failed? • Retest up to 4 times in a calendar year • Full application fee required for each retake • 2 calendar years to pass the NCE following graduation • Failure to pass NCE after 2 years results in ineligibility to take the NCE without completing an unabridged COA accredited program

27. Notification for Upcoming Recertification • Email reminder • Packet mailed reminder EXTREMELY IMPORTANT NURSE ANESTHETIST RECERTIFICATION MATERIALS ENCLOSED

28. Criteria for Recertification • Eligibility for recertification after initial certification • RN +/- APRN Licensure • 40 hours of Continuing Education (CE) • Demonstration of substantial engagement in the practice of nurse anesthesia. • Completed application • Fee • $100 AANA members • $300 non AANA members • Certifications

29. Recertification 2010 Option to recertify via electronic or paper application Deadline July 31st No retroactive recertification Print recertification cards when approved Reinstatement fee will be required for lapsed recertification Recommended to have all CEs 6 weeks before application for recertification to allow for 4 weeks processing

30. Recertification Comparison

31. Recertification Satisfaction Survey

32. Future of Recertification “Continued competence /Continued Professional Certification is an ongoing, multimodal, and iterative process supporting the level of expertise in nurse anesthesia competencies as defined in the AANA Scope and Standards of Nurse Anesthesia Practice to promote protection of the public.”

33. Future of Recertification? • Continued Professional Certification • Requirement of categories of CEs • Time - 3-5 years instead of current 2 years • Use of simulation for competencies • Testing : Self Assessment • Recertification date on birthday

34. Anesthesiologists • MOCA: Every ten years (if certified after 1999) • 350 Continuing Education Units in 10 years • Current license as a medical doctor • Maintenance of Certification Assessment in years 7 to 10 each cycle • Clinical practice is required and evaluated locally, with case evaluation and clinical simulation.

35. Doctors face board specialty “expiration dates” • “Changed in the 1990’s — doctors certified since then must retest every six to 10 years to prove their skills haven't gone stale.” • “More than a quarter of a million of them were "grandfathered" with lifetime certificates, but are being urged to retest voluntarily to show they still know their stuff.” • "I am choosing to renew. It's just an opportunity to maintain my skills and confirm to myself that I can do what I've been trained to do," he said.

36. Doctors face board specialty “expiration dates” • “Research shows that what doctors think they know does not match what they do, and that performance declines with years in practice.” • Testing emphasizes recall of facts rather than making full use of available sources of information, such as electronic references and the Internet, as modern doctors are taught to do. Recertification tests are a work in progress. • Eventually, testing may include rating a doctor's technical skills and directly observing performance,

37. Anesthesiologist Assistants • National Commission for Certification • Initial certifying examination • Time-limited certificate – 6 years • 40 hours of CME every two years; CME hours >40 required hours will not be registered • Take the Continuing Demonstration of Qualification Exam every six years for continued demonstration of qualifications.

38. Anesthesiologist Assistants • CDQ Examination is designed to test the cognitive and deductive skills of the practicing anesthesiologist assistant. • If CME registration, including payment of registration fee, is not complete by August 31st, then that practitioner will be decertified by the National Commission. • The only way in which an individual can re-establish certification will be to apply for and successfully complete a Certifying Examination.

39. NBCRNA Focus Groups • Participant Recommendations • Students, Educators, Practitioners • Community of interest • Communication • Emphasize value of credential • Attention to process • Transition timeline • Adequate input and planning • Requirements for the Future

40. NBCRNA Website

41. Communication • NBCRNA Website: www.nbcrna.com • Toll free number: 866-894-3908 • Facebook • Email: • recertification@nbcrna.com • certification@nbcrna.com

42. NBCRNA in Action The NBCRNA booth at its debut at the Assembly of School Faculty , February 2010