Raising the Bar in CRNA Education: What the 2025 Deadline Means

With more complicated cases, more education for advanced practice nurses has taken hold. By 2025, all new certified registered nurse anesthetists (CRNAs) will need doctorate degrees.

“The nurse anesthesia profession has always supported advanced education for nurse anesthetists,” said Francis Gerbasi, PhD, CRNA, chief executive officer at the Council on Accreditation of Nurse Anesthesia Educational Programs in Park Ridge, Illinois.

Gerbasi indicated that other health care professions, such as pharmacy and physical therapy, have already moved toward practice doctoral degrees.

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The move to a doctorate for entry to practice 

The trend toward more education for advanced practice nurses began in 2004, when the American Academy of Colleges of Nursing (AACN) members published a position statement advising its member colleges to transition all advanced practice nursing education to the Doctor of Nursing Practice (DNP) degree.

“The complexity of health care was changing, the knowledge was growing, and the knowledge these graduates had and their experience in practice was growing,” said Joan Stanley, PhD, RN, FAAN, CRNP, CNL, chief academic officer at AACN. “It warranted a higher degree.”

That action by AACN “prompted us to take a closer look at moving nurse anesthesia education to the doctoral level,” Gerbasi explained.

In 2007, the board of directors of the American Association of Nurse Anesthetists (AANA) approved a position statement that entry to practice for CRNAs must be a doctorate by 2025. The organization did not specify the type of doctoral degree.

“The focus of nurse anesthesia education has been and continues to be ensuring high quality nurse anesthetists who can provide all types of anesthesia in all types of settings,” Gerbasi said.

In support of the AANA’s position statement, the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) in 2009 voted to require nurse anesthesia educational programs to transition to a doctoral framework no later than January 1, 2022, Gerbasi said. So far, 91 of the accredited 121 nurse anesthesia educational programs have been approved to transition to grant doctoral degrees.

“We are making good progress,” Gerbasi said.

The transition has required nurse anesthesia programs to adjust curriculums. However, Gerbasi said many programs already were teaching classes and requiring credits close to a doctoral degree.

“It made sense to move the education to the doctoral level,” he added.

The two entry-level doctoral degrees approved by the COA are the Doctor of Nursing Practice and the Doctor of Nurse Anesthesia Practice (DNAP); the latter is typically offered by nurse anesthesia programs that are not housed in schools of nursing. Nurse anesthesia programs are also located in allied health, health sciences and medical colleges.

The minimum length for entry-into-practice nurse anesthesia programs is 36 months. All of the entry-into-practice programs require full-time enrollment, but some programs may allow student registered nurse anesthetists (SRNAs) to work part time as registered nurses.

What do current CRNAs need to do? 

Current CRNAs are not required to return to school to obtain a doctorate.

“The decision to go back to school is an individual one, which would be based on their personal and professional goals and the time they have left in their careers,” Gerbasi said.

CRNAs who are early in their careers may want to pursue a doctorate to remain competitive in the workforce, Gerbasi said. Additionally, he noted that CRNAs could face regulatory requirements in the future to have a doctoral degree.

Twenty-four educational programs in the United States currently offer a CRNA completion degree, enabling nurse anesthetists with a master’s degree to earn a doctorate. Much of the education takes place using distance education.

“They are designed so CRNAs can continue to work while getting their degree,” Gerbasi said.

Will the practice doctorate change CRNA jobs? 

Gerbasi reports an increase in the number of nurse anesthesia programs and graduates during the past 10 years, which is also the time period when educators and SRNAs knew about the requirement for programs to award a doctorate degree for entry-into-practice by January 1, 2022.

In 2008, there were 110 nurse anesthesia programs and approximately 2,000 graduates in the United States. Ten years later, there are 121 nurse anesthesia programs, graduating about 2,500 CRNAs. 

AACN also did not approve a position statement advising currently certified and licensed nurse practitioners (NPs) to go back to school for a doctorate. However, Stanley reported that many NPs have done that. In the past year, more than 3,400 NPs with master’s degree enrolled in a post-master’s DNP programs. Additionally, more than 14,300 are enrolled in BSN-to-DNP programs.

Every year, the COA surveys the nurse anesthesia programs, asking how many of their graduates are employed in CRNA jobs, which pay an average annual salary of $180,000.

“The nurse anesthesia programs report on average that all of their graduates are employed within six months of program completion as CRNAs,” Gerbasi said. “The job market is very good for nurse anesthetists.”

Related:
CRNAs Seeking New Best Practices in Pain Management
CRNA Scope of Practice: Advancing Anesthesia Safety 

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