Development of the Certification Examination by the American Association of Nurse Anesthetists (1933–2012)

Abstract

The first US nurse anesthetists appeared in the 1870s. First directed by surgeons, these Catholic sisters later adding their own education and techniques. In 1908, surgeon Crile at Cleveland’s Lakeside Hospital (later Cleveland Clinic) asked Agatha Hodgins to become his personal anesthetist. Hodgins developed a school of nurse anesthesia and promoted formation of the Lakeside Alumni in 1923, leading in 1931 to organization of the National Association of Nurse Anesthetists (NANA), In 1933, NANA president Fife proposed establishing a national board examination for nurse anesthetists, a proposal furthered in 1934 by appointment of an Education Committee to study establishment of the examination, and set standards for schools of nurse anesthesia. In 1939, the NANA became the American Association of Nurse Anesthetists (AANA). In 1941, Shupp suggested that passage of a certifying examination could define eligibility for AANA membership, and by mid 1940s new AANA members had to be certified by examination. The number of AANA-approved schools of nurse anesthesia progressively increased in the 1940s, but World War II delayed implementation of the qualifying examination until 1945. The title Certified Registered Nurse Anesthetist (CRNA), came into use in 1956.