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Addressing structural and systemic barriers in nurse anesthesia programs: Recommendation to eliminate the GRE and adopt holistic admissions

Published:December 30, 2022DOI:https://doi.org/10.1016/j.outlook.2022.10.001
Addressing structural and systemic barriers in nurse anesthesia programs: Recommendation to eliminate the GRE and adopt holistic admissions
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      The American Association of Nurse Anesthesiology (AANA) estimates that the majority of the 59,000 Certified Registered Nurse Anesthesiologists (CRNA) identify as White Americans, with significant under-representation of African-Americans/Blacks (3%), Hispanics (4%), Asian/Pacific Islanders (4 %), and Native American Indians (0.7%) (

      American Association of Nurse Anesthetists (AANA). (2021). Profile Membership Survey, Retrieved December 20, 2021 from www.aana.com

      ). This lack of diversity is even more worrisome among PhD-prepared and pain management fellowship-prepared CRNAs. Approximately 15 African-American/Black and 5 Hispanic CRNAs (<0.03% and 0.008% of the CRNA population, respectively) hold a Ph.D. degree, and only about 8 CRNA pain management fellows (0.01%) are historically racialized (
      • Gould W.
      Intersectionality of racial/health disparities and social isolation and nurse anesthesia students of color: Strategies for feasible solutions and measurable outcomes [conference presentation abstract].
      AANA Annual Congress, Chicago, IL, United States2020
      ). Similarly, only about 20 full-time African-American/Black and Hispanic CRNAs, who have historically excluded educators, are among full-time nurse anesthesia faculty (
      • Gould W.
      Intersectionality of racial/health disparities and social isolation and nurse anesthesia students of color: Strategies for feasible solutions and measurable outcomes [conference presentation abstract].
      AANA Annual Congress, Chicago, IL, United States2020
      ). The lack of diversity may be compounded by the fact that, as of 2020, predominantly white institutions housed 116 of the 124 accredited nurse anesthesia programs (NAPs) (
      • Gould W.
      Intersectionality of racial/health disparities and social isolation and nurse anesthesia students of color: Strategies for feasible solutions and measurable outcomes [conference presentation abstract].
      AANA Annual Congress, Chicago, IL, United States2020
      ). This lack of diversity in the nurse anesthesia profession persists despite growing diversity among the United States population. The lack of diverse anesthesia professionals may contribute towards health disparities, racial biases in pain assessment, and inadequate pain management services in communities of color (
      • Hoffman K.M.
      • Trawalter S.
      • Axt J.R.
      • Oliver M.N.
      Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.
      Proceedings of the National Academy of Sciences - PNAS. 2016; 113: 4296-4301https://doi.org/10.1073/pnas.1516047113
      ).

      Key words

      Abbreviations:

      GRE (Graduate Record Examination)
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        View in Article

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      Article info

      Publication history

      Published online: December 30, 2022
      Accepted: October 5, 2022
      Received in revised form: August 26, 2022
      Received: March 31, 2022

      Publication stage

      In Press Journal Pre-Proof

      Identification

      DOI: https://doi.org/10.1016/j.outlook.2022.10.001

      Copyright

      © 2022 Elsevier Inc. All rights reserved.

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