Awakened Anesthetist

[PROCESS] Exploring the Expanding Field of Certified Anesthesiologist Assistants with Shane Angus, CAA

• Mary Jeanne, Certified Anesthesiologist Assistant • Season 3 • Episode 38

Share episode

As the program director for the Case Western Reserve University-DC Anesthesiologist Assistant program and a fervent advocate for the CAA profession, Shane's story is one of exploration, personal growth, and the power of a tiny 3x5 card. We explore Shane's fascinating path from aspiring med student to influential figure in the rapidly expanding field of Certified Anesthesiologist Assistants. If you are a CAA practitioner, AA student, or simply curious about this rapidly growing profession, this episode is a must-listen.

Connect with Shane @ shane.angus@case.edu

Glossary of very confusing acronyms:

  • (AAAA) American Academy of Anesthesiologist Assistants
  • (APSF) Anesthesia Patient Safety Foundation
  • (ASA) American Society of Anesthesiologists
  • (AAAEP) Association of Anesthesiologist Assistant Education Programs
  • (CAAHEP) Commission on Accreditation of Allied Health Education Programs 
  • (ARC-AA) Accreditation Review Committee for the Anesthesiologist Assistant
  • (CHE) Commission on Higher Education

You can now text me! Questions/Suggestions

Looking for a pause and reset? Join us Sunday, November 24th at 6pm CST/ 7pm EST for November Mindful Connections Get on the List

Can't make November? Receive all future Mindful Connections invites HERE

I want to learn more about CAA Matters.
CAA Matters is the 1st comprehensive wellness curriculum for 1st year AA students. I designed CAA Matters to be flexible, relevant, and seamlessly integrated into an already packed first year schedule so you don't have to compromise.

CAA Matters is now enrolling for the '25/'26 Academic year.


Want more? Stay in the know by subscribing to the Awakened Anesthetist Newsletter- more resources, exclusive content and ways to connect.


Interested in practicing mindfulness with this CAA community?

Speaker 1:

Welcome to the Awakened Anesthetist Podcast, the first podcast to highlight the CAA experience. I'm your host, mary Jean, and I've been a certified anesthesiologist assistant for close to two decades. Throughout my journey and struggles, I've searched for guidance that includes my unique perspective as a CAA. At one of my lowest points, I decided to turn my passion for storytelling and my belief that the CAA profession is uniquely able to create a life by design into a podcast. If you are a practicing CAA, current AA student or someone who hopes to be one, I encourage you to stick around and experience the power of being in a community filled with voices who sound like yours, sharing experiences you never believed possible. I know you will find yourself here at the Awakened Anesthetist Podcast. Welcome in. Hello all my fellow CAAs, aa students and anesthes colleagues. Welcome back to the process series. I'm your host, mary Jean, and I'm hoping that these episodes show us all what a CAA can be and do and move us in the direction of creating our life by design rather than default. If you happen to be new to the CAA profession or don't really have a clear understanding of our profession's history, then let me tell you that the CAA profession has not always been the rapidly growing health care field it is today. I happen to have a really long and personal history with CAAs because my dad graduated with the second class of CAAs ever out of Case Western Reserve University back when it was still an undergrad degree, circa 1976. And then when I graduated from that same AA school in 2008, more than 32 years later, I was still only licensed number 761 in the nation. It wasn't even until the mid-2000s that we had more than two schools where you could be trained as a CAA. So how did our profession go from an isolated group of CAAs working in two states to over 20 schools and more than 3,500 practitioners? The answer to our growth is something I hope you already have a sense of if you're a frequent awakened anesthetist listener. Which is to say, this growth happened and is still happening because one person, or a few people, made it their mission to do so, because we are still a relatively small profession next to our counterparts, the physician anesthesiologist and the certified registered nurse anesthetist. It's an incredible truth that one person in the CAA profession can create a big change, and hearing how one CAA made their big impact can inspire you to ask what am I uniquely meant to do To that end. In this episode you will hear my guests and I throw around a lot of what appear to be insider lingo with lots and lots of acronyms. In an effort to be inclusive to all stages of listeners who are interested in the CAA profession, and because I can get confused with all the acronyms myself, I have inserted a reference glossary in the show notes for the acronyms mentioned in this episode and some previous episodes. My guests and I do a decent job of explaining the organizations we're talking about, but I don't want anyone to get lost in the weeds, because the weeds is often where a lot of the work needs to be done. So I hope this helps everyone follow along. You may have already heard of my next guest. He is a well-known, highly respected CAA within the tight circle of practitioners who have been doing the decades long behind the scenes work to grow our profession and while he is still working to do so, he wants us all to realize that the circle was never meant to be tight knit or closed looped. He invites us all to be the change we wish to see within a profession, whatever that means to you. So let's do a quick timeout so I can tell you a bit more about my next process guest, shane Angus. Shane is the epitome of multidimensional Get this. He graduated from high school when he was just 15 years old and then went on to culinary school to become a classically trained chef At the age of 23,. He had a choice between becoming the executive chef at a new restaurant in Santa Barbara, california, where he's from, or going to UC Berkeley for undergrad. He chose Berkeley and graduated with a degree in integrative biology, thinking he was going on to med school. You will hear how he diverted into AA school instead and went on to graduate from Case Western Reserve University's AA program in 1999. He currently practices as a PRN CAA, so he works as needed or as he wants in the Washington DC area because his primary focus is being the program director for the Case Western Reserve DC program. Shane also sits on two boards the Anesthesia Patient Safety Foundation and the AAEP. Check the show notes. Shane's process episode will exemplify how one CAA can make a huge difference within our profession. You may not be interested in any of the action items or organizations that Shane has found himself in, but I hope it inspires you to follow your own interests and talents and see how you can use those to strengthen our CAA profession. With that, welcome Shane to the Awaken Dynastis podcast.

Speaker 2:

Thank you very much. Great to be here.

Speaker 1:

I'm excited to have you and I would love to start with a little rapid fire question, just so everyone can kind of get to know you. Would you say that you're an extrovert or an introvert, Shane?

Speaker 2:

Well, Mary, I'd have to say both, A little bit of both. I do enjoy my quiet time and I do enjoy some isolation, but I also enjoy quite a bit of interaction with humanity of all varieties.

Speaker 1:

And what did little Shane want to be when he grew up?

Speaker 2:

I had quite a few aspirations when I was younger. Astronauts were very much a thing, and even at that time I was interested in the sciences, so that was big aspiration. I also had quite an admiration for my father and he was a builder, so working with my hands was really important to do as well. But those two things were kind of the big components.

Speaker 1:

What time do you go to bed every night?

Speaker 2:

8 o'clock.

Speaker 1:

Oh, what time do you get up?

Speaker 2:

About 5 o'clock.

Speaker 1:

Okay, and do you spend any time on social media and, if so, how much?

Speaker 2:

Limited. I do have some responsibilities to sort of participate and be involved with some of my other roles, but for the most part that's on a professional level, so I don't spend too much on social.

Speaker 1:

That's good for you, shane. We're all aiming for that. Okay, last one best TV show or streaming show that you've watched lately.

Speaker 2:

Oh, lately, my goodness, we don't watch a lot of.

Speaker 1:

Or ever Give me an ever.

Speaker 2:

For an ever. I was a big fan of MASH, which was a TV series back in the day. I enjoyed it for several reasons. Clearly it had a medical focus on it, but there was a lot of moral, ethical components to it. The writing was well done. There was different conflicts. My father was in the Vietnamese War and so that was a Korean War for MASH, but still there was a parallel for me to watch that and one of the curiosities for that was the hills that were the opening shot were the hills that were behind where I was raised.

Speaker 1:

Really, how does one watch MASH these days? Can you still watch it?

Speaker 2:

I think you can. Yeah, I'm sure it's on one of them. I'm sure it must be.

Speaker 1:

Someone will tell you. We'll get feedback. Okay, I would love to hear just about your cultural background and your upbringing. You mentioned a few things there, but just help us get to know you, not as a CAA, but just, shane, as the person.

Speaker 2:

Yeah, so I come from humble means. Most of my family had a history of either within the farming, themselves as farmers, or within the arts or within construction. So most of my family were laborers of one type or the other. And throughout the growth of that family, fortunately for me, I was born and raised in Santa Barbara, which is a pretty unique place that I've come to really appreciate as I've gotten older. So I grew up most of my time there. I did mention that a lot of my family were artists and educators and so with that I did a tremendous amount of traveling globally, very humbly. So it could be in a car going to Mexico and living there for six months, or it could be on a Pan Am flight If anybody is old enough to know what Pan Am flights were going to Morocco, living there for a year, living in the Mediterranean, north Africa, europe. I spent a lot of my time in my childhood traveling around and living in many places around the country and the world.

Speaker 1:

Wow, yes, I'm sure that definitely informed you and shaped who you are In all those travels. How did you first hear about the CA profession?

Speaker 2:

I first heard of it during my time in undergrad. My interest was in healthcare and there was two majors where most students who had that interest focused on, and one was pretty intense and a lot of lab time. The other one was very much more open. You had a lot of other coursework you could take, for example, some of the coursework and economics you could take to fulfill some of the biological requirements and the like, and so that was really enjoyable to really diversify the biological interests across the different domains in education. With that during my time as a student I was also doing some work for Kaiser Permanente, which is a very large HMO system out west, and so they have their kind of their mother's ship in Oakland, california, which is what the very first Kaiser was, and I was doing some work and research there, and while I was there I had a chance to meet a lot of the medical students, the residents, the fellows and develop some friendships, and so when I was accepted to the medical school I shared that with them and they paused and really advised me to take a gut check and make sure this is what I wanted to do. Mind you, I was a bit taken aback by that, because no one had ever expressed that yet. Everybody else was just like great, you'll do wonderful, go get it. And so, all of a sudden, here I was faced with this. Now, mind you, I have to acknowledge that I was naive. To where they were in their training, they were definitely at the apex of the amount of time and effort and energy it would take for them to learn their craft. So you know, they hadn't slept, and this is before work hour limitations, right? So there's, a lot of other factors involved with this. Regardless, I did take the advice and I went back to my advisor, who I had a chance to develop a relationship with, and they said, as I'm a little stressed I went back to her office and she had looked. I'm really busy. I'm with some students right now. Once you have a seat outside Shane, you and your anxiety can just pause there for a little bit, and I'll be with you soon. And so I'm looking through the binders and I kid you not, a three by five falls out of one of the binders upside down.

Speaker 1:

Oh, my goodness.

Speaker 2:

It waffs in the air, lands on the floor and I have to bend over and I turn it over and it says anesthesiology assistant and gravity sort of shifted a little bit for me there. I was like what is this, what's it all about? And so she finally was done with the other students and found some time and she shared with me a little bit more information about it. I pretty much applied the next day and was fortunate enough to get into the last interview group at case and flew out there a couple days later and then had my interview on a Friday flew back because the time difference. I got in pretty late and woke up the next morning my roommate knocking on my door hey, when you get a moment, you should probably listen to the voicemail recordings that we have and I was like what are you talking about? So I went and listened to it and they said you've been accepted. So I was like, wow, this is great. So there you go.

Speaker 1:

Oh my goodness, and this all happened in California.

Speaker 2:

In California.

Speaker 1:

Wow Go Case Western for their seriously good marketing in the 90s. Wow, that is very interesting and impressive that they called you less than 24 hours later. I think probably a lot of people who are applying now wish that that would happen? Yeah, because when you applied, there were only two AA schools at the time correct, it was just Case Cleveland, but it was just Case Western and then Emory. And so what were you aware of in terms of like you really started really at the, I would say, at the beginning of this kind of explosion of growth, or like the momentum really started to build? Were you aware of that? Did you know anything about where you could practice after you graduated?

Speaker 2:

Yeah, thoroughly aware where I could practice after I graduated and thoroughly aware of where this path might lead, broadly speaking, so I went in with my eyes wide open on that one, mind you optimistic, I do have that thread in my being so I thought we'd get a chance to open up some doors. And, regardless, I got a chance to open up a lot of doors and here I am today.

Speaker 1:

Yeah, I mean, it's just interesting because so much of your work now is really creating that snowball effect and that momentum and you're like really in the trenches opening up the schools and just all of that. It's interesting to hear, like if you had a sense of that when you were a student, that like, hey, maybe one day this diversity of interest that I have could be put to good use. Or if it was just like happenstance.

Speaker 2:

Quite a bit of both. I think that the circumstances as they were led to the opportunity Right. So, without the circumstances being, without there being two programs, without there being a limited number of people, without there being an opportunity to have a voice because the group was so small, your voice counted a lot. It still does count quite a lot, while most of the other health professions it's just it's very large, and so it takes a while to have your voice heard and for that to then be implemented. So with that, I think, in addition to my approach on well, what's the worst that can happen? So let's go try it.

Speaker 1:

And what were your career goals? You know right when you graduated, were you just wanting to work for a while or were you wanting to, right away, get in there with the people who are making things happen?

Speaker 2:

A little bit of both. I had a very fortunate first job out. There was a group in Atlanta, georgia that practice at Atlanta Medical Center, that was willing to hire not just one, but about four recent grads, one from a year above me and one from a year below me and then one in the current year, and so that was Dane Johnson, gary Jones and Michael Nichols, and so the four of us worked together at a hospital there and it just so happens to be that Columbia quite the figure in our field was one of the leaders there on the chief and other people like Mark Cappell, so it was a great place to be. It was a teaching hospital. We had students from memory and from case there and I got a chance to do cardiac and trauma. So it was a fantastic place to be where I could be able to to really identify more of what it was I wanted to do with my career.

Speaker 1:

And what was that Like? What were those first few steps into figuring that out?

Speaker 2:

I think I'll go back to my background a little bit, or my cultural background was, and there are many people in my family who are teachers and professors, and so that was always part of what I found interesting maybe just because that was a conversation around Thanksgiving and birthday parties, but it was still there. So I was very excited to have that opportunity to do teaching and I got to teach pretty much every single day, so that was very fun for me. The other pieces that came to bear were related to policy and patient safety. So we had a high acuity patient population and our outcomes for our cardiac cases were not that good and there was lots of questions about why were they so poor comparatively in our region, and one of the primary reasons was that we were doing cases that other hospitals in the region were not doing. We had a lot of very, very sick patients and so when you factor that in, our outcomes were actually okay comparatively. So that focus on patient safety early was a unique opportunity. And then the other opportunity as related to policy, where people like Rob Wagner were working on the state of Florida and getting a chance to participate in that exciting endeavor. So they all kind of coalesced in that unique place, plus having all my friends there, really was pretty special.

Speaker 1:

Yeah Well, I just like the idea that you said earlier that in a small profession, your voice really matters. But I was wondering if it felt like you had the thought like gee, our profession needs to take a step here or do this, and you were like certainly someone else is doing that. And then you realize you look to your right and left and you're like, oh wait, there is no one doing that. Maybe that person's me, or were you asked to do these things, or you know like was it all self-generated? I'm just I think this is an interesting thing because that's still happening now, like you can still be that person now.

Speaker 2:

You can absolutely be that person now, and I see it time and time again. I've had the fortune of having some fantastic graduates and some of them are doing amazing things today and they just graduated a couple of years ago Like nationally influencing decisions. It's pretty, pretty cool to be a part of their journey. So for me, when it came, I think the biggest factor I had the biggest influence on early on was on faculty development, and so what I had noticed in our profession and this is related to the education piece and the policy what I'd noticed is we were not going to be able to have more programs, which means more graduates, which means more care to the patients that are available and not having to wait right At the end of the day, that's what it's all about. So, recognizing that if we didn't do our best to help support people who had an interest in education, or maybe people who didn't know they had much of an interest in education until it was presented to them to develop that. So, seeing that on the landscape, recognizing where we wanted to be with more than two programs or three programs or four programs, that we needed a national presence and at least a program in every state, well, we needed faculty to do that and without the faculty you're not going to have a program, you're not going to have more graduates or meet the needs of your communities of interest. And so, recognizing that and just speaking up and doing my best to understand the present issues related to that and starting developing workshops and the QA was at the time willing to support carving out a little bit of time at the meeting on the side where we could have educational workshops In our first workshops we probably had, you know, eight or nine people. Our last one, we think we had about 80 or so. Wow.

Speaker 1:

And just regular CAAs who were. You know, it's kind of like all CAAs end up being teachers, you know, on some level. But it was just for the regular CAA staff to come to the Quad A and receive some like how to be an educator, which is vitally important, yep.

Speaker 2:

That's pretty much it. We had, of course, a lot of people within the educational programs doing it, but sometimes there were junior faculty, which was great, and then most of the key leadership faculty knew this information already. But we would focus on the junior faculty and the instructors and just giving them some information. There wasn't like an absolutes, but it was just giving them some foundational ideas on how to teach in the operating room.

Speaker 1:

Well, I'm actually kind of want to dig into this. I'm interested what you're seeing grow out of that faculty development. Are those people who are receiving the training going on to want to start schools? Or are they, you know, just like making really good CAAs that then make hospitals want you know what I mean creates like that, that desire for us? What are you seeing?

Speaker 2:

I am seeing that, and there's a lot of people who have been in the workshops to them. They themselves have gone on and made further pursuits. Some of them have gone on to further graduate degrees. Many of them are instructors or faculty or assistant program directors or program directors at other institutions across the country, and so that's very gratifying to share, you know, a portion of what their journey was and how they were going to go go find it fulfill that.

Speaker 1:

And what do you think makes a really good faculty instructor Great?

Speaker 2:

So the most important thing about teaching anybody in a clinical space is making sure that, first and foremost, that your patient is safe period. That is the most important thing and it goes beyond that. Right and clearly. You want to focus on the patient and that's a priority and that's really important throughout that, making sure that the learner sees that as well, that they are not the most important thing in the room, that there are other things that are more important than them. That day and following days is the patient's outcome and their safety. So focusing on that allows them then to sort of step back and have it be less about me or less about them. Right, reflecting on themselves, which typically, for most people, takes down some of the barriers and fears about performance and so forth, because it's no longer about them. It's about the patient and that outcome. And so how do I make that work? How do I make it safer for someone else? How do I support someone else getting healthier, getting back to being the mother with their children, but they can't because of an injury, or getting back to being with their grandchildren or whatever the thing might be? How do I help that? And dropping that barrier down, I think, allows people to focus on what's really important.

Speaker 1:

And our current president, jen Stever. When I interviewed her, she said that the biggest barrier to our growth as a CA profession her opinion was quality, first year preceptors and their availability, and I just it sounds like you would maybe agree with that.

Speaker 2:

Jen and I agree on many things.

Speaker 1:

Yeah, that's very interesting. I know another passion of yours is patient safety, so I would love to hear just that journey into the APSF. Maybe break down you know what that acronym is and what your involvement is? Yeah.

Speaker 2:

So I feel very privileged to work and help support the APSF. It's the Anesthesia Patient Safety Foundation. It was developed many years ago by some very thoughtful individuals recognizing that there were some safety issues in anesthesia that had solutions, and so they brought together some, some bright, thoughtful people, and what end up becoming the Anesthesia Patient Safety Foundation, sponsored by the ASA in its early years and continues on through today. So the key figures for that when I started was Dr Stolting, so he was a president of APSF at the time and they were looking to broaden the spectrum of people involved with APSF, and so I was invited to a meeting, one of their annual meetings, and then subsequently offered to represent our profession within their board, and so I happily said, yes, I'd be very pleased to do that. As time went by, with Dr Stolting, there was a transition that took place and Dr Mark Warner became the president, and now it's Dr Cole, and so all three of them have been really visionary in making sure that we bring as many voices and ideas to the table to understand how better we can be as practitioners, how we can be focused on our patients and their safety from the systems, from pharmacological perspectives, from management, from hospitals from all these different angles that make the decisions, at the end of the day, regulators right. How can we help influence that? And so, with that, we do have a meeting that takes place once a year. It's coming up in a couple of weeks and this next one is going to be focused on items like AI and the future of tech and wearables in anesthesia. So with these meetings then, we hope to influence thought leaders and kind of helping navigate where we can have an influence on those thought leaders to make sure we're still keeping patients safe.

Speaker 1:

When I was doing a little bit of research, it looked like are you the only CAA on that board, or have ever been? Is this like a personal interest of yours, or is there opportunity for more CAAs to get involved with this work?

Speaker 2:

Yeah, so I serve on the board and I'm the only one. There was one prior to me for a short bit of time. Deb was her name and so she was on there for a number of years. Deb Lawson, oh yeah, and I was able to work with the development of our 10 priorities. And so within our 10 priorities town safety priorities there is sort of a work group, and so this patient safety advocacy work groups they, for the most part, have some type of a CAA on their work group to help contribute to each of the 10 priorities we have.

Speaker 1:

Oh good, so there are others besides you. It just you're the one on the board. Okay, interesting, I just. I think it's so fascinating to hear everyone's little individual passions and how, once you get into something, you find all the other people who are interested in that and like that's where the power is is like this collective group of like-minded people, and I just love that. This episode can really highlight how again you can look to your writer, to your life. You're like, oh, this is me. I'm really passionate in patient safety or educating faculty or whatever you know legislation. I can make a really big difference and I would love if you have any insight on, like what's a first step. It sounds like you kind of fell into a community because of when you graduated. You fell into this community. That was kind of like the movers and shakers. Is there some way to replicate that? If you're about to graduate or you've maybe been practicing for a few years, what's your advice?

Speaker 2:

Yeah. So I've seen these waves take place and I don't know how they happen. But, just like you know, wave comes in, you get these sets of waves and with any of these sets there's several rideable waves, and then there's a break between the sets where it's not as much of a ride you're gonna get. So timing is a very key figure in determining how things can go, I think, that being said, I do know people that have sort of broken up between the sets and look to their left and look to the right, like you're talking about, and so they're saying, okay, maybe these people are a little bit ahead of me, but I'm interested, right, or you can just sort of start it and the next step coming in, those people will become interested in what you're doing. And that's self-fulfilling opportunities I think is a reality. I'm a keen believer that the thoughts are very powerful and acting on those thoughts is incredibly rewarding. There's a lot of good that people have in their minds that if they took some steps to realize it, it's a good chance it's gonna take place.

Speaker 1:

Yes, I completely agree. I believe in the power of our thoughts and I also know that there is some logistical concern. You have to have enough margin or white space or free time in your life in order to take on a new role or task, and I just love that people can see okay, shane, who is the DC program director and also has all these interests, but I do know that the reality is that sometimes it does get really overwhelming. So I'd love to hear of any time where you're just like I need to take a break or maybe step back or like a reevaluation, if that's ever happened for you, juggling all of these various passions and projects.

Speaker 2:

Yeah. So I have two significant examples to share. One was during COVID. That was a very challenging time for everybody to go through and to witness within education and within healthcare, within those two classic domains. Both areas went through tectonic changes and when you bridge those two together healthcare, education it was, you know, galactic movement here we're talking about, and so it was incredibly challenging for everyone in that space during that time to keep our students safe, keep patients safe, get them what they needed to get in order to meet their competencies and get them out practicing, because everybody needed them so bad. So that was a very stressful time. There wasn't much of a margin though, to kind of I think we all recognize where we were, but the ability to not be overwhelmed by the next thing that came at you, because they didn't stop that just kind of kept coming. There was no break between the sets on that wave. But the second part, my two-part answer, is I've got these two amazing daughters and they do a fantastic job just being themselves, and that is a great measurement for me to see where I am through their eyes, and it's pretty easy to pick up. So those are my two examples of where I can identify where I am and so my relationship with them and how that goes, and I can see, okay, I need to slow down or change gears or take some time, and I've done that before for sure.

Speaker 1:

We're making some hard decisions or like saying some hard no's, like I just can't do that now, but maybe I'll do that in the future.

Speaker 2:

Yeah, yeah, for me, though, I mean. I know you're just saying it as an example, but they're not hard no's. They're pretty much like that's a great idea, great opportunity. I'm gonna look at it in the future and right now I'm gonna focus on this other thing, and I've never had anybody say my gosh, I can't believe you're doing that. That's the wrong choice.

Speaker 1:

Yes Sounds like you have very good boundary Shane, which is great. I mean, that's what we all need and that is one of those secrets to doing a lot of things well, or doing your chosen things well, is that you don't say yes to everything and that you focus on, like, where your energy naturally comes. I'm trying to learn to do that myself Well, selfishly. I know that you are involved with K-HEP and the selfishness comes because I just have so many personal questions about all of these schools that seem to be appearing or like legislations passed in a state and then a school appears and just like everyday CAA. I would love to hear and see some behind the scenes of how these programs are coming to be, and I know you work with accrediting the new schools through K-HEP. If you can kind of explain all of that to us.

Speaker 2:

Yeah, sure, just a point of clarification. So I was a member of KHAB, I was a commissioner and I was the chair of the ArcA. I have stepped down from that role after my term limited, well, but I still participate actively and support KHAB, so both of them do play a role. The accrediting side I can speak to my role, so we as creditors. There is a couple things that are really important and to recognize. One is that the US Department of Education is one of our nation's accreditors. They do a solid job, right, they have to look at policies that cover everything from Art school to theologic school, to medical school, to everything in between, right To elementary school to high school. Right, they've got to look at all these different pieces. And then the other bigger creditor is Chia, which is a commission and a higher education accreditation. They are the one that helps the university based accreditation. So you're looking at an entire university that has multiple schools in it and each of those schools has multiple Degrees they might offer. So you've got the school of engineering and you've got schools letters of science and the school of law and the school of nursing, and within each of those there's multiple degrees. And so how do they create policies such that they are doing the best to maintain quality at each of these programs and these schools, so that they can demonstrate that they Focus on their students, they focus on their communities of interest. They focus on their curriculum and and their outcomes. So that's kind of the Chia and that's where K-Hip fits under. K-hip fits under Chia and so it is a programmatic accreditor and so within that arena there are many different programs which are part of Allied Health, and we are one of them, and so with that, with on under that umbrella once again, it's a little more focused because it's more health care focused, and that's fantastic. But you still need to have standards that Are measurable outcomes, and that's one of the biggest decision pieces that I think most people outside of accreditation Is a little tricky to understand at first, and so one might think, hey, before you start a program you must demonstrate these ten things, and all of these ten things have to be exceptional, and that's can be very true, and Yet the students still don't succeed, right? So what K-Hip has, and Many other accreditors now, is they are looking more on the outcomes. Yes, you need these ten things to start. They don't have to be exceptional, you have to have a competent amount to get them there. But we really want to measure is you know You're those initial first steps and then your outcomes. How do the students progress through the curriculum? Because what they do in Tulsa, oklahoma, might be different than what they do in Tampa, florida, might be different than they do in Washington and Seattle. And those are different communities, different interests, different hospital systems, different backgrounds, different cultures, different patient populations, and so a one-size-fit will not work for all of them. So you want to have a system that allows each of them to excel where they need to excel, with their patient populations and their student populations that are coming into their systems, but the same time maintains quality across the country. So retrospectively, it'd be great to say hey, you're supposed to have x, y and z every single time to start a program period. And then what's gonna happen is someone's gonna raise their hand and say, well, I have x and y and I don't have z, but I have a double z, and my community thinks that's preferred, and Let me demonstrate to you why that's preferred, and take a look at our outcomes, and then the organ other like okay, that's a great idea. I see how that might work for you in your situation. So, anyways, the accrediting piece is absolutely vital. We want to make sure we have all the necessary requirements to start a program, and so KF and RK are responsible for making sure that's there. The other piece of it, though, is the students, the communities that they're in, the hospital systems, the academic institutions making sure that they have all the support for the students to succeed all the way through to graduation, after practice, and so our graduates continue to show that, and the public data for that is shown on the KF website on what the outcomes of the graduates are, and overall, they're very good.

Speaker 1:

And just as a point of contrast, who is credentialing CRNA schools? Is this all in the same umbrella or they do something different?

Speaker 2:

Yeah, great question. So there are different Organizations that look at all the different healthcare accrediting bodies and so they have meetings on a regular basis and the nursing desks accreditors are part of that organization and they are part of that discussion as well, and so many of their standards are very similar to many of our standards. When it comes to the curriculum, the foundational, the faculty ratios, the, the contents right, the composition of the clinical standards performed that the students must have met before they can graduate, they're Very, very, very close and in very small instances or minor differences that is very interesting just on a School level, like what kind of education are you going to get when you're in CRNA school versus a school?

Speaker 1:

Can you speak to this sort of like burst of AA schools that are coming about, like why and and who is starting them?

Speaker 2:

sure, multi-factorial, to say the least. I think the biggest components we have here are the. There's just not enough people anymore and that's probably going to continue for some time, and Sometime meaning a long time. So right now we have A elderly population that's growing, we have a population younger than them that is shrinking and With that you do not have enough resources, people to Care for that patient wave that has is going through now and we'll be going for on for at least the next 10 or 15 or more years. So with that, there's not enough nurses, there's not enough tax, there's not enough doctors, there's not enough CAA, there's not enough CRNAs, there's not enough anybody. And it's not just happening here, it's happening everywhere in the world. And so, with that, many of the universities and communities that Don't have us as either a practitioner or don't have us as an educational institution that can support practitioners in their community, are seeking out how do they fulfill that, how can they help their patients and maintain that and increase their access if possible. So those are the biggest drivers. There's not enough of us, globally speaking, and all the different disciplines in the health care to care for all the patients that we have.

Speaker 1:

Hmm, and so it's like, like on the lawmakers side, someone's tracking that and being like, let's find a solution and okay, opening Healthcare programs is a solution. Or is it like we need a CAA to go to the lawmaker and say, hey, you know what a good solution is to this problem? Like, which way is it coming from? I guess?

Speaker 2:

It's primarily coming from the individuals talking to the legislators, from the practitioners. So you know Nevada's opening that was driven by individuals who are from the state who are excellent practitioners and wanted to go back home, and so that's a big driver, and many of the other states where that has taken place, that's been a big driver as well. Utah is another example of that. So here are these people that are practicing and very well and established and many times prestigious health care institutions that are saying I'm doing this here and there's a way for me to do it back there, where there's not enough people either, and let's find a way to bridge that gap.

Speaker 1:

Yeah, I just actually interviewed three of the CAAs who were really on the ground floor of passing Nevada and among a really exciting coup for them was that there were no objections. They like unanimously passed. There was not even anyone in the audience who stood up and said, no, we shouldn't do this, because it was just so glaringly obvious that they need more anesthesia practitioners that just you couldn't make an argument to say this isn't a great idea. But it did take the CAAs to go to the lawmakers and say, hey, this is the solution. So we're still at that place, even though it feels like, gee, I am hearing a lot of schools opening and there's like kind of this momentum of like you know, especially if you graduated when I did, which was like around 08, it feels like there's this thing that's happening, but it's only really happening still because an individual CAA is speaking up. Is that still an accurate representation of it?

Speaker 2:

I would say so, speaking frankly, I think there's a lot of other people that are involved with it. That individual is the thing, though. I think that individual person taking that initiative, seeking advice, seeking counsel, trying to find a good measure to move forward with that interest of theirs, and then there are tremendous behind the scene systems that take place to support that individual and that process, and so that individual or that group of people are the ones that make the difference. Look just my example when I was looking through the binder and I was stressed out about what that's going to do, and that little 3x5 card fell out, you know. So that's analogous to that individual going to the legislator and saying, hey, here I am you know you might not have seen this before or heard of this, but take a look and let's have a conversation, and so when most legislators hear that they can understand it and look forward to help them.

Speaker 1:

So interesting. I would love to have a little lens in like 10 or 15 years to just see where this is all going, because you could just feel. You can feel where it's going, but it just would. It's going to be so interesting to watch it all unfold really in the course of my career. Yeah, so I'm just really grateful that you decided to, or that you agreed to be on this podcast, because I just love your perspective and I love how you were kind of you know, one generation before me in this momentum. So much of this podcast is about highlighting voices like yours that really debunk the mystery behind what a CAA can be and do. And I really believe that our profession is uniquely able to just create a life by design, meaning we have enough resources because of what we do, because of our profession, to really go after our passions, our truest path. And I wonder what you think about that statement what's true for you and your life?

Speaker 2:

What's true for me? I feel like it changes on a minute basis and I fully own that. I'm okay with that. My life has been quite a meandering path and I tend to follow my interests. Whether they change, they change, and so be it. I will reflect upon both of my grandmothers. Both of them had a variety of jobs, a variety of jobs they created on their own right. That they are like this is something I want to do. I'm going to go check it out, let's go try it out. And so their life just kind of flowed from one to the next, to the next, and I got to see and witness them doing that, the both of them pretty remarkable women. So for me, speaking trying to go like okay, this is where I want to be in 20 years, that's a tough one, that's a tough one. So for me, it's more like I like this idea of where I might be in 20 years. But for the most part, there's a vision, and I think that's the part that I would focus on is this idea that might not be concrete, might be hidden behind clouds, but it's there. And then, as you follow that cloud, as it moves through the atmosphere, it might shift and collide with our clouds and then idea might change and become something else and become something else, and that is really fun to be a part.

Speaker 1:

Yes, yeah, I totally, I totally get that. And I also hear that like the CAA profession is kind of working this magic in your life because it's supporting you as you meander. Like what a wonderful thing to be supported by this profession. That like, even just if it's this thought of like hey, I could take a leap, I could make a mistake and if I fall I'll just go back to giving anesthesia in the operating room, like to know that there's a safety net there and this thing that's like allowed you to grow and like held you up and said like hey, here are these opportunities. I just really see how the profession I think uniquely is capable of doing that. Yeah, it's just interesting your interpretation of like you just kind of want to let it be loose and like what a wonderful privilege really.

Speaker 2:

Yes, I couldn't agree with you more in those things. It's incredibly rewarding to be a part of this profession. I feel incredibly lucky to have had that three by five card fallout of that binder and fortunately enough that she didn't call me back and to let it already take place. The experiences that I've had in this field and this profession have been incredibly enjoyable thought provoking, interesting, rewarding, enjoyable. I just yeah, it's as you said. Your phrase was there was a privilege. It's very much a privilege to be a part of this profession, very much a privilege to be allowed to care for other human beings who are hurt and need your help. That is amazing to be able to be a part of.

Speaker 1:

Yes, yes. Well, just as my final, I'm wondering, in all of the many things you've touched or done, if there's anything that we've missed that you'd like to talk about. We didn't even talk about how you're the program director for KSC and that evolution. Anything that you want to get on the books, on the record?

Speaker 2:

You, mary Jean, have asked a great amount of very thoughtful questions. I think you covered the bulk of ideas that I'd like to share. I can get a bit off tack. Next thing I know my sailboat's way off in some other direction. There's only good job pulling it and gearing it back. So before you have to pull my sail in a different direction to get us back to shore, I'm going to hold there.

Speaker 1:

Awesome. Well, if anyone has further questions for you or they know you've done something they wanted to hear more about, are you open to people contacting you and, if so, what's the best way to do that?

Speaker 2:

Yeah, people are contacting me regularly. Pretty much daily. I get people reaching out. So my university email, which is ShaneAnguscaseedu.

Speaker 1:

Wonderful. Okay, well, I will put that in the show notes and yeah, just again, I really am grateful that you took the time. I know how busy you are and, as you said, healthcare and education are two things that are time and energy, and so I appreciate you taking some of that with me and I just I wish you and our profession all the best and I'll be in contact.

Speaker 2:

Wonderful. Thank you so much.

Speaker 1:

All right. Thanks, Shane. Bye. I hope you loved this process episode with Shane. It's been very cool. Recently I've been getting a lot of feedback from past guests as well as listeners of Awakendinestas podcast that they heard something or the story that was shared really spoke directly to them and their specific journey as a CAA or a pre-AA student or a current AA student and there's just a lot of connections that are being made. And exactly what I hoped would happen with this podcast is that we're finding our like-minded people, our other CAA-minded people, and when you share stories within a like-minded community, it becomes really expansive for you personally to take those risks or to take that next step into the life that is uniquely meant for you. I just think it's really interesting the synergy that's happening through this podcast and the connections that are being made. If you want to further those connections, two things you can do are to rate and review this podcast on whatever platform you're listening right now, and the second is to share this episode with one of your CAA colleagues or a fellow AA student. I'll be back in two weeks with part two of my self-discovery journey. I hope you're enjoying that little series and between episodes you can connect further with me on Instagram at AwakendAnesthetist. I hope to talk soon. Okay, awesome. Thank you, Gail. I feel like you were very on the point.

Speaker 2:

Okay.

Speaker 1:

You were good. I don't feel like there was much meandering, as you had said.

People on this episode

Head Shot

Mary Jeanne Roberts, CAA

Host