Awakened Anesthetist

[Your Complete Guide to Understanding Certified Anesthesiologist Assistants] Pt. 6 POV: CAA Hosting a Shadower

• Mary Jeanne, Certified Anesthesiologist Assistant • Season 5 • Episode 83

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Curious about what it truly means to be a Certified Anesthesiologist Assistant (CAA)? You're in the right place! From nearly two decades of experience, I share a clear and comprehensive breakdown of the CAA profession. Think of me as your older sister or best friend, guiding you step-by-step through the essentials—from what CAAs actually do to how much money we make, no topic is off limits. Whether you're an aspiring AA student or simply exploring a career in medicine, this guide equips you with the insights you need to understand the CAA profession.

In Part 6 I'm pulling back the drape to share what it's really like hosting a shadower as a CAA. 

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SPEAKER_00:

Before we dive into part two of my conversation with Sarah Whitfield from aspiringca.com, I wanted to make sure you're all caught up. So if you've missed part one of this larger shadowing conversation where Sarah and I covered her journey, what aspiring CAA is all about, and the foundational shadowing mindset every pre-AA should have, then go back and listen to that first. It's linked for you in the show notes. Now, in today's episode, we're taking you behind the scenes as two practicing CAAs who have taken more than 100 combined shadowers in our years. We're giving you an honest, open look at what it actually feels like to host a shadower, what we appreciate, what makes the experience smoother, and yes, what we really wish shadowers would not do. If you've ever wondered what's going through a CAA's mind when you walk into their OR, this is the episode you want to hear. And because Sarah and I want to make sure you're supported as much as possible on your pre-A journey, I created a totally free shadowing guide to go with this two-part series. You can grab that in the show notes as well. No cost, no catch, just something I hope will make your path a little clearer and a lot less stressful. All right, let's get back into it. Here's part two of how to land and leverage those darn shadowing hours. 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 Anestetist Podcast. Welcome in. Welcome to a little bonus conversation between me and Sarah Whitfield, who is a practicing CAA as well as the founder of AspiringCAA.com. We wanted to have you all be able to listen in to two CAA preceptors who take students, AA students, as well as shadowers in the operating room and have done so for years. We wanted to just share some behind the scenes of what it feels like as the CAA in that dynamic so that you, the shadower, can listen in and be a little bit more prepared, be a little bit more comfortable, and maybe avoid some pitfalls to make sure that your shadowing experience is as positive for both of you, the CAA, and for you, the shadower, as possible. So welcome back, Miss Sarah Whitfield. I am excited to continue our conversation.

SPEAKER_01:

I'm excited to get into it. This is a really good topic.

SPEAKER_00:

I know. I I'm I love sharing behind the scenes of all things. So let's start off. Um, someone had asked what are the worst experiences that we've had with shadowers and what are the best. So let's start off with the negative first because that's a little juicier. So is there any lasting negative impression that a shadowing experience has left on you? And let's hear all the details.

SPEAKER_01:

Something that is coming to mind is a student who shadowed me. And at, you know, we had a great day together. At the end of the day, this person thanked me and went on their way. And then a couple of days later, I got an email with multiple, multiple shadowing forms that this person wanted me to print off and sign an email back. So to put a little context around this, each CIA program requires their own shadowing form. And don't get me started on this topic. If it were up to me, I would make each program, you know, have the same form. So it's just one form and it's good for each program, but that's just not how it is. So it was just a lot of work on my end to have to print, I'll figure out how to print off 10 forms, sign them, scan them, email them back. So that left a negative impression on me because it tremendously added to my workload to accommodate this shadower. Um, so you know, to flip it, how could that have been positive? That negative could have been turned into a positive. This person had come prepared and anticipated and had already printed off all the forms they wanted me to sign and had those ready to go at the end of the day so I could just knock it out and not have to worry about printing and uploading and emailing back.

SPEAKER_00:

I cannot believe you did that. That was very gracious of you. Um, I'm just wondering if that student was a good shadower. Like, did you have a good shadowing experience? And then this last interaction kind of left a bad taste in your mouth, or was the kind of writing on the wall with this person?

SPEAKER_01:

It was a very positive shadowing experience. Overall, I really had nothing negative to say until a couple days later when I was printing off lots of shadowing forms.

SPEAKER_00:

Yes. So probably just like an air, a mistake on their end that they didn't realize. And now, you know, they have to backtrack. So yeah, that's um unfortunate. And I just think you just have to own your mistake. Kind of like in AA school, if you get a wrong answer or your interview, you get a wrong answer, you just say, Thank you for sharing. I will do better next time. Yeah, just being really transparent with this, the error that you made and how much extra work you're putting on the preceptor. Um, okay, any lasting positive experience, Miss Sarah, that you'd love for people to duplicate?

SPEAKER_01:

Yes, I love punctuality. So it's always a really positive impression when the the rendezvous point, the meeting point that we agree on in the morning and the time, when I show up there, I love for the shadower to be waiting for me so that I just can swing by that location and get our day started. The anesthesia profession is very punctual. So you want to make sure that you know you're always on time and and not causing any sort of delay. So that's always a really positive impression for me when somebody is punctual. Um, and then it's always really positive too for me when I see their attitude being positive, when I see them being excited to be there when they do have questions. Um, so it can get a little bit awkward. So this is kind of going back to the negative. I've had it where while we're sitting down and I just they're not talking and I'm I then I'm trying to make conversation. I say, you know, do you have any questions? And they say, no, not really at this time. That can be kind of discouraging because I'm thinking, oh, I'm excited to share about the ACAA. What could I teach them? And then it kind of feels like I'm shut down. And so that can be discouraging. But on the flip side, to kind of address the positive side of it, I love when I get people in there who do say, yes, tell me. Tell me about how you decided how to manage that airway. Tell me about why you use the drugs that you used. Tell me about this or that, even open question, open, open-ended questions like tell me about fill in the blank. I think that's a good way just to get the conversation going. And then it lets your preceptor kind of take it in the direction that they want. So it's really always positive to me when somebody gets me talking and excited about my job.

SPEAKER_00:

Yes. Yes. And and CAAs love their job. Most CAA, well, I really have never met a CAA who does not like their job, does not like anesthesia. And so if you get us talking about the thing we love, you're gonna have a great experience and you're gonna feel that connection with your preceptor, with the CAA, and be able to go a little bit deeper with your personal questions. Like some of the my best experiences are when I leave the interaction and feel like I've gained a new friend. And that's mostly because they're asking questions of me. Why did I choose the CAA profession? What do I love about it? And, you know, almost flipping the role, like questions that they would receive in their interview, they're kind of asking me. Um, and that can build some strong rapport. And then my best experiences are when just the curiosity is palpable, like oozing off of the shadower student. So I um appreciate a shadower who is interested in the surgery as well as the anesthesia. Anesthesia is um when we say the word anesthesia, oftentimes when we're in the operating room, we are referring to like a what, six foot by six foot space, maybe. I mean, just like a very small anesthesia space. Um, and you'll be back there with your preceptor with me. And oftentimes there is some like, you know, I'm standing or you're sitting, or vice versa, which is why we got the seated question, because like where your butt actually is is a real thing in anesthesia. Um, and so it can get a little close quarters. And if the conversation isn't flowing, it can feel awkward for me, the CAA, as well as for you, the shadower. And so I love a moment when the um shadower maybe can have some um situational awareness and they'll ask me to watch the surgery, especially if it's a really long case, a really long day, it can give us some breaks from talking to each other nonstop and can give you some time to formulate questions and it can give your CAA a break because again, having a shadower while we love it is extra work that we are not being paid for. And sometimes the CAA just wants to take a break. And so you watching the surgery and just being engaged and interested, you know, is just a break for everyone while you're also learning and looking super curious and engaged. So those are always my best experiences when the person looks curious and they also can read the room energetically. Um and again, you know, it it's um it's kind of a little bit awkward. It's gonna be a little bit awkward. It just really is, which is why that debrief is so important in the beginning of a day to kind of lay that groundwork between you and the preceptor. Uh, interesting, I don't have physical shadowers as much in the operating room anymore because I'm only in the operating room a day a week. And um, I often have a first-year AA student. And so I don't have then a shadower as well. And so my interaction right now with shadowers is often in the cold reach out or the, you know, trying to make a warm reach out. And so, yeah, just the negative lasting experience I've had aside from the mothers, well, I don't know why it's not fathers, but always mothers, reaching out is just when I can feel from the reach out, from the cold call that the the preAA is wanting me, the CAA, to take my time to make their life easier. And whether that's the actual sentiment, the reach out feels that way. Like you haven't done enough work on your end to kind of lead me into helping you. So, for example, in my area, if you were to reach out to me and be like, hey, I know I can shadow at Liberty Hospital and St. Luke's on the Plaza, I know that you work at St. Luke's on the Plaza. I've tried to contact the educational department. I can't find the number. Is there a contact that you know? And so all I have to do to help you is give you this one answer to this one problem, really makes my life easier, offers you help and also establishes a relationship where you're not asking me to come shadow immediately, but you're building that rapport, that bond. And the shadowing experiences that I have facilitated have come from pre-AAs who facilitate a relationship from that groundwork. Um, because at my hospital, it's a big process.

SPEAKER_01:

I absolutely agree with everything you just said. That is so important to keep in mind that you want to reduce the friction for the person that you're asking to shadow as much as possible. It is more work for them. And I honestly don't think that a lot of pre-CAAs understand that because they see all the work from their perspective. Like, sure, look at all this work it is for me. And the truth is it is a lot of work for both can be true. It can be a lot of work for the person who's trying to find shadowing, and it can be a lot of work for the person who's trying to make it happen and facilitate it. And so it's always important to keep both perspectives in mind. And I wanted to share similarly that I don't really take shadowers right now either, simply because ever since COVID, my hospital has really gotten very strict on who can shadow. And in fact, the only people that can shadow are people who are currently employed. So, for example, I've had a patient care tech shadow me, but that was because she's worked at our hospital for six months already. So I can't, I can't just say yes to the person who messages me from LinkedIn. What I will say though is most CAAs know other CIAs. So don't see somebody who says no as, you know, oh, well, that's that's a complete dead end. You want your message to land in such a way where they would be comfortable referring you to somebody else in their network. Yes. So that's that's something that I really like to focus on is that your message should make them so comfortable with you and it should speak about your professionalism and how you communicate so powerfully that they would be comfortable introducing you to somebody else. Because if it comes across as unprofessional to me, I will not refer you to a colleague because I will be embarrassed. If if my colleague texts me and is like, whoa, that person that you sent me to shadow was late, did not seem interested, was on their phone in the OR, I would be mortified if I had sent somebody like that to one of my friends. Um, and they would give me a hard time about it too. So I I'm just I'm not going to do it. If I don't feel really strongly that this person is going to represent themselves extremely professionally, then you know, I'm not going to be willing to refer out.

SPEAKER_00:

Um, let's talk about shadowers that have made mistakes. So things like touching something that's sterile, that's not supposed to be touched, or um maybe, you know, um doing like a non-obvious mistake, like overstepping a verbal boundary with a patient or with a surgeon or the anesthesiologist. Any examples that that you remember that you want to share?

SPEAKER_01:

I'm trying to think. Um, I kind of have the personality where I try not to hold on to the the bad things that people do. Um I I I am kind of vaguely now recalling something that um, you know, maybe didn't go exactly as I would have wanted it to with a shadower, and that was in the pre-op area. And I started to do the the interview and I briefly introduced the person who was shadowing me just so that everybody in the room is aware and feels included. And it's just respectful to always make sure that the patient knows everybody who's going to be in the room. That's the appropriate thing to do. Um, and I was trying to do my pre-op interview where I get very important information. I review allergies, I review past medical history, do an airway exam. And the student ended up interrupting it a little bit and having their own conversation with the patient. And I will say though, it was initiated by the patient. The patient, you know, was like, oh, you're interested in anesthesia and and started that conversation. But I ended up feeling a little awkward having to cut it off because the student just kept going on and on, which I could tell the student was excited to be there and that was great. But it just really at that point was not appropriate to delay my interview because they're waiting for me to finish my interview to roll back. So, you know, I had wished that student would have read the room and give a very given a very brief answer so that I could jump back to what I was doing. So, you know, whether or not I'd call that a mistake, I'd probably hesitate to use that word. You know, I I would feel comfortable saying this person didn't really read the room or the situation very well, though. Yes, yes.

SPEAKER_00:

And that is the hard part, is that so many quote unquote mistakes are just not reading the room appropriately. Um, and uh I will offer that I I had more of a true, like I gave that sterility suggestion because that in fact did happen to me. So when you are in an operating room, there are non-sterile areas, areas that you can touch without being donned sterile, like with sterile gloves and a gown. And there are areas that you have to be sterile. And generally, this is in general, the sterile areas are draped in blue. Um, and so it's just something really important to understand when you're coming into shadow, like what's sterile and not sterile. You can watch YouTube videos, like this is a very basic concept. But I had a shadower who accidentally touched something blue and then tried to say they didn't touch it, which it was like something kind of further off from the field. But you know, your natural inclination when you are yelled at or you are told you did something wrong is to become defensive. And unfortunately, in anesthesia, um mistakes do happen on various levels. I have touched things that are sterile and I and I was not supposed to touch. And you have to so actively fight the feeling of hiding that as a secret or not telling someone or like, hey, maybe no one saw me, so I don't have to say anything. Like our human brains want us to hide that information to avoid, you know, getting in trouble. And a a CAA can never hide information like that. And so seeing the shadower become so defensive, again, understandable, but like verbally defending themselves was just a huge red flag. So I want shadowers who are listening to hear me say mistakes happen. You don't know what you don't know. You can kind of help smooth out, like accidentally do something wrong by a nice debrief with your shadowing preceptor in the morning. Like, hey, I've never been in an operating room before. I really want to make sure I'm not in your way, that I don't interrupt the flow, that I know when to ask questions. Here's what I'm thinking. Does that work for you? Like phrasing it like that. Um, but still, sometimes things may happen and you just have to instantly own up to it. There's just no other way around it. You just have to own up to the mistake or mishap or whatever.

SPEAKER_01:

Thoughts. I really like that you brought that up. I think defensiveness is one of the top ways to disqualify yourself as a competitive candidate. Yes. Defensiveness is going to cause so much trouble in your anesthesia training as well. So if you're defensive, you're not being teachable. Becoming an anesthesia professional requires a lot of humility because you will be corrected and guided and molded by not only your faculty members at your program, but each and every preceptor you have, and that will be a different person each and every day. So if you're a shadower and you're already starting off defensive, that is not a good indicator that you would one, even get accepted. But if you did get accepted, you would have a very rough time in school if you hold on to that defensiveness. Yes.

SPEAKER_00:

Yes. Okay, that got that off my chest. So and it's just such a beautiful teaching moment. Um, if you are teachable, that like, hey, this is gonna happen in AA school, and how are you going to respond? Um, because I still make mistakes as a CAA. I just put a EKG lead like over something that was sterile under the drape. I was like trying to get a new EKG lead on, and I like plop, plopped it right on the edges of like the sterile abdomen. And they were like, What's this? I'm like, well, that was me doing something wrong. I'm so sorry. And you fix it and you move on. But okay. Um, let's see here. Let's talk about the situation where maybe a shadower has gotten in. This has happened to me where a shadower got approved. They um maybe met their minimum eight-hour requirement, and now they keep coming back and back and back and back to build more and more hours to theoretically look better on the application. Break down for me from your perspective as a CAA, like should they still keep coming back to the same provider? How many hours do they need, et cetera, et cetera?

SPEAKER_01:

Schools have a minimum number of hours that people need in order to apply. So the minimum requirement is what you absolutely have to have. Now, is it a good idea to go above and beyond the minimum? Yes, I think it's always a good idea to ask yourself, how can I go above and beyond the minimum? And if that means continuing to shadow the same person, I think that's great. I think it builds a relationship with that person. And maybe then you feel they've seen enough of you to even potentially write you a letter of recommendation. Now, by the way, do discourage if you've just shouted them one time and they don't know you very well, it, you know, it probably wouldn't be uh a very strong letter of recommendation. So, yes, you can start building relationships if you keep coming back to the same anesthesia provider. And I think that when you do exceed minimums, I think that that is a positive reflection of your drive, of your commitment, of your dedication. Keep in mind the more shadowing hours that you have, the more I would expect of you in an interview situation. And that's just the truth. So it would be more alarming to me as somebody interviewing you if you cannot answer a very basic anesthesia question. If you've shadowed for 75 hours in the OR, if you couldn't tell me what that white drug is that we push before general anesthesia, like if you can't name propofol, I would kind of wonder, well, was this person just shadowing for the hours? Or, you know, were they shadowing to actually try to learn something and further their understanding of the profession? And that's where shadowing is kind of a a two-sided coin. On one end, you know, it's it's required. And so you're trying to be competitive, you're trying to get more and more hours. But then think about the other side of the coin as to why is that a requirement in the first place? And it's a requirement so that you understand the profession, so that you know this is what you want to do, so that you start to learn, even if some of these uh anesthesia words, this anesthesia jargon. So if your number of hours go up, but your level of understanding and familiarity with the profession isn't also going up, there's a disconnect there. The admissions committee members can pick up on that. So just always keep in mind that with more hours, there's more expectation.

SPEAKER_00:

Mm-hmm. I did not ever really think about that, like about more hours is more expectation in terms of the interview. Cause what I was gonna share was that I had a delightful shadower who I would say we became sort of friends. Um, he was a standout candidate. Um, and I happened to know that about him after three or four shadowing interactions. And he kept coming to get, he won like a hundred plus hours because he thought that was gonna make him stand out. This was two years ago. And he ended up asking me to write him a letter of recommendation, which I feel like I could write a very strong letter of recommendation for him after the amount of time we spent together. He wasn't just shadowing me, it was like one of four CAAs at my at my previous surgery center. And then he ended up not getting in and asking me to write him a second letter of recommendation for this year. And I was like, actually, I can't write you that. Like my interaction with you was a year ago. It was very particular after this amount of shadowing and like the person I knew you to be like, I don't know you well enough now. After time has passed, I've moved on to a different job. So it was just kind of an interesting interaction where shadowing doesn't solve everything. A hundred hours of shadowing doesn't solve everything, is the moral of this story. And you know, it's just it's so many things, including shadowing, that will get you into AA school, you know?

SPEAKER_01:

Absolutely. It's about the big picture, and shadowing is just a piece of that.

SPEAKER_00:

Yes, yes. And it's just one of the pieces that pre-As cannot control. And so it, I don't know, what is it the biggest piece you cannot control? Maybe you can't, you know, uh, you can kind of study for the MCAT and the GRE and keep taking them, keep taking it. Shadowing is like you have to wait to be invited into the club a little bit, and you have to keep asking for an invite. Yeah, so I'm not surprised that it's the biggest question we get asked. And I do think there is benefit to hearing other people's stories, to obviously this episode, our previous episode, I will link to where we talk about shadowing, among other things. It was, was that a couple of years ago, Sarah, that we recorded together? I think so at this point. Yeah, I know. Time is going. It's been interesting because Sarah and I have sort of branched out as CAA entrepreneurs on a similar timeline. So so much has happened to us since then. So true. Um, yeah, and just I encourage everyone who's listening to, you know, share stories, ask upperclassmen, as Sarah said, um, reach out with intention, with the curiosity, and just really be sure that you're using a shadow experience to make sure you want to be a CAA. It is a two-way street, right? And the point of it is to know you want to do this.

SPEAKER_01:

You know, yes. Yes. I think that's a super important distinction. The point of shadowing is to know that this is the right profession for you and then to be able to articulate that to the admissions committee.

SPEAKER_00:

Okay. All right, Sarah, one more time. If people want to work with you, tell us again the best way to contact you.

SPEAKER_01:

I would love to show you how to get accepted to CAA school. The best way to connect with me is through my website. You can see my coaching and you can message me directly through that contact tab. You can also find me on social media. I am active on LinkedIn and I also am on Instagram at aspiring CAA underscore official.

SPEAKER_00:

Amazing. What's your handle on LinkedIn? Do we search for you like Sarah Whitfield or do we search for aspiring CAA or does it matter?

SPEAKER_01:

You can search for me specifically. I post under my personal account. So just search Sarah Whitfield. All right, awesome.

SPEAKER_00:

And I will put that all in the show notes so it's easy peasy for those who are listening. But all right, Sarah, thank you so much for your time. It's Halloween 2025 that we're recording this. Are you guys going trigger treating tonight?

SPEAKER_01:

Oh, definitely.

SPEAKER_00:

Yes, my my kiddos are very excited. Yes, yes. All right, well, I will talk to you soon, Sarah. Thanks for listening, everyone.

SPEAKER_01:

Thanks for having me. Bye.

SPEAKER_00:

Thanks for listening to Awakened Anesthetist. If this episode resonated with you, share it with a CAA friend, an AA student in your life, or a perspective, and let them know why you loved it. It's the most important thing you can do to support this podcast and its mission. You can always find more ways to connect with me and this CAA community at awakenedanesthetist.com, including an invitation to join season five Mindful Connections. These are free virtual gatherings open to anyone in our Awakened Anesthetist community. And while you're scrolling the website, check out my trusted CAA partners who make this podcast possible with a special thank you to my season five sponsor, Harmony Anesthesia Staffing. Talk soon.

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Mary Jeanne Roberts, CAA

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