Bridging the Gap: Longitudinal Assessments in Healthcare Practitioner Education

Starting out as a Certified Registered Nurse Anesthetist (CRNA), I remember stepping into the operating room for the very first time, both prepared and curious about how my education would guide me through real-life patient care challenges.  
 
The journey to become a CRNA is demanding, beginning with a nursing degree and then critical care experience — usually in a fast-paced environment, such as an intensive care unit. From there, CRNA trainees enter rigorous graduate programs focused on the science of anesthesia, mastering topics like physiology and pharmacology, and spending countless hours in clinical settings to refine their skills alongside experienced CRNAs and anesthesiologists. This hands-on training prepared me for a wide range of patient care needs, everything from routine cases to complex surgeries.  
 
This foundation of knowledge and experience propelled my CRNA career forward, and I am grateful for the time I spent both in an educational setting and in clinical practice.  
 
Connecting Knowledge to Practice 
Despite the thorough preparation in nurse anesthesia programs, there’s often a gap between theoretical knowledge and practical application for CRNAs. I believe bridging this gap is key to professional growth. This learning journey doesn’t end after graduation—it continues as we adapt and apply our knowledge in dynamic settings. While traditional education lays a solid foundation, real-world clinical practice demands continuous learning and flexibility. 
 
This belief is what prompted me to become Chief Credentialing Officer at the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). I wanted to help further the professional development of CRNAs and connect the education CRNAs learn in school to their actual day-to-day practice. 
 
I am dedicated to promoting lifelong learning, all with the goal of elevating patient care quality and safety. I am focused on strengthening the CRNA credential and reinforcing patient trust, which is why the implementation of longitudinal assessment is so important to me. This continuous evaluation process helps bridge the gap between academic knowledge and practical application. 
 
Longitudinal Assessments in Professional Development 
Longitudinal assessments follow healthcare professionals over time, adapting to changes in best practices and new clinical insights. Unlike one-time exams, which capture only a snapshot of knowledge, these unique assessments provide ongoing learning opportunities that mirror the realities of clinical practice. 
 
Studies indicate that continuous assessments enhance long-term retention far better than traditional exam-based methods, which often lead to repetitive review cycles. This method isn’t just about closing knowledge gaps—it transforms how practitioners demonstrate proficiency and apply what they’ve learned in real-time settings.  
 
An NBCRNA study found that these assessments support lifelong learning for CRNAs, offering continuous feedback that allows participants to improve over time. The results of the study showed that CRNAs performed better as they received feedback and learned from their mistakes. This data led NBCRNA to adopt a longitudinal assessment approach in our Maintaining Anesthesia Certification (MAC) Program. By creating a supportive learning environment, we encourage CRNAs to grow, which ultimately leads to improved patient care. 
 
Imagine receiving personalized feedback based on assessment performance—an opportunity to identify and address knowledge gaps before they affect patient care. This feedback extends beyond scores, as it provides detailed insights into areas of strength and opportunities for improvement. For example, a CRNA might receive targeted recommendations related to anesthetic dosing or patient monitoring techniques, which could then be addressed through workshops, online modules, or training tailored to individual needs. 
 
The MAC Program is about more than just passing an exam; it supports CRNAs as they evolve in their practice. With continuous evaluation, CRNAs can refine their knowledge and prepare for new challenges. The ongoing support and personalized feedback allow us to grow with the complexities of patient care, ultimately enhancing anesthesia practice and patient safety. 
 
Creating a Culture of Continuous Improvement in Certification 
Transitioning to a system that values longitudinal assessments requires a shift within healthcare. Traditional certification processes have relied on high-stakes exams that often invoke feelings of stress and pressure. By rethinking what it means to be a competent healthcare provider, we recognize the limitations of these traditional models. Ongoing assessments help us establish a framework that prioritizes both knowledge and adaptability in response to evolving clinical demands. 
 
The MAC Program exemplifies this shift, offering a structured yet flexible assessment pathway that empowers CRNAs to guide their learning journeys. With real-time feedback, CRNAs can adjust their focus based on performance metrics, fostering a culture of lifelong learning that benefits both practitioners and patients. By enhancing our standards, NBCRNA set a new benchmark in continued certification, sending a message to other certifying bodies: investing in practitioners is ultimately an investment in healthcare. 
 
Becoming and maintaining oneself as a skilled healthcare provider is a nonlinear path filled with challenges and opportunities for growth. Each stage of a CRNA’s career brings unique hurdles, from managing complex patient histories to staying current with medical advancements. With longitudinal assessments, we equip CRNAs at every career stage with the tools needed to navigate this ever-evolving field confidently. 
 
References 
1.    American Board of Medical Specialties, (2024) “What is longitudinal assessment?” https://www.abms.org/assessment-development-and-delivery/what-is-longitudinal-assessment/#:~:text=The%20longitudinal%20assessment%20evaluation%20process,repeatedly%20studying%20the%20same%20material. 
2.    Choudhry, S. A., Muckle, T. J., Gill, C. J., Chadha, R., Urosev, M., Ferris, M. & Preston, J. C., (2024) “Transforming Assessments of Clinician Knowledge: A Randomized Controlled Trial Comparing Traditional Standardized and Longitudinal Assessment Modalities”, Practical Assessment, Research, and Evaluation 29(1): 7. doi: https://doi.org/10.7275/pare.2028 

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