June 01, 2025 12:00 AM

For the past 20 years, nurses have earned their place as the most trusted healthcare professionals in the U.S. Trust isn’t something you get and keep without work. Like a contract, it’s only renewable if you keep living up to the promise. Every patient interaction is an opportunity to build and strengthen it, or just as quickly, lose it. As healthcare evolves, so must the ways providers earn and maintain trust. The public’s health—our collective responsibility—depends on it.

The role of continued certification in maintaining trust

This is where continued certification and longitudinal assessment comes in. For certified registered nurse anesthetists (CRNAs), the maintenance of our certification, and all the components of the continued certification process, reflect how seriously we take our credential. It’s proof to patients—and ourselves—that we are committed to not only maintaining our knowledge, but also to ongoing learning, continuous practice improvement and strategic adaptation in an ever-changing healthcare environment.

The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) took a significant step toward these goals nearly a year ago with the launch of our Maintaining Anesthesia Certification (MAC) Program. Our MAC Program is unique in nursing because it incorporates longitudinal assessment (LA), a continuous knowledge assessment format, allowing healthcare professionals to demonstrate their robust practice knowledge throughout each four-year certification maintenance cycle. This approach is unlike traditional point-in-time assessment, as LA offers continuous evaluation and provides immediate feedback to each response. Single point-in-time testing/retesting, in contrast, may only evaluate a practitioner’s knowledge once every four to eight years.

The flexibility and impact of MAC

In the months since the launch of MAC, the program has proven invaluable. Not only does it support CRNAs’ efforts to stay on top of advancements in anesthesia care, but it also provides the flexibility busy nurse anesthetists need to balance professional development with real-world responsibilities. As the only advanced practice nursing certification corporation to utilize this state-of-the-art methodology, and one of only a few non-physician certification corporations to implement longitudinal assessment in this matter, I believe that NBCRNA is setting a new benchmark for continued certification.

When we first launched MAC, we didn’t set out to create another program simply to fulfill compliance requirements. We recognized that the healthcare world doesn’t stop to allow individuals to access the learning and knowledge evaluation that is so important for safe, competent care. Neither can the evaluation programs that exist to ensure provider knowledge interrupt busy CRNAs who need to be providing critical anesthesia care. The flexibility built into the MAC Program—breaking knowledge down into manageable, quarterly intervals—has been one of the keys to its success. This approach allows CRNAs to integrate ongoing learning evaluation into their busy life and work routines without it feeling like another career burden. From the feedback we’ve received, it’s clear the impact is real: CRNAs are no longer overwhelmed preparing for a single, daunting exam every eight years. Instead, they’re engaging in meaningful assessments with immediate feedback, in a regular and ongoing manner, making their certification requirements feel more manageable, relevant and pertinent.

Protecting patient safety

It’s not just about checking boxes and keeping up with new technologies. The real value, the thing that sets the MAC Program apart from most others, is how ongoing knowledge assessments, in tandem with lifelong learning, tie back directly to patient safety. Not just doing something for the sake of meeting a requirement, but assessing knowledge to guide continuing professional education, and ultimately improving the care patients receive.

While part of the focus is on testing CRNAs on the latest practice information, equally important is helping them see the areas they may want to focus future learning and ongoing practice development. Applying timely intervention to help them ensure they maintain the knowledge and skills to handle whatever clinical situations come their way. From understanding emerging practices in pain management to navigating new medical devices, comprehensive knowledge assessments and meeting continued certification requirements provide CRNAs with insight, experiences and strengths so they can be ready for what they see in today’s clinical environment.

A new standard for healthcare certification

Certification has a positive and lasting impact on the people who depend on the certified practitioners. The ongoing process of assessment, learning and adapting builds trust with the public served by CRNAs. A recent patient survey from NBCRNA backs this statement up— 82% of respondents said knowing their CRNA was committed to ongoing certification made them feel more confident in their care. This is why MAC is so important. It’s a necessary step toward ensuring nurse anesthesia professionals remain capable, informed and confident for whatever the future holds.

As healthcare evolves, continuous certification utilizing longitudinal assessments to ensure the necessary knowledge of new and emerging technologies and treatments should become a gold standard for all providers. This goes far beyond meeting minimum requirements—it reinforces the trust patients place in us to care for them. Each year, CRNAs perform their critical work more than 58 million times across the country. This is where the "C" for “certified” in CRNA matters most. By committing to continuous, rigorous certification, CRNAs demonstrate their expertise and ensure that the trust patients place in them is upheld, one safe, high-quality interaction at a time.

About the author

John Preston, DNSc, CRNA, APRN, FAANA, FNAP, FAAN, is the Chief Executive Officer of NBCRNA. John has over 36 years of experience in nursing and advanced practice nursing, of which 25 were spent leading nurse anesthesia education and professional development.