This qualitative study was designed to develop a grounded theory that would provide an understanding of what certified registered nurse anesthetists (CRNAs) and their colleagues value and expect from the nurse anesthesia profession's recertification process. The grounded theory was based on analysis of the data obtained from a total of 27 CRNAs during four face-to-face focus group sessions. Analysis of the data from mailed surveys completed by 21 CRNA associates also contributed to the grounded theory. Rank order scaling of the survey activities identified three recertification activities CRNA associates felt would provide assurance of CRNA competency: (1) Hands-on simulation testing, (2) continuing medical education (e.g., interactive workshops), and (3) written exams. Focus group participants indicated that hands-on simulation experience and testing provided the most assurance of CRNA competency. Analysis of the focus group and survey data resulted in themes, which established that a recertification process fostering a commitment to professional lifelong learning and providing an assurance of CRNA competency was needed.

The resultant grounded theory, based on voices from within the nurse anesthesia profession, supports the development of a systematic view of the profession's recertification process. The grounded theory can inform the nurse anesthesia profession as it seeks to develop a recertification process that assures CRNAs' competency. It provides direction for the profession and aids in the determination of future actions which would assure CRNA competency. The presentation of the theory in three distinct formats using narrative statement, table, and visual illustration provides the foundation for a strong competency-based recertification design for the nurse anesthetist profession. The grounded theory may also provide direction for other medical specialties and non-medical professions (e.g., legal, business, and education) as they look towards providing needed assurances of competency to the public, patients, clients, students, and governmental regulatory agencies.