Introducing Michelle Gonzalez, Ph.D., CRNA

Jan. 14, 2019 | Michelle Gonzalez, Ph.D., CRNA, joined UAMS on Jan. 2 to guide the formation and accreditation of the new nurse anesthesia educational program in the College of Nursing. She comes to UAMS from the University of Maryland School of Nursing, where she served as an assistant professor and simulation coordinator, and performed clinical practice as a Certified Registered Nurse Anesthetist (CRNA) at the University of Maryland Medical Center.

Gonzalez earned a bachelor’s degree in nursing from North Park College in Chicago in 1986. She earned a master’s in nursing from DePaul University, also in Chicago, and concurrently, a diploma in nurse anesthesia in 1998. Over the following eight years, she earned another bachelor’s degree in Chinese Nutrition and a master’s in Oriental Medicine. In 2016, she completed her doctoral degree in Educational Leadership at Trident University International in Cyprus, Calif.

Gonzalez has been a practicing nurse anesthetist since 1998, beginning at Cook County Hospital in Chicago. She continued in that role working in hospitals and private practice in Illinois, Texas and Maryland before joining the faculty of the University of Maryland Medical Center in 2010 and the University of Maryland School of Nursing in 2013. During that time, she also served in the U.S. Navy Reserve, Department of Anesthesia, rising to the rank of commander and heading the department.

 

What factors influenced your decision to join UAMS to direct the CRNA program?

I have been a CRNA for more than 20 years and a nurse for more than 30. In that time, I have come to enjoy (and miss) working in environments that tend to be smaller or community based, and I always envisioned myself moving back to that type of environment. But life happens, and I kept moving right along with it. Having spent the last 15 years moving around with my military spouse, I have had the opportunity to live and work in a variety of areas. I also have learned a great deal about teaching and education. I decided that this was the time to start exercising those muscles, so to speak. I have been told that I am a great teacher “with the patience of Job” and an engaging leader, and I have heard more than once that I should be a program director. I wasn’t ready then, but I am now!

When I was invited to UAMS for an interview, I was incredibly grateful for the opportunity. I felt welcomed from the moment I arrived at my departure airport, where I struck up a conversation with a gentleman heading home to Little Rock. He inquired if I had been to Little Rock before, and when I shared the reason for my trip, he began to talk about what a great place UAMS is to work and what a great city Little Rock is becoming. During my two-day interview process, I was extremely impressed by the collegiality of those present and returned home pleasantly exhausted and thrilled at this potential opportunity! When I received “the call” from Dean Cowan, I was a wreck (in a good way) with all sorts of possibilities running through my head. Tears flowed, family huddled, wine was poured, calls were made, ideas were hatched… and here I am – thrilled, excited and humbled to be a part of this fantastic journey!

 

What are some of the specific challenges of getting the nurse anesthesia educational program started?

Starting an educational program from scratch can be a formidable task, as there are many processes that must take place before we can actually begin to admit students. Specific challenges will be those related to obtaining accreditation from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), the financial impact of obtaining the necessary equipment, and ensuring adequate facilities for the conduct of educational endeavors for students. It’s very important to earn buy-in from the community and engagement of early adopters and supporters of this program, and we are grateful to them. Their commitment of time will be an enormous help in overcoming many challenges and making this program a success from day one. I won’t be creating this program alone.

As in any new endeavor, there may be some unforeseen challenges as well, and those will be addressed as they arise. However, I have heard an incredible amount of support for and excitement about this program and look forward to doing the work to make it a success. Being part of a team with a group vision to create this program has been an incredible experience. I meet new people every day and learn about them, their roles at UAMS and how we can work together. I share information on the history of CRNA practice and the trends in nurse anesthesia education. I have offered information for further learning about the CRNA profession and what we are going to accomplish for Student Registered Nurse Anesthetists at UAMS-together!

 

What are the specific challenges of getting accreditation?

In order to provide details on the accreditation process, it is important to understand some of the history of accreditation for nurse anesthesia educational programs. The American Association of Nurse Anesthetists (AANA) began accrediting nurse anesthesia educational programs in 1952 and formed the COA in 1975 in response to changes from the U.S. Office of Education. Each nurse anesthesia program must undergo accreditation by the COA. Additionally, the COA is recognized by the United States Department of Education and the Council for Higher Education Accreditation as an accrediting agency for nurse anesthesia education programs (Council on Accreditation of Nurse Anesthesia Educational Programs, 2018).

As such, the COA has a rigorous and comprehensive list of requirements to meet nationally established standards of academic quality. Each program must meet these initially and periodically for ongoing accreditation. The time commitment to this process is extensive, requiring not only documentation, but an inspection of the facilities, interviews with faculty, staff and students (with re-accreditation). We will be under a microscope while the reviewers are present, similar to a hospital accreditation only more extensive (and exhaustive), but all with good reason: to ensure an environment supportive and capable of a high-quality education for students.

 

How will you meet all those challenges?

I think the key to meeting any challenge is the ability to respond in an objective manner. We have a goal, we have a process we must adhere to become accredited, but as human beings, we also have a great deal of passion and emotion. This emotion can sometimes prevent us from seeing the reality that may be around us. When looking from an objective vantage point, the true reality may have a chance to materialize, differing perspectives may be seen or heard, and the bigger picture may emerge more clearly.

I really am a very curious person, and I find that asking for others’ perceptions is the first order of engagement. I often ask others around me what their perspectives are, and I welcome feedback to ensure I am getting multiple viewpoints. This is always a work in progress, but I believe this helps me to overcome any challenge that may come my way. In particular, I do not rely only on my own perspective when it comes to things that will impact others. I intend to continue this throughout this process and beyond. It’s an opportunity to grow and develop my own knowledge while sharing that knowledge with others so that they may do the same.

 

How do you plan to make sure the UAMS College of Nursing nurse anesthesia educational program not only gets started on the right foot but also succeeds long term?

I am fortunate to have recently gone through the accreditation process and have some familiarity with the “to do list.” Additionally, I have a large community of resources to tap into. Many of my colleagues have been through this process as well, so I feel I always have someone I can ask questions of. Additionally, in talking with colleagues who have been reviewers for the COA, I have come to firmly believe that the COA has high standards for student education to foster quality practitioners. This, in turn, benefits our patients. This is no different than the expectations that I have when I work with students in the clinical setting. I want to foster their growth and encourage critical thinking so that they may adapt their ability to provide quality care to any patient, anytime, anywhere.

I think this will be beneficial in the short and long term. However, I believe an essential element to the success of any program is to evaluate the program in an ongoing manner, formally and informally. Taking information from evaluations will allow for changes to be made that will improve the program for each successive cohort of students. Incidentally, this is a requirement of the COA. As students evaluate courses, faculty and the program, it is imperative to address any deficiencies, not only for continued accreditation, but for student benefit. My goal is to be proactive, to prevent deficits from occurring. However, realistically, as with anything new, there will likely be growing pains. My responsibility to this program and UAMS is to ensure that I am continually looking for ways to enhance the program with assistance from those around me. I am not perfect. I don’t have all the answers. But I know that I am not doing this by myself, and I do know how to ask for help when I need it or the program needs it.