(Also click here to see other historical media)The United States Army Graduate Program in Anesthesia Nursing (USAGPAN), based at Fort Sam Houston, TX, has roots dating back to World War I. Officially organized educational programs in Army Nurse Anesthesia began nearly 70 years ago at Walter Reed General Hospital, Washington, D.C. and the Army Regional Hospital, Fort Jackson, South Carolina; from these programs came the first Certified Registered Nurse Anesthetists (CRNAs). By the end of 1960s there were six independent Army schools of nurse anesthesia. As well the first Master’s Program in nurse anesthesia was established in 1969 by Ira Gunn and affiliated with the University of Hawaii.
The Army Nurse Corps consolidated nurse anesthesia training in 1970 at William Beaumont General Hospital, El Paso, TX, however this was not university affiliated. During the early 1970s, COL Marion Waterhouse and LTC Mary Cavagnaro began to actively investigate university affiliation. But that did not materialize until the 1980s. In 1977, the program moved to its current location at Fort Sam Houston, TX and the first program director was LTC Joseph Rando.
In 1981, in large part due to the efforts of COL Sarah A. Haliburton, the program became the United States Army Graduate Program in Anesthesia Nursing as it became affiliated with the State University of New York at Buffalo. Graduates were now awarded a Master’s Degree upon completion. During the years that followed graduates of USAGPAN still received a Master’s Degree, however the university affiliations changed:
1986 to 1992 – Texas Wesleyan
1993 to 2001 – University of Texas at Houston Health Science Center
2006 to Present - Northeastern University
USAGPAN will begin its first DNP class with those students entering in June of 2012.
USAGPAN is unique as it trains Army, Air Force, and Civilian Veteran’s Affairs students. In 2000, the United States Air Force began sending students to USAGPAN. In 2004, Veteran’s Affairs followed allowing students to enter. Clinical Phase II training is conducted all over the country. Our clinical sites are as follows:
Tripler Army Medical Center, Hawaii
Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA
Carl Darnall Army Medical Center, Fort Hood, TX
William Beaumont Army Medical Center, El Paso, TX
Madigan Army Medical Center, Fort Lewis, WA
Womack Army Medical Center, Fort Bragg, NC
Brooke Army Medical Center, San Antonio, TX
David Grant Air Force Medical Center, Travis AFB, CA
Charlie Norwood VA Medical Center, Augusta, GA
The mission of USAGPAN is to produce clinicians educated in the complexity of practice at the doctoral level and competent in the unique skills of anesthesia nursing. USAGPAN graduates, both military and civilian, are prepared to function as a leader advocating for quality patient care in time of peace, and when necessary, in time of war, civil disorder, natural disaster or humanitarian missions. USAGPAN training is one of the premier nurse anesthesia programs nationwide offering high quality and autonomous training in general and regional anesthesia.
Phase I USAGPAN has 4 CRNA PhD faculty with backgrounds in Pharmacology and Neuroscience and 1 RN PhD faculty with a background in Physiology. As well in Phase I, there is 1 DNP CRNA, 3 MSN CRNA, and 1 RN MSN faculty. All didactic instruction is conducted by this dedicated faculty. The faculty hallway is behind the student classroom making student/faculty interaction seamless. In Phase II, each Phase II site has a MSN CRNA Program Director, a MSN CRNA Assistant Program Director, and a MSN CRNA Senior Clinical Instructor. The low faculty/student ratio yields an atmosphere where students are closely observed throughout the training process.
During Phase I of the program, USAGPAN has 3 state of the art high-fidelity simulation operating theaters, of which 1 simulates an austere forward surgical team experience. The simulation program and curriculum has 1 fulltime instructor and 1 fulltime person for logistics support. As well the program offers the students the following:
The Accutouch Endoscopy Simulator for FOB simulation
“Harvey” Cardiopulmonary Patient Simulator
3 GE Regional Ultrasound Machines for nerve imaging during Phase 1 and well as the blue phantom to practice needle guidance.
The robust simulations program at Phase I has greatly enhanced student learning and has eased their transition into the clinical Phase II. For images of our simulation equipment please refer to www.usagpan.org.
During Phase II, one of the great assets is the practice model. CRNA practice in the military is defined by AR 40-68 and promotes independent CRNA practice in Military and VA Treatment Facilities. As a result, the training environment promotes an autonomy that is very unique when compared to the civilian experience. The day of a USAGPAN SRNA is also unique when compared to most civilian institutions. USAGPAN SRNAs have mandatory “morning reports” in which they present their daily cases to the Staff CRNAs and MDs. In these sessions, key concepts and techniques related to their individual cases for the day are reinforced. It is a tool that greatly enhances learning. Another asset is a dedicated ultrasound machine specifically for the SRNAs at each clinical site and thus graduates have, on average, placed over half of their PNBs with ultrasound guidance.
USAGPAN’s hard work has not gone unnoticed, in February 2008, USAGPAN received the Army Surgeon General’s Excalibur Award to honor its team and organizational performance and excellence in stimulating best practices. Additionally, in 2011, USAGPAN was rated #1 in the nation according the US News and World Report for top schools for graduate nurse anesthesia training. In conclusion, USAGPAN continues to provide high quality education in pursuit of our mission.