Surgical Assisting — Evolution of a Profession
When a need arises, it often happens that multiple responses may occur in differing times and locations. The development of surgical assisting nationally as an independently recognized profession is certainly example of such an evolutionary process.
Certified Surgical Assistants (CSA)
In 1979, a group of surgical assistants formed the Virginia Association of Surgical Assistants, created a job description, developed standards of practice and recognized the need for education. Subsequently, the Eastern Virginia Medical School housed the program, and with the assistance of Norfolk General Hospital’s Department of Surgery, developed a certification examination.
Results from a survey indicated that many practicing surgical assistants were unrecognized. Four years later, the Virginia Association of Surgical Assistants became the National Surgical Assistant Association (NSAA in 1983). The credential awarded by NSAA is the Certified Surgical Assistant (CSA). Currently, there are 1,250 CSAs practicing today.
Certified Surgical First Assistants (CSFA)
Closely paralleling the Virginia organization, the surgical assistant career for Certified Surgical Technologists developed during a meeting held at the 1984 AST National Conference in Los Angeles, California. Two years later, the First Assistants Committee was formed to gather information and develop a formal job description. In 1987, AST hosted a meeting of organizations interested in the role of nonphysician first assistants. Representatives from the American College of Surgeons (ACS), Association of periOperative Registered Nurses (AORN), American Academy of Physician Assistants (AAPA), and the American Association of Surgeon Assistants (AASPA), attended. Ultimately, the group determined that each organization would establish standards and guidelines for its own members.
In 1988, the AST House of Delegates passed a position statement that included the first general definition of the role of the surgical first assistant. During these formative years, four separate surveys were administered that results in the creation of a detailed job description that was approved in 1990.
Several committees were then formed. One was assigned to develop a formal surgical first assisting curriculum and, after examining the existing programs of other organizations, developed requirements for student eligibility, curriculum content, program length and qualifications. The first Core Curriculum for Surgical First Assisting was published in 1993.
The early 1990s saw the launch of certification. In 1991, The AST Board of Directors and a committee of the Liaison Council on Certification for the Surgical Technologist (LCC-ST), now the National Board of Surgical Technology and Surgical Assisting (NBSTSA), studied the feasibility of developing a certifying examination for surgical first assistants. Their efforts culminated in the first surgical assisting examination offered in 1993.
Also, in the early 1990s, efforts to institute a program accreditation process led in time to the establishment of a CAAHEP-accredited surgical first assisting program in 2003. Others followed and today there are 10 accredited programs and nearly 1,700 CSFAs.
Surgical Assistants – Certified (SA-C)
The American Board of Surgical Assistants (ABSA) was founded in 1987 in Colorado and functions as a national credentialing organization. ABSA requires formal training as a prerequisite for certification and documented performance as a surgical assistant in the clinical setting as a requirement for recertification. Today, more than 1,400 SA-Cs are practicing.
Overall, there are nearly 5,000 surgical assistant practitioners among the three credentials now working in the operating room, and the challenges confronting health care will only demand that more surgical assistants enter the field to address the needs.