CRNA vs DNP & DNAP

September 26, 2023

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Certified Registered Nurse Anesthetists (CRNAs) are one of the fastest-growing fields for nurses and one of the most in-demand careers. According to the Bureau of Labor Statistics (BLS), CRNAs are expected to see a 38% increase in career growth from 2022-2032, and the average CRNA salary is $203,090 per year! But as of January 2022, in order to become one, you need either a DNP or DNAP doctorate degree. To help you choose between the two options, we’re breaking down the differences.

There are two common types of doctoral degrees for aspiring CRNAs: the Doctorate of Nurse Practice (DNP) and the Doctorate of Nursing Anesthesia Practice (DNAP).

What is a DNP Degree?

The DNP is a doctor of nursing practice that is rooted in clinical practice and can be earned by any individual who holds an MSN degree. The DNP is obtained through a school of nursing, and has its curriculum is set by the American Association of Colleges of Nursing (AACN). Individuals who do not have a degree as a nurse anesthetist but a Master’s degree in another nursing-related field can obtain a DNP.

What is a DNAP Degree?

The DNAP degree is a professional practice degree in nurse anesthesia, which focuses on the utilization of research findings for evidence-based clinical practice, education, and/or administration/business management related to nursing anesthesia.

It is approved through the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which focuses on the utilization of research findings for evidence-based clinical practice, education, and/or administration/business management related to nurse anesthesia.

What’s the Difference Between a DNP and a DNAP?

The American Nurses Credentialing Center (ANCC) accredits DNP programs while the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) approves DNAP programs, which are specially designed for nurse anesthetist students. Nurses with other Master’s degrees can earn a DNP, while ONLY CRNAs can earn a DNAP.

Most doctoral-level degrees require around 100 credits and take about 36 months to complete. This is slightly different for CRNA programs that award DNP or DNAP degrees upon completion. The programs typically are the same length with only a few changes to the practicum aspect.

The main difference between these two degrees is that some institutions do not recognize the DNAP as a terminal degree — meaning they don’t consider it the highest degree in the field. A DNP is considered a terminal degree for any advanced practice nursing field.

This primarily affects those who wish to obtain a university faculty position, as this may have a bearing on tenure eligibility. If you’re seeking to use your doctorate for practice, however, this shouldn’t hinder your career prospects.

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DNP and DNAP Programs

DNP and DNAP programs can be completed both online and in class. To pursue a DNP or DNAP, individuals already would have completed a traditional or accelerated BSN program and have an MSN. There are some programs that allow students to go from BSN to DNP. These programs are longer than a traditional DNP program because they combine everything from an MSN degree program and a DNP program. To apply for a DNAP program, individuals must have an active CRNA license.

A DNP or DNAP program completion can take roughly one to four years. This will depend on the program and whether it is being completed on a full-time or part-time basis. Programs are typically between 30-40 credit hours and 1,000 clinical hours. A percentage of clinical hours earned during an MSN program can transfer to some programs.

Nurses who have earned their CRNA with an MSN can go back to earn their DNP or DNAP.

DNP & DNAP Classes

Individuals should expect to take the following classes:

DNP Curriculum

The American Association of Colleges of Nursing released a position statement for the basis of a curriculum for a DNP program:

Scientific Underpinnings for Practice
Organizational and Systems Leadership for Quality Improvement and Systems Thinking
Clinical Scholarship and Analytical Methods for Evidence-Based Practice
Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care
Health Care Policy for Advocacy in Health Care
Interprofessional Collaboration for Improving Patient and Population Health Outcomes
Clinical Prevention and Population Health for Improving the Nation’s Health
Advanced Nursing Practice

Requirements for DNP and DNAP programs will vary but most will require the following:

MSN degree from a regionally accredited higher education institution and a nationally accredited school of nursing
Valid CRNA certification
GPA of at least 3.0 or higher in the Master’s program
Current, unencumbered nursing license
RN experience
Letters of Recommendation (both academic and professional references)
Official Transcripts (from all previous colleges/universities)
Current Resume/CV
Goal statement
Personal essay
Advanced Practice Registered Nursing license at the state level
Interview with faculty
Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS) if applicable
Application fee

>> See Accredited CRNA Programs in Every State

What is a CRNA?
- A certified registered nurse anesthetist is an advanced practice nurse who administers anesthesia for surgery and/or other medical procedures.
What is the average salary for CRNAs?
- The median pay for a certified registered nurse anesthetist as of May 2021 was $195,610 per the BLS.
Where can a CRNA work?
- Colleges and Universities
- Research
- Textbook author
- Public Health/Government Health Policy
- Legislation
- Hospital administration
- Medical and surgical hospitals
- Critical access hospitals
- Mobile surgery centers
- Outpatient care centers
- Offices of plastic surgeons, dentists, ophthalmologists, pain management specialists, and other medical professionals
- U.S. military medical facilities

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CRNA programs, regardless of whether an individual will earn their DNP or DNAP, are extremely time-consuming. Students are highly discouraged from working as they can expect to spend about 60 hours a week studying and preparing for classes on top of the time spent in class. During the practicum, students have call time and work full-time hours while still taking classes. Some programs will offer a stipend to students. Additionally, some programs do not allow students to work because of how rigorous the program is.

After graduating from an accredited nurse anesthetist program, individuals will be able to take their National Certification Exam (NCE) administered by the National Board Certification and Recertification for Nurse Anesthetists (NBCRNA).

The NCE is,

Test takers have three hours to complete the exam, which includes questions related to:

Basic sciences (25 percent)
Equipment, instrumentation, technology (15 percent)
Basic principles of anesthesia (30 percent)
Advanced principles of anesthesia (30 percent)

The recertification process for CRNAs can be confusing. It is a combination of continuing education hours, practice hours, and examinations. CRNAs will have to recertify both their state-level APRNs as well as their CRNA certification.

The NCE recertification is broken down into two-year blocks. CRNAs will have to complete a two-year check-in and by year four are expected to complete the following,

60 Class A CE Credits
40 Class B Credits
4 CPC Core Modules (optional)
NO CPC Examination

During the second four-year cycle the requirements are,

60 Class A CE Credits
40 Class B Credits
4 CPC Core Modules
First CPC Examination (does not affect certification)

The CPC examination is a new requirement that is starting to be implemented. According to the NBCRNA, the first CPC exam (mandatory by 2024 or 2025) will be used to familiarize CRNAs with the exam content/format and will not impact certification. The second CPC exam (mandatory by 2032 or 2033) must be passed in order to recertify.

APRN recertification will vary by state but is typically every 2-4 years and includes,