Adri: Tiffany, I know reached out ⁓ and done this before successfully multiple Can you put together all those steps as an example of something that you've done when you requested?
Tiffany: Okay. So off of the framework that you gave, Adri, let's say I am a state academy. I would say, my name is [your name] Based in [your I'm a pre-anesthesiologist assistant, (spell it out) applicant in the 2027 CASAA cycle. have a background in [so-and-so]. I am working as [this]. ⁓ I amassed this many hours of patient care experience. I've reached to the nearest AA program or the local hospital or the anesthesia department. Either I haven't heard back or I was told they don't host observers. can travel within a few hours and I am flexible on schedule. I'm for an introduction to a CAA or anesthesiologist open to an observer. Any insight into a facility that established process would be helpful. any would be genuinely useful. I appreciate your time. Definitely say that you are very appreciative of their time because they don't have a lot of that. ⁓
Adri: Mm-hmm. And one thing I would add is please attach your resume. Doesn't matter if you don't have any patient care experience yet. That's the idea is we want the profession to grow, right? So it's okay if you're coming with an accounting background, ⁓ show that you are a professional, that you are prepared, that you have some sort of documentation and what your path is. ⁓ you
Tiffany: Yes. Mm. No.
Adri: On your resume, you can show that you're a member of your local pre-AA club, or maybe that you're an affiliate member of your state organization as well, and that could be really helpful. that's just a big, big difference than emailing them and saying, Hey, can I shadow anyone?
Tiffany: Yeah. they're like looking at this like, where do I start with you? ⁓ as opposed to, okay, you gave me all of logistics. I be able to help you. So you're lowering that barrier to that "yes" that we really want.
Adri: Yes. And so this last idea that I want to talk to you about, Tiffany, it can be a little sensitive, but this is something that we see as fellow pre-anesthesiologist assistant students. if we're seeing it, certified anesthesiologist assistants and program directors and other admissions committee members are seeing this. And this how you show up online, how you show in social media pages.
Tiffany: Mm-hmm. Mm, mm. Yes, these practicing CAAs and program affiliated professionals are in those groups. So when someone a very desperate cry hey, I'm frustrated. Please, please, someone, anyone, let me shadow. No one give me a chance.
Adri: Mm-hmm.
Tiffany: We get it. That frustration is so valid. We have been there. We know how it feels. but are ⁓ multiple well-known in the community saying when they see posts like this that, shadowing itself disrupts the CAA workflow. and at the end of the day.
Adri: Mm-hmm. We felt it.
Tiffany: The patient safety is what is incredibly important. Shadowing liability. It requires a clinician to take responsibility for you. The way that you ask signals whether you fully understand the magnitude of your ask.
Adri: Mm-hmm. when a post reads is somebody just please let in, it doesn't signal readiness for the profession. Even if you are on the other end absolutely ready, once again, that frustration and that increased stress, it's coming across as unprofessional.
Tiffany: Mm-hmm.
Adri: just ready,
Tiffany: Yeah. So this same person is commenting in this post, they can have amazing qualifications. like super determined. They can come across completely different depending on how they frame that question. So version signals desperation and the other can signal paired with professionalism. So how you navigate that pre-AA process is being read the second that you post it. this is a preview of how you'll handle pressure in training,
Adri: Mm-hmm.
Tiffany: In the room, in didactic training, everywhere that you go during AA school.
Adri: Exactly. There's a reason why professionalism is one of the key and core tenets of the anesthesiologist assistant profession. and we've mentioned this briefly before, but you may have to travel. further than you think. If every facility in your city has said no, like when I was living in Washington State. All the cities around me said shadowing in the operating room specifically. So I could shadow an anesthesiologist outside of the OR, but that doesn't necessarily help ⁓ trying to get inside OR shadowing hours. So it may be a four-hour drive. It may be a weekend trip. It may be flying across the but that shows persistence, dedication, that you're willing to budget your time and bide your time.
Tiffany: Mm-hmm. Yes.
Adri: Just like everything I feel in the pre AA world, taking our time and finding that joy in the journey, even though it's longer than we may want, that is part of the pre AA process. And if you're able to come through that with resilience, I think you come out a stronger person.
Tiffany: Yeah, and we've seen CAAs respond to a frustrated post saying, You're welcome to come shadow me. I'm in Tampa. This person was in Houston. That's the reality of a regionalized profession, unfortunately. That opportunity does exist. It just might not be at your zip code.
Adri: Mm-hmm. And that's not a failure. that's an okay. But it also means that like a plane ticket or train ticket or you know, gas costs and things like that. People do it. If you need to get it done, ⁓ you will find a way. If you've already posted something like this and you're hearing this and maybe a little embarrassed, don't worry.
Tiffany: Yeah.
Adri: Everyone starts somewhere and we can always improve. So we're giving you a framework that we've used to help us land shadowing. so hopefully the next time when you do make that ask, it may land a little differently or a little bit better.
Tiffany: Once have the yes, you are there to observe, like we You want to follow ⁓ every instruction immediately. Don't touch anything, nothing blue. Do not touch anything Don't touch anything that you have not been told to.
Adri: Mm-hmm.
Tiffany: I remember when I was shadowing, they were transporting the and there was someone missing to move the patient's legs, but
Adri: Mm-hmm. Mm-hmm.
Tiffany: knew role was to stay there as just an observer. I was simply a fly on the wall. ⁓ So stayed back and they the OR circulator went and helped. But as much as I wanted to I had to remember my role is to observe, is to shadow.
Adri: Mm-hmm. Mm-hmm. Mm-hmm. Yeah. other etiquette of things, You don't wanna be leaning on the med cart when an AA or an anesthesiologist needs to pull out drugs. Like you don't wanna get in the way of doing that. when you are in the operating room, you want body language show that you're engaged, that you're ⁓ listening, that you're paying attention. That means asking questions about things around getting curious about these things.
Tiffany: Mm-hmm.
Adri: And the person you're watching is going to respond to you so much better when you have that curiosity and those questions and that instinct to be able to show that you're an agreeable person to be with. If you're wanting to be in healthcare at all, your team needs to know that you are someone that is enjoyable to be around someone you spend a lot of time with and work and collaborate with. And a lot of that has to do with. how we communicate and how we come across. So being prepared in that way. And once again, read the book by Jeff Steiner. It will be very helpful.
Tiffany: Yes. And just Whitfield, aspiringCAA, has a great shadowing prep guide, where she talks about the shadowing etiquette. So we'll link that our show notes as well. But she does say, Your body language says everything. don't lean on don't cross your arms,
Adri: Mm-hmm. Mm-hmm.
Tiffany: don't take your phone out. if you do take notes on your phone, discuss it with the AA or whoever you're shadowing first. If the is tense, be quiet. Nobody ever got asked to leave for being too quiet. If you do have a question about something that was done during that moment, write it down. Wait until the situation has the tension a little bit and then you can ask your questions. Yeah.
Adri: Mm-hmm. Mm-hmm. Exactly. Exactly. guide really, really makes the invisible visible. So definitely we recommend that you read that. like Tiffany said, link is in our show notes. ⁓ Between is where more conversation tends to maybe happen. you can ask things that are related to the case that you just saw, or ask things about the case that is coming up if you have no idea, like you haven't started the day yet, or the first case hasn't started. there are so many ways to ask questions, instead of just saying, what's the hardest part of your job? That's a really vague question, as opposed to, hey, I noticed you did something with those dials over there. What is that machine? What does it do?
Tiffany: Mm-hmm.
Adri: Or how did it impact the anesthetic depth of the patient during the case? And why did you do that? what's the hardest part of the job? It's a really vague generic answer that anybody could ask but that second question is so specific to anesthesia.
Tiffany: Right.
Adri: It's going to give you more information about what you might be doing in this profession.
Tiffany: Yes. there are no stupid questions. if I could back and tell who first shadowed, I was so scared of asking questions because I thought, ⁓ my God, they're gonna think so dumb. I don't know what that basic thing does. But it shows that are engaged. shows that you genuinely curious and want to know more about the job and the profession. ⁓
Adri: Mm-hmm. Mm-hmm. Asking about what tools are called that they're using. may have exposure to these things, but it isn't gonna stick the first time around, So our memory degrades so much faster than you think it does. our to hold things in our very short-term memory brain is extremely, extremely fickle. And we may think that it's better than it So within 48 hours, you're gonna lose a lot of the details and specifics. So writing it down is encoding it into your brain in a much more efficient way. After you shadow, Write down everything that you remember, everything you saw, go through those shadowing notes and get out that Word document and type as fast as you can ⁓ so that you can remember and retain details so that a later.
Tiffany: Mm-hmm. Okay.
Adri: you can look back on those details,
Tiffany: Yes. Perfect. That was beautiful. Yes. ⁓ thing I'd like to say is make sure that you get your supervisor's contact information or just whoever you shadowed before you leave. I forgot to also mention, have them sign your shadowing forms. Bring your shadowing forms.
Adri: Mm-hmm.
Tiffany: And we emphasize get your contact before you leave. ⁓ just send a quick thank you email within 24 hours ⁓ again to express that professionalism and that courtesy. Three sentences, thank you, ⁓ one specific thing appreciated, ⁓ and hope stay in touch. That email is why someone remembers you when a second opportunity or even a letter of rec request comes in six months later.
Adri: Mm-hmm. Exactly. So Tiffany, just to kind of wrap this up, let's go through some of the key takeaways for today.
Tiffany: Yes. Okay. ⁓ So ⁓ key takeaways. CAAs practice in 24 jurisdictions. If you're one the 26 plus states, ⁓ the access problem is very structural, not personal. ⁓ VA facilities, AA programs, Department of ⁓ at local schools. ambulatories, surgery centers, all of are very real options.
Adri: Mm-hmm. Yeah. And another takeaway is when obvious routes fail, go lateral. look at all of those different areas. Look at your friends' friends, find friends in healthcare or in healthcare that you can reach out to and ask.
Tiffany: Yes, program open houses also are great. ⁓
Adri: you also want to structure your ask, have your clearance documents ready, have your resume ready, send that thank you within 24 hours, log every session the day it happens and get those shadowing forms prepared, ready to be signed and signed at the end of the day.
Tiffany: before your first shadowing day, read Anesthesia Made Easy by Jeff Steiner. Check out Sarah Whitfield's Shadowing Prep Guide on AspiringCAA.com. Both will be linked in the show notes. one concrete thing: if you have already sent shadowing requests that went unanswered, go back and look at what you sent. Would someone know who you are, what you've and what you're asking for when they read that?
Adri: Mm-hmm. Mm-hmm.
Tiffany: If not, rewrite it using the framework that Adrienne said. send it again. The message is part of the access problem and it's the part you can control.
Adri: Mm-hmm. And if you're just starting, build your documentation this week. Gather that resume. Gather that framework of who I am, what I'm doing.
Tiffany: Mm-hmm.
Adri: that sort of thing. It doesn't take a long time. Research the areas where you're interested in shadowing and find the documentation you would need beforehand to really show that you're prepared. So that if and when you do get that yes, you are ready
Tiffany: episode will be about what it looks like the pre-AA context, How it's distinct from clinical experience and shadowing and why programs keep mentioning it. So stay You don't want to miss it.
Adri: Mm-hmm. This is pre AA Pathways.
Tiffany: Thanks for listening. We'll see you next time.
Tiffany: Okay. So off of the framework that you gave, Adri, let's say I am a state academy. I would say, my name is [your name] Based in [your I'm a pre-anesthesiologist assistant, (spell it out) applicant in the 2027 CASAA cycle. have a background in [so-and-so]. I am working as [this]. ⁓ I amassed this many hours of patient care experience. I've reached to the nearest AA program or the local hospital or the anesthesia department. Either I haven't heard back or I was told they don't host observers. can travel within a few hours and I am flexible on schedule. I'm for an introduction to a CAA or anesthesiologist open to an observer. Any insight into a facility that established process would be helpful. any would be genuinely useful. I appreciate your time. Definitely say that you are very appreciative of their time because they don't have a lot of that. ⁓
Adri: Mm-hmm. And one thing I would add is please attach your resume. Doesn't matter if you don't have any patient care experience yet. That's the idea is we want the profession to grow, right? So it's okay if you're coming with an accounting background, ⁓ show that you are a professional, that you are prepared, that you have some sort of documentation and what your path is. ⁓ you
Tiffany: Yes. Mm. No.
Adri: On your resume, you can show that you're a member of your local pre-AA club, or maybe that you're an affiliate member of your state organization as well, and that could be really helpful. that's just a big, big difference than emailing them and saying, Hey, can I shadow anyone?
Tiffany: Yeah. they're like looking at this like, where do I start with you? ⁓ as opposed to, okay, you gave me all of logistics. I be able to help you. So you're lowering that barrier to that "yes" that we really want.
Adri: Yes. And so this last idea that I want to talk to you about, Tiffany, it can be a little sensitive, but this is something that we see as fellow pre-anesthesiologist assistant students. if we're seeing it, certified anesthesiologist assistants and program directors and other admissions committee members are seeing this. And this how you show up online, how you show in social media pages.
Tiffany: Mm-hmm. Mm, mm. Yes, these practicing CAAs and program affiliated professionals are in those groups. So when someone a very desperate cry hey, I'm frustrated. Please, please, someone, anyone, let me shadow. No one give me a chance.
Adri: Mm-hmm.
Tiffany: We get it. That frustration is so valid. We have been there. We know how it feels. but are ⁓ multiple well-known in the community saying when they see posts like this that, shadowing itself disrupts the CAA workflow. and at the end of the day.
Adri: Mm-hmm. We felt it.
Tiffany: The patient safety is what is incredibly important. Shadowing liability. It requires a clinician to take responsibility for you. The way that you ask signals whether you fully understand the magnitude of your ask.
Adri: Mm-hmm. when a post reads is somebody just please let in, it doesn't signal readiness for the profession. Even if you are on the other end absolutely ready, once again, that frustration and that increased stress, it's coming across as unprofessional.
Tiffany: Mm-hmm.
Adri: just ready,
Tiffany: Yeah. So this same person is commenting in this post, they can have amazing qualifications. like super determined. They can come across completely different depending on how they frame that question. So version signals desperation and the other can signal paired with professionalism. So how you navigate that pre-AA process is being read the second that you post it. this is a preview of how you'll handle pressure in training,
Adri: Mm-hmm.
Tiffany: In the room, in didactic training, everywhere that you go during AA school.
Adri: Exactly. There's a reason why professionalism is one of the key and core tenets of the anesthesiologist assistant profession. and we've mentioned this briefly before, but you may have to travel. further than you think. If every facility in your city has said no, like when I was living in Washington State. All the cities around me said shadowing in the operating room specifically. So I could shadow an anesthesiologist outside of the OR, but that doesn't necessarily help ⁓ trying to get inside OR shadowing hours. So it may be a four-hour drive. It may be a weekend trip. It may be flying across the but that shows persistence, dedication, that you're willing to budget your time and bide your time.
Tiffany: Mm-hmm. Yes.
Adri: Just like everything I feel in the pre AA world, taking our time and finding that joy in the journey, even though it's longer than we may want, that is part of the pre AA process. And if you're able to come through that with resilience, I think you come out a stronger person.
Tiffany: Yeah, and we've seen CAAs respond to a frustrated post saying, You're welcome to come shadow me. I'm in Tampa. This person was in Houston. That's the reality of a regionalized profession, unfortunately. That opportunity does exist. It just might not be at your zip code.
Adri: Mm-hmm. And that's not a failure. that's an okay. But it also means that like a plane ticket or train ticket or you know, gas costs and things like that. People do it. If you need to get it done, ⁓ you will find a way. If you've already posted something like this and you're hearing this and maybe a little embarrassed, don't worry.
Tiffany: Yeah.
Adri: Everyone starts somewhere and we can always improve. So we're giving you a framework that we've used to help us land shadowing. so hopefully the next time when you do make that ask, it may land a little differently or a little bit better.
Tiffany: Once have the yes, you are there to observe, like we You want to follow ⁓ every instruction immediately. Don't touch anything, nothing blue. Do not touch anything Don't touch anything that you have not been told to.
Adri: Mm-hmm.
Tiffany: I remember when I was shadowing, they were transporting the and there was someone missing to move the patient's legs, but
Adri: Mm-hmm. Mm-hmm.
Tiffany: knew role was to stay there as just an observer. I was simply a fly on the wall. ⁓ So stayed back and they the OR circulator went and helped. But as much as I wanted to I had to remember my role is to observe, is to shadow.
Adri: Mm-hmm. Mm-hmm. Mm-hmm. Yeah. other etiquette of things, You don't wanna be leaning on the med cart when an AA or an anesthesiologist needs to pull out drugs. Like you don't wanna get in the way of doing that. when you are in the operating room, you want body language show that you're engaged, that you're ⁓ listening, that you're paying attention. That means asking questions about things around getting curious about these things.
Tiffany: Mm-hmm.
Adri: And the person you're watching is going to respond to you so much better when you have that curiosity and those questions and that instinct to be able to show that you're an agreeable person to be with. If you're wanting to be in healthcare at all, your team needs to know that you are someone that is enjoyable to be around someone you spend a lot of time with and work and collaborate with. And a lot of that has to do with. how we communicate and how we come across. So being prepared in that way. And once again, read the book by Jeff Steiner. It will be very helpful.
Tiffany: Yes. And just Whitfield, aspiringCAA, has a great shadowing prep guide, where she talks about the shadowing etiquette. So we'll link that our show notes as well. But she does say, Your body language says everything. don't lean on don't cross your arms,
Adri: Mm-hmm. Mm-hmm.
Tiffany: don't take your phone out. if you do take notes on your phone, discuss it with the AA or whoever you're shadowing first. If the is tense, be quiet. Nobody ever got asked to leave for being too quiet. If you do have a question about something that was done during that moment, write it down. Wait until the situation has the tension a little bit and then you can ask your questions. Yeah.
Adri: Mm-hmm. Mm-hmm. Exactly. Exactly. guide really, really makes the invisible visible. So definitely we recommend that you read that. like Tiffany said, link is in our show notes. ⁓ Between is where more conversation tends to maybe happen. you can ask things that are related to the case that you just saw, or ask things about the case that is coming up if you have no idea, like you haven't started the day yet, or the first case hasn't started. there are so many ways to ask questions, instead of just saying, what's the hardest part of your job? That's a really vague question, as opposed to, hey, I noticed you did something with those dials over there. What is that machine? What does it do?
Tiffany: Mm-hmm.
Adri: Or how did it impact the anesthetic depth of the patient during the case? And why did you do that? what's the hardest part of the job? It's a really vague generic answer that anybody could ask but that second question is so specific to anesthesia.
Tiffany: Right.
Adri: It's going to give you more information about what you might be doing in this profession.
Tiffany: Yes. there are no stupid questions. if I could back and tell who first shadowed, I was so scared of asking questions because I thought, ⁓ my God, they're gonna think so dumb. I don't know what that basic thing does. But it shows that are engaged. shows that you genuinely curious and want to know more about the job and the profession. ⁓
Adri: Mm-hmm. Mm-hmm. Asking about what tools are called that they're using. may have exposure to these things, but it isn't gonna stick the first time around, So our memory degrades so much faster than you think it does. our to hold things in our very short-term memory brain is extremely, extremely fickle. And we may think that it's better than it So within 48 hours, you're gonna lose a lot of the details and specifics. So writing it down is encoding it into your brain in a much more efficient way. After you shadow, Write down everything that you remember, everything you saw, go through those shadowing notes and get out that Word document and type as fast as you can ⁓ so that you can remember and retain details so that a later.
Tiffany: Mm-hmm. Okay.
Adri: you can look back on those details,
Tiffany: Yes. Perfect. That was beautiful. Yes. ⁓ thing I'd like to say is make sure that you get your supervisor's contact information or just whoever you shadowed before you leave. I forgot to also mention, have them sign your shadowing forms. Bring your shadowing forms.
Adri: Mm-hmm.
Tiffany: And we emphasize get your contact before you leave. ⁓ just send a quick thank you email within 24 hours ⁓ again to express that professionalism and that courtesy. Three sentences, thank you, ⁓ one specific thing appreciated, ⁓ and hope stay in touch. That email is why someone remembers you when a second opportunity or even a letter of rec request comes in six months later.
Adri: Mm-hmm. Exactly. So Tiffany, just to kind of wrap this up, let's go through some of the key takeaways for today.
Tiffany: Yes. Okay. ⁓ So ⁓ key takeaways. CAAs practice in 24 jurisdictions. If you're one the 26 plus states, ⁓ the access problem is very structural, not personal. ⁓ VA facilities, AA programs, Department of ⁓ at local schools. ambulatories, surgery centers, all of are very real options.
Adri: Mm-hmm. Yeah. And another takeaway is when obvious routes fail, go lateral. look at all of those different areas. Look at your friends' friends, find friends in healthcare or in healthcare that you can reach out to and ask.
Tiffany: Yes, program open houses also are great. ⁓
Adri: you also want to structure your ask, have your clearance documents ready, have your resume ready, send that thank you within 24 hours, log every session the day it happens and get those shadowing forms prepared, ready to be signed and signed at the end of the day.
Tiffany: before your first shadowing day, read Anesthesia Made Easy by Jeff Steiner. Check out Sarah Whitfield's Shadowing Prep Guide on AspiringCAA.com. Both will be linked in the show notes. one concrete thing: if you have already sent shadowing requests that went unanswered, go back and look at what you sent. Would someone know who you are, what you've and what you're asking for when they read that?
Adri: Mm-hmm. Mm-hmm.
Tiffany: If not, rewrite it using the framework that Adrienne said. send it again. The message is part of the access problem and it's the part you can control.
Adri: Mm-hmm. And if you're just starting, build your documentation this week. Gather that resume. Gather that framework of who I am, what I'm doing.
Tiffany: Mm-hmm.
Adri: that sort of thing. It doesn't take a long time. Research the areas where you're interested in shadowing and find the documentation you would need beforehand to really show that you're prepared. So that if and when you do get that yes, you are ready
Tiffany: episode will be about what it looks like the pre-AA context, How it's distinct from clinical experience and shadowing and why programs keep mentioning it. So stay You don't want to miss it.
Adri: Mm-hmm. This is pre AA Pathways.
Tiffany: Thanks for listening. We'll see you next time.
