Health Career Education in Two-Year Colleges - Challenges and Changes Presented by Carolyn O’Daniel, EdD Dean of Allied Health and Nursing Jefferson Community & Technical College Louisville, Kentucky Barbara Jones, EdD President South Arkansas Community College El Dorado, Arkansas

Objectives By the end of this presentation, participants will:  Recognize emerging challenges for two- year health career educational programs.  Learn how some sister colleges are coping.  Identify promising strategies for addressing those challenges. American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Allied Health Education  97,206 students in various allied health professions and fields graduated from colleges, universities, medical schools, proprietary schools and hospital based programs in 2002  58,068 of these students (63%) graduated from two-year colleges and schools American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Democracy’s College/Educational Ellis Islands  59% of new nurses are from associate degree programs  63% of other health care workers are also prepared by community colleges.  84% of EMTs are prepared by community colleges. Source: AACC American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Allied Health Education in Two-Year Colleges Radiographer/Radiologic Technologists  48.5% graduated from community colleges  Respiratory Therapists  85% of Respiratory Therapists graduate from accredited programs in two-year colleges  Paramedic, Emergency Medical Technicians  96% receive training and education in two-year colleges  Medical Assistants  88% of accredited Medical Assistants programs in two- year colleges American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Health Care Workforce Shortage Areas  Respiratory Therapy (14.2% vacancy rate)  Occupational Therapy (15.7% vacancy rate)  Physical Therapy (14.6% vacancy rate)  Bernard Hodes Group Report, 2003  Clinical Laboratory Sciences (9.5% vacancy rate)  Imaging Sciences (Radiographers, Sonographers, Nuclear Medicine Technologists, Radiation Therapists) (<7.0 % vacancy rate) ASRT survey, 2006 American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Challenges to Health Career Preparation at the Two-Year Level  Clinical Practice Site Availability  Clinical Placement Requirements  “Degree Creep”  Access to Funding and Other Resources American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Crowding of Clinical Practice Sites  Unrestrained proliferation of programs and preferential placement of BS students can lead to:  Increasing competition for clinical placement sites,  Sub-optimal clinical exposure and practice for students, and  More student observation – less student experience. American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Crowding of Clinical Practice Sites  Effects of crowding might be offset by:  Evening, night and week-end scheduling  Alternative site development  Human Patient Simulation American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Clinical Placement Requirements  CPR Certification  TB Testing  Immunization Records  Federal Criminal Background Checks  Drug Screening  Physical Examinations American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Health Professions that have increased degree requirements  Audiology (Doctorate)  Occupational Therapy (Masters)  Pharmacy (Doctorate)  Physical Therapy (Masters/Doctorate)  Physician Assistant (Baccalaureate)  Pharmacy Technician (associate)  Respiratory Therapy (associate)  Surgical Technology (associate) American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Health Professions considering increased degree requirements  Dental Hygiene  Dietetics  Nuclear Medicine Technology  Nursing  Respiratory Therapy  Others American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Impetus for Degree “Creep”  Increased educational and skill requirements of the profession  Increased access for patients  Increased recognition of profession  Increased salary  Profession?  Accreditation? American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Adverse Effects of Escalating Degrees  Threaten research  Cause faculty to “scramble” for degrees, as many faculty members do not have doctoral degrees  Cause a reduction in the number of new graduates during time of workforce shortage  cause only more wealthy to seek degrees because of time and cost  Create a need for more assistants and technicians  Create a decline in job satisfaction and morale if advanced skills and knowledge underutilized. ~ Siler, W. & Randolph, D. (2006). A clinical look at clinical doctorates. The Chronicle Review American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Impact of Degree “Creep”  Workforce shortages exacerbated  Lack of capacity in colleges in universities (faculty, facilities, funds, clinical sites)  Lack of credentialed faculty to deliver instruction  Decrease in workforce diversity as inaccessible to minorities and economically disadvantaged  Increase in tuition  Increase in time in college  Access to health care limited in rural areas American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Considerations to Degree “Creep”  Review data and evidence to support increased educational levels  Assess educational preparation and performance abilities an requirements  Assess job demands and requirements as prescribed by healthcare facilities  Determine demographic characteristics of health professionals at various degree levels  Consider career pathways and expanded functions gained through educational and practical experience ~ transitional degrees American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Associate Degree Nursing  Two hospitals in large Baltimore-DC area healthcare system (Med Star) announced that they will no longer accept 2-year RN graduates as employees or 2-year RN students for clinical practice.  Another 2-hospital system in Baltimore (LIfeBridge Health) stopped hiring 2-year RN graduates several years ago. When Community Colleges participate in career fairs, they are asked not bring any information about nursing programs.  Several major hospitals in Louisville, KY are preferentially placing BSN students clinically, and one is no longer hiring ADN graduates. American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

Where are the breaks on this run- away train? American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans

“NN2 Response to Degree Creep” American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans  NN2 Position Paper on Career Pathways - Access & Success - Multiple Entry and Exit Points - Seamless Articulation  Respiratory Care Roundtable  Formation of New Organization – NN2RC - Advocacy for 2-Year Programs

New Respiratory Care Organization (similar to NoADN) American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans  provide advocacy for the two-year education level  offer an alternative professional organization that is supportive of associate degree entry-level therapists  serve as a sponsoring organization for accreditation, if needed  give a unified voice to the previously “silent majority”

CoARC Memorandum to Communities of Interest Regarding 2015 Recommendations November 13, 2010 American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans... CoARC was neither consulted, nor did it approve, the use of this Standard in the presentation of the 2015 recommendations.... CoARC will continue accrediting and serving associate degree programs. While the CoARC supports the development of academic advancement pathways for the associate degree graduate in gaining baccalaureate and graduate degrees, the members of the Commission continue to strongly support the associate degree as the minimum degree required for entry to the profession.

American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans National Network of Associate Degree Respiratory Care

American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans Access to Funding/Resources  State and Local Appropriations 2-Year Colleges = $10,324 million 4-Year Colleges = $62,180 million (AACC, “08)  Advocacy for Federal Funding Most goes to bachelors and graduate programs.  Infrastructure Needs  Clinical Instructors/Preceptors  Accreditation Standards Mandated ratios, secretarial support, release time

American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans Strategies for Surviving and Thriving:  Human Patient Simulation  Local Partnerships (Secondary Career Ed, Clinics, Foundations, Hospitals, etc.)  Coordinated Clinical Planning  Shared Resources  Career Pathways  Efficiency / Cost Effectiveness Cost of AH/N training for one year: Community College$2272 University$5836

American Association of Community Colleges Annual Convention, April 9-12, 2011, New Orleans Questions (and hopefully answers)