1. Degree “Creep” ~ What is the Impact? Barbara R. Jones, Ph.D. Dean of Instruction Louisiana Delta Community College

2. Health Professionals ~Bureau of Labor Statistics  As the largest industry in 2004, health care provided 13.5 million jobs—13.1 million jobs for wage and salary workers and about 411,000 jobs for the self-employed.  8 out of 20 occupations projected to grow the fastest are in health care.  More new wage and salary jobs—about 19 percent, or 3.6 million—created between 2004 and 2014 will be in health care than in any other industry.  Most workers have jobs that require less than 4 years of college education, but health diagnosing and treating practitioners are among the most educated workers.  ~http://www.bls.gov/oco/cg/cgs035.htm Management, business, & financial 4.4% Physicians & Surgeons (3.2%), Optometrists, Dentists, Chiropractors, Podiatrists, Psychologists 5.1% RNs15.2% LPNs4.5% Allied health professionals (therapists, technologists, and technicians) 18.5% Allied Health service occupations (assistants and aides) 31.8% Office and administrative support 18.2%

3. Allied Health Education  Taught in 2-year and 4-year higher educational programs in private, public, proprietary and hospital-based programs  43.7 % of all accredited allied health educational program are located in two-year community colleges and schools.

4. 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

5. Allied Health Education in Two-Year Colleges  Some of the fastest growing occupations in health care include  health information technicians,  dental hygienists,  respiratory therapists,  radiologic technologists,  cardiovascular technicians, and many other occupations that require a two year associate degree or certificate

6. Allied Health Education in Two-Year Colleges  Radiographer/Radiologic Technologists  48.5% graduated from community colleges  Registered Respiratory Therapist and Certified 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  62.4% of accredited EMS programs are in two-year colleges  Medical Assistants  88% of accredited Medical Assistants programs found in two- year colleges  Nursing  60% of all new RNs are Associate Degree prepared

7. 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

8. Health Care Workforce Shortage Areas  RN turnover rate in acute care hospitals-21.3%.  RN vacancy rate - 10.2%  critical care units (14.6%)  medical-surgical care (14.1%) ~Acute Care Hospital Survey of RN Vacancies and Turnover Rates in 2000 (January 2002), American Organization of Nurse Executives www.aone.org www.aone.org  Buerhaus and colleagues reported in JAMA (June 14, 2000) that the US will experience a 20% shortage of nurses needed by the years 2020, translating to a shortage of more than 400,000 RNs. U.S. Bureau of Labor Statistics

9. Health Care Educator Shortage  U.S. nursing schools turned away qualified applicants in 2003 due to insufficient faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. ~ Southern Regional Board of Education (SREB), February, 2002 February, 2002

10. What is Degree “Creep”  Degree expansion  Degree migration  Upward degree progression ~ Increased degree or credential requirements for entry into a field or profession.

11. Professional Degrees  Dentistry  Medicine  Osteopathy  Podiatry  Veterinary  Chiropractic  Optometry  Law  Theology

12. 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)

13. Health Professions considering increased degree requirements  Dental Hygiene  Dietetics  Nursing (NY, NJ, MI, NM)  Respiratory Therapy  Others

14. Health Professions with advanced practitioner clinical degrees  Clinical Laboratory Sciences  Nursing  Diagnostic Medial Sonography  Advanced certifications in Radiography (CTR, MRI, Mammography)  Advanced certifications in Dental Hygiene (Expanded Functions)

15. Impetus for Degree Creep  Increased educational and skill requirements of the profession  Increased access for patients  Increased recognition of profession  Increased salary  Profession?  Accreditation?

16. Adverse Effects of Advanced 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 ~ Siler, W. & Randolph, D. (2006). A clinical look at clinical doctorates. The Chronicle Review

17. Realities of American Healthcare  Insurance companies pay for service provided, not educational level of the provider

18. Data to support increased educational requirements

19. 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

20. 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

21. Degree “Creep” ~ What is the Impact? Barbara R. Jones, Ph.D. Dean of Instruction Louisiana Delta Community College bjones@ladelta.cc.la.us