Using Distance Learning to Strengthen Access to Rural Healthcare Career Pathway Programs

A key challenge to builders of career pathway programs is creating entry points for adults with multiple academic and skill levels. The National College Transition Network (NCTN) has designed accelerated career pathways with adult education, community college and workforce systems and knows first-hand that this challenge is intensified for pathways in rural areas. Geographic distance, limited childcare options, lack of public transportation, and adult basic education class schedules contribute to this intensity.

Located in the very rural region of Southwest Minnesota, Southwest Adult Basic Education’s (Southwest ABE) Pre-Healthcare Bridge program uses distance learning programming to complement classroom instruction to address these challenges.  The region is roughly the size of Vermont. The largest city has 12,000 residents with most communities having a population of less than 1,000.

A unique aspect of this Pre-Healthcare Bridge program is that it engages the students at the point when they show interest in Certified Nursing Assistance (CNA) training without their needing to wait for a cohort to begin their study. The program uses Northstar Digital Literacy Assessment to ensure that students can benefit from online learning. Once enough students are participating in the online Pre-Healthcare Bridge program, a CNA training cohort is formed. Southwest ABE uses the Learner Web, a State-approved site. (Students’ time on the Learner Web is considered as “seat time” for classroom instruction.) The Pre-Healthcare Bridge program includes self-paced online coursework with additional independent learning activities to prepare students for CNA training, support from a Navigator to provide assistance with personal and financial barriers, and college readiness support from the community college. The Navigator position is funded by the Southwest Private Industry Council, a partner of the Southwest MN Workforce Development Board.

Students start their study by completing online assessments in reading, math, and digital literacy to determine their skill needs. Program staff determined that students need to attain a CASAS reading score of 230-235 to be successful in the CNA class. Minnesota West Community and Technical College sends an individual student an online career assessment to help to assure that this career is a good fit. These assessments help the instructor steer learners to activities that address their needs. Students work concurrently on pre-healthcare content through their Learner Web assignments. These self-paced activities involve students in increased levels of self-management as they work through the lessons. Additionally, with online tools, the instructor can check how many hours each individual has invested in activities. Students who prefer not to use online tools are invited to come to the classroom for help.

If students lack either sufficient reading or digital literacy skills (or both) to benefit from the program, the ABE staff can help them.  Students can go to the Southwest ABE’s computer lab during hours of operation. The local library has the Southwest ABE website bookmarked on their computers to allow students easy access to these digital tools, plus the library waives the one-hour time limit for students working on school material.

Students work with the Navigator to determine any educational barriers that may exist (e.g., assisting with tuition, childcare, transportation, integrated instruction, etc.). The Navigator builds a relationship with each student to support them in overcoming those barriers. Navigators also help students use the resources of the local Career Center to complete a resume, take a creative job search class and a financial education class, and register in the state job bank.

The Pre-Healthcare Bridge program was developed and is managed as a collaborative effort among Southwest ABE, Southwest Minnesota Private Industry Council, and the Minnesota West Community and Technical College. The program gives rural students a starting point and a path to follow to make sure they get the assistance needed to be successful in the CNA training. Ninety-eight percent of the students participating in this Pre-Healthcare Bridge program earn their CNA, and about seventy-five percent of these completers are employed as CNAs.


RESOURCES

Mortrude, Judy. (2016). Defining On-Ramps to Adult Career Pathways. Center for Law and Social Policy. Center for Law and Social Policy. Washington, DC.

World Education E-Learning PD. Navigating Pathways to Opportunities: Comprehensive Student Supports. Facilitated online course.

World Education EdTech Center. Tech Tips for Teachers. Hands-on ideas for integrating technology into adult education.

Building Community and Strengthening Health

The National College Transition Network at World Education, Inc. is committed to improving the quality and accessibility of health services career pathways for adults. As many of us know, a popular entry point onto this career pathway is the highly visible Certified Nursing Assistant (CNA) position. The emerging Community Health Worker (CHW) profession is another option that draws on the strengths and service interests of many adult learners.

Students enrolled in spring 2016 Foundations of Health course at Holyoke Community College.

Becoming a Community Health Worker (CHW) can be the start of a very meaningful career in public health for adult learners.  Coming from a multitude of backgrounds with a starting pay range of $14 to $22 per hour, members of this emerging profession build community connections to support good health, and may provide informal counseling and screening. Their duties resonate with many of the experiences, values and qualities of adult learners.

The Massachusetts Department of Public Health defines Community Health Workers as public health workers who apply their unique understanding of the experience, language, and/or culture of the populations served in carrying out duties such as:

  • Providing culturally appropriate health education, information, and outreach in community-based settings, such as homes, schools, clinics, shelters, local businesses, and community centers;
  • Culturally mediating between individuals, communities, and health and human services, including actively building individual and community capacity;
  • Assuring that people access the services they need;
  • Providing direct services, such as informal counseling, social support, care coordination, and health screenings;
  • Advocating for individual and community needs.

As an innovative pioneer, Professor and Project Manager Janet Grant launched the Holyoke Community College (HCC)   Community Health Worker Certificate Program in January 2016.  Twenty-five participants, mostly incumbent workers from Massachusetts, have enrolled in the program during its first year.  In order to receive this certificate, students must earn 26 college credits of required classes and complete 125 hours of field experience. Upon completing their academic certificate some students may choose to continue their studies, or some may choose to do so at a later time, at HCC for an associate degree in Foundations of Health. With this A.S. degree, they can advance to a four-year school and earn undergraduate and graduate degrees in health care administration or public health.  The development of this program is funded as part of the $20 million Department of Labor Guided Pathways to Success in STEM (GPSTEM) initiative managed by Massasoit Community College (MA). Janet Grant’s vision is that the CHW certificate program becomes a successful and sustainable academic program at Holyoke Community College educating 15-20 highly skilled students per semester that employers will readily hire upon completion of their academic certificate.

Janet is a well-seasoned public health professional committed to building community and strengthening health.  She shared that, “Public health equates to social justice. Developing this program, engaging with employers and working one-on-one with students allows me the opportunity to have an impact by sharing my lessons with new people entering the field.”  The program’s connection with the New American Program of Jewish Family Service of Western Massachusetts is an example of this impact.  New American Program staff welcomes hundreds of new refugees into the greater Springfield, MA area from countries such as Somalia, Nepal, Iraq, and Afghanistan. They guide these new refugees’ effort to access medical care; secure housing, jobs, and schooling for their children; and receive financial assistance.  Five staff members from this organization were among the first in HCC’s Community Health Worker Certificate Program by participating in a class called Core Competencies for the Community Health Worker.  To learn more about this successful collaboration, click here.

What are some lessons from the first year of the Holyoke Community College CHW program?

According to Janet, the importance of developing a structured program was validated.  Most of the students entered with a strong work ethic and commitment to their community; however, they needed  professional training.  Participating in the program is a great way for students to strengthen their knowledge and skills to augment their other strengths.  Also, it is important to build in time for students to network with employers. This increases the likelihood of being hired in the best setting for him/her.

Another big lesson is that it takes time to align the college’s institutional requirements with the requirements of employers.  It is well worth the time to make the alignment, but expect challenges. For example, when placing a student in a practicum, one needs to think about the health clearance that is needed (i.e., immunizations).  The clearance for the college is likely to be different than that of the employer.  Each system may require similar documentation, but may not accept each other’s validation. This means that it will likely take longer to negotiate a practicum contract with employer partners than one expected. All of this needs to be done in a way that minimizes students’ frustrations.

Janet believes that it is very much worth having patience when dealing with this challenge. The HCC CHW program now has seven agencies signed on as practicum sites. She suggests when looking for practicum sites that one considers refugee resettlement community organizations.  They have been a great match for students, in her experience.

Another important alignment is with the competencies (currently in draft form) of the Massachusetts Department of Public Health (DPH).   Staying connected to the DPH’s work as it designs a state-wide CHW certificate is critical for the development of the Holyoke Community College’s Community Health Worker Certificate Program.

Resources

City College of San Francisco, Community Health Worker Program

ExploreHEALTHCareers.Org – Community Health Worker

Rural Health Information Hub, Community Health Workers Toolkit                      Includes examples of states with CHW programs and their certification approach

College and Career Readiness

Introduction

Adult literacy has been at the heart of World Education’s work since it was established in 1951 in India and founded the Literacy House upon the urging of Mohandas Gandhi. Sixty-four years later, while gains have been made in many parts of the world, the need for literacy education remains great:  there are nearly 800 million adults and out-of-school youth in the world with limited or no literacy and numeracy.  In the U.S., adults’ basic skills are falling behind those of other developed nations.  For the first time, the skills of young adults are lower than those of their parents’ generation.  At the same time, people need even more different types of literacies to move ahead in their lives than in 1951. World Education’s approach to literacy education and how we define it has evolved and expanded commensurate with the skills adults need to navigate systems, pursue opportunities, and address problems successfully in their personal lives, work, and communities.

To commemorate the Adult Education and Family Literacy Week, in this series of blog posts World Education/ U.S. staff share their views on what literacy means to us today and how we are helping to advance adult education in multiple ways.  Our list is not comprehensive: there are not enough days in a week to feature all the types of literacy youth and adults need in today’s world!  Please join the dialogue.


College and Career Readiness

How can we improve adults’ opportunities to attain a family sustaining wage as the need for postsecondary education and training, and industry-recognized credentials continues to grow?

Approximately two-thirds of adults age 25 or older do not persist in postsecondary education long enough to earn a credential, and many others do not even enroll (Camille and Siebens, 2012). These adults are less likely to succeed in the labor market than those with postsecondary credentials, earning up to 40 percent less than those who earn an associates degree (Baum, Ma, and Payea, 2010). Future labor market demand is expected to favor workers with higher levels of education (Sommers and Franklin, 2012). For adults with low literacy and numeracy skills and those learning English as a foreign language, the transition to and completion of postsecondary education and training can be difficult. They face a range of challenges, including a lack of academic preparation for college, and knowledge of and access to financial aid and other supports.

Given these challenges, how does World Education support the strengthening of college and career readiness for adults? World Education believes that college and career readiness consists of four interconnected elements: personal, career, college knowledge, and academic.  All of these elements must be addressed for adults to succeed in postsecondary education and training.   The National College Transition Network (NCTN) at World Education works to increase the capacity of adult education systems, programs, and educators to address all four areas of college and career readiness.

CCR

Learning Outside the Classroom Counts

Reinvigorating Prior Learning Assessment (PLA) is emerging as a priority across the US; although, it remains an underutilized strategy for accelerating college completion and the attainment of industry-recognized credentials by adults deemed low-skilled by academic assessments. The aim of this article is to introduce PLA as a way to strengthen the bridge to college for adults enrolled in career pathways and Adult Basic Education transition programs. A second article will be published this summer (2015) to discuss the impact of PLA for these adult learners based on the National College Transition Network’s (NCTN) recent work to strengthen, expand, and promote PLA as an effective acceleration and retention strategy.

The term prior learning is used to describe the knowledge and skills one acquires while living one’s life: working, participating in employer training programs, serving in the military, studying independently, and volunteering or doing community service. PLA measures the college-level learning one has acquired outside of a college setting. This learning may be assessed and credit awarded through a PLA process established by a college to validate the college-level skills many adults possess.

PLA research shows that this strategy can lead to improved retention and completion rates. Students also learn the value of their experience, which gives them confidence to complete their degrees. By validating the knowledge and skills one has already acquired, the PLA process can also have a motivating effect for some students. When students earn their credentials faster, they save time and money. A Council for Adult and Experiential Learning (CAEL) study of 48 postsecondary institutions, Fueling the Race to Postsecondary Success, found that 56% of the students who earned some credit through prior learning completed a degree within seven years, compared to only 21% of students who received no credit for prior learning. Latino students are 7 ½ times more likely to persist if they receive some credit via PLA. PLA is an effective tool for helping veterans to translate military training to civilian credentials

Further, PLA is encouraged in workforce training programs. For example, the U.S. Department of Labor’s Training and Employment Guidance Letter 15-10 (December 15, 2010) lists PLA as a strategy “to help adults and dislocated workers obtain academic credit for independently attained knowledge and skills, thereby accelerating the process of credential attainment.”

The use of PLA does not obviate the need to strengthen adults’ academic skills; it validates the college-level skills and knowledge many adults possess. Credit earned for prior learning can help recover lost time for those whose path to college credit is delayed by placement into developmental education. Gaining credit through PLA has also been shown to boost the confidence of returning adults and contribute to their success in degree attainment.

The onus of implementation lies on colleges, however, adult college transition programs need to be informed about PLA to raise adult learners’ awareness that prior learning, training, and military experience matter and may translate into college-level credit. Advisors need know how to identify potentially eligible adults to assist them to pursue PLA as part of the college enrollment process. Instructors need to engage adults in examining their prior learning through reflection, readings, writing, and discussions. There are, or course, challenges for adult learners. These challenges are consistent with the types of college and career readiness skills that these education providers work to address in their program curricula.


NOTEWORTHY

NCTN partnered with the Council for Adult Experiential Learning (CAEL) and the National Council for Workforce Education (NCWE) with funding from SkillWorks to produce Environmental Scan of Prior Learning Assessment Policies and Practices. This report provides recommendations on how PLA policies and practices might be strengthened, expanded, and promoted as an effective acceleration strategy in creating bridges to college completion and job attainment for low-skilled adults in the Metro Boston area. You can read the report here.

Musings on Collaborative Leadership

Effective adult education administrators realize the importance of forging partnerships with other organizations to better meet students’ needs. For example, characteristics of a strong adult education-college partnership include relationships with appropriate people in the college who can advocate for and deliver services to adult students. These partnerships take time to develop and are characterized by a high degree of coordination of services (Gittleman, 2005).

Partnerships by their very nature imply collaboration. Collaborative leadership focuses on the skills, qualities and knowledge needed to successfully cross organizational boundaries and achieve results through resources outside one’s control. It is a leadership style particularly useful for operational managers who lead in the “middle zone” across organizational boundaries with multiple peers and direct reports. What qualities does one need to cultivate to be this type of leader? Madeleine Carter, writing for the Center for Effective Public Policy as part of research project funded by the United States Department of Justice and State Justice Institute, defines five qualities of a collaborative leader:

  1. Willingness to take risks
  2. Eager listeners
  3. Passion for the cause
  4. Optimistic about the future
  5. Able to share knowledge, power and credit

Program administrators need to cultivate these qualities as they cultivate partnerships and as they work with teachers and other staff to develop program goals, curriculum and materials, and professional development plans. It is a balancing act that needs to align the program with the needs and goals of adult learners, external partners, and funders. In addition, adult educators often need to insert themselves strategically into a work group or process in order to be a part of emerging partnerships. This may require one to develop a sixth quality: assertiveness.

By its very nature, collaboration tends toward disorder at times. It is therefore challenging and unpredictable. One cannot always predict the specific outcomes with the trial-and-error, experientially driven nature of collaboration. The ability to produce important, concrete programmatic outcomes through collaborative strategies is the mark on an outstanding educational administrator.

In consideration of the needs of program administrators, World Education provides professional development on educational leadership for adult educators. An additional way to support program administrators’ efforts to build outstanding and effective programs will be available in 2013 when the National College Transition Network launches two online courses on innovative leadership. Course topics will include: building engagement across organizational boundaries and functions, selecting and mentoring effective instructors and staff, leading marketing and recruiting efforts, developing partnerships; helping to mobilize funding sources, and assessing operational capacity. Stay tuned.