Health-care and medical pathways have been among the fastest growing and most popular choices for evolving high school career education programs for much of the last decade, and the pandemic is accelerating demand.
The challenge has been: how to provide future medical professionals with the hands-on and on-site experience they need at a time of social distance and school closures.
Health and medical pathways have proven useful in part because they are so diverse—spanning careers from doctors and nurses to paramedics, nutritionists, and even forensic medical examiners—but also because the earnings premium for more education can be particularly high in the health field. A 2020 analysis of Bureau of Labor Statistics data by the Georgetown University Center on Education and the Workforce found health workers average $63,000 a year in earnings, but those with a bachelor’s degree earn a third more ($76,800) than those with a two-year degree ($49,200), and more than double the income of workers with only a high school diploma ($36,600).
Health care, like most career fields, took a massive hit in the immediate wake of the coronavirus, with 1.5 million health-care jobs lost from February to April of last year, according to industry reports . But as the virus spread, health care lost fewer jobs and bounced back more quickly than the U.S. labor market as a whole; by this past October, unemployment in the health field was 2.8 percent, less than half that of other fields.
In part, that’s because many communities already needed more medical workers and had started working with schools to grow their own. In rural Lawrence County, Ky., the need for medical workers predated the current crisis.
“Our local hospital … they’re struggling so much with just getting nurses there. They offer a $10,000 signing bonus to any nurse that will sign on—for [registered nurses] and even for [licensed practical nurses] and the two-year associates, they have a signing bonus for them, too—and they still don’t have all their positions filled,” said Robbie Fletcher, the superintendent of Lawrence County, Ky., public schools, which has both nursing and biomedical dual-credit pathways at Lawrence County High School.
In a nationally representative survey of 1,060 educators in late January, 55 percent of teachers told the EdWeek Research Center they have seen more students express interest in health-care careers since the start of the pandemic, and nearly 40 percent of teachers reported they had made a bigger effort to encourage their students to enter the health-care field. By contrast, about 13 percent of teachers reported the pandemic had made their students more reluctant to pursue those frontline jobs, and only 1 percent of teachers reported trying to dissuade their students from a health-care path.
The economic fallout from the pandemic has hit young female workers harder than their male counterparts, and recent studies suggest health pathways may be key to helping young women stay on track to college and career in an uncertain economy.
For example, a 2020 evaluation of California’s $500 million career pathways initiative (launched in 2014), found it was associated with 23 percent lower high school dropout rates. Study author Sade Bonilla of the University of Massachusetts Amherst noted that this was driven by more female students choosing to stay in school. Because the “health-care sector entry-level roles are traditionally dominated by female workers,” Bonilla said, “this intervention may provide schools with an approach for engaging female students in [career-technical education] pathways.”
In some states such as Ohio, high school seniors working in apprenticeships or internships in fields considered “essential workers,” including health care, were allowed to continue working during general state quarantine orders last spring.
But for many students and programs, the school closures and social distancing brought the work-study and job-shadowing aspects of their programs to an abrupt halt. Forty-five percent of educators told the EdWeek Research Center some or most of their district internship programs have been shut down because of the pandemic, and 17 percent of teachers said all of the programs had been discontinued. Teachers have been making do, with 18 percent telling EdWeek that they have substituted virtual heath-care career training for lessons that had been on-site and hands-on in a medical facility.
The loss of job-shadowing opportunities for students has been a deep blow, Fletcher, the Lawrence County, Ky., superintendent, said. “You know, I had interviewed one young lady who said that she changed her ‘major’ three times [in high school] . because she had so many opportunities to job shadow. She knew she was able to see what she enjoyed and what she didn’t enjoy,” in high school, rather than waiting until college and possibly costing her parents more money down the road, he said. “But now, we’ve been in the red [quarantine status] since October, so even as we go back to in-person [instruction] … we haven’t had those types of opportunities with our students since the pandemic.”
Elizabeth McGinnis, a teacher in the medical pathway program at Lawrence County High School, has learned to work around the obstacles. The pathway begins in 10 th grade and includes health science and terminology, emergency procedures, first aid and CPR, and physiology, among other courses, with heavy lab work. By the end of high school, students on the track must complete CPR and a 75-hour nursing assistant and/or phlebotomist certificate needed to secure pre-admission to nursing schools in the state.
This year, with the school in hybrid instruction throughout the fall, McGinnis prioritized more delicate procedures like catheterization for the few socially distanced, in-person labs that the students were allowed to have in groups of 10.
For the rest, McGinnis sent home instructional videos for each practical skill, along with kits of medical supplies. Students videotaped themselves performing different skills, such as sanitation—including COVID-19 hygiene—checking vital signs or doing basic patient care in their homes. McGinnis viewed the tapes and sent feedback on their techniques for the students to correct and resubmit.
“That worked out very well for my students; they were very creative in it and it really kept everybody engaged,” she said, adding she’s likely to keep the video feedback approach even if the school returns to full in-person, nondistanced instruction. “I love watching the students at home and in their own comfortable environment, you know, and it really was enlightening to me … and I think it was very good for involving parents and letting the parents see what the students were doing because many of my students use their parents as their patient.”
The program has expanded its curriculum to include more safety procedures related to the pandemic, as 15 percent of teachers told EdWeek their health-care programs have done, but McGinnis said it has also changed more informal discussions in class about the field.
None of her students have said they are afraid to work in health care during the pandemic, McGinnis said, but “it has opened our eyes and health care in general as to what happens during a pandemic. You know, we’re already strapped for staff. Health care has been working short [-staffed] for the last 15 years, and now we’ve got our [local health] workers off on quarantine for two weeks” if they get exposed to COVID-19.
The crisis has launched conversations about the institutional response to other pandemics, like HIV and avian flu, she said, as well as more discussions of how students should handle their own social-emotional needs as professionals.
“We’ve had a lot of questions and some good discussions about how to handle stress and things that they can do. I think one of the big things right now that everybody’s kind of focused on is our health-care staff are getting just burned out daily,” she said. In the survey, 15 percent of teachers reported their health-care programs had added lessons in dealing with trauma and chronic stress.
The crisis also helps underline for students the importance of fundamental protocols in the field, like hygiene. “Even something like handwashing . my classes are either all credit or no credit because there’s really no mulligans in health care. Right? You know, if you do something wrong, you don’t always get to do it over,” she said.
Of McGinnis’s 18 seniors in the medical pathway last spring, a dozen were put on the state’s nurse aide registry after graduation.
