Introduction - Center for Student Success

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					                    Promising Practices
                    Promoting Diversity

                                in

            California Community College
            Health Occupations Programs


           The Center for Student Success

                            March 2006




Project Director
Robert Gabriner, Ph.D.
rgabrine@ccsf.edu

Research Team and Authors
Lisel Blash, MA
Eva Schiorring, MPP
Gail Waldron, BA
For additional copies of this report,
please contact:


Office of Institutional Research, Planning & Grants
City College of San Francisco
50 Phelan Avenue, C-306
San Francisco, California 94112
415 / 239-3014
djtong@ccsf.edu




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                                EXECUTIVE SUMMARY

In 2004, the California Wellness Foundation awarded the Center for Student Success
(CSS) a $100,000 grant to identify, review and document promising practices that
community college health occupations programs have developed to increase the
recruitment and retention of underrepresented minority (URM) students.

CSS researchers used statistical data from the chancellor’s office of the California
Community Colleges to identify health occupations programs that have achieved
significant increases in diversity over the past eight years. The researchers also identified
programs that, for the past ten to fifteen years, have served highly diverse student
populations and maintained high pass rates on state tests. Stakeholders from both types
of programs were subsequently interviewed and site visits conducted to (a) identify and
review promising practices at work in each program; (b) assess the impact and
replicability of the interventions; and (c) to ensure that the targeted programs were
willing to share their practices with colleagues from around the state. The CSS
researchers divided the findings into interventions that:

   o Develop awareness and interest in health care careers among URM groups and
     communities
   o Prepare URM students to get into a health occupation training program
   o Enroll and retain URM students in these programs

The researchers found that developing interest remains a challenge for several programs
such as psychiatric technology, respiratory therapy, medical assisting, and to some extent,
licensed vocational nursing and certified nursing assisting. Other programs, especially
registered nursing, need no further introduction because of recent media attention on
workforce shortages and rising nursing salaries. However, the research still showed that
many URM students in high school do not realize that they can gradually work their way
toward, for example, an RN degree.

Interventions that prepare students to get into health occupations training programs have
tremendous potential for increasing both participation and retention of students in the
harder to enter (because of the prerequisite requirements) programs such as radiologic
technology, dental hygiene, and registered nursing, and to a lesser degree respiratory
therapy and psychiatric technology. Strategies investigated include diagnostic testing and
assessment as well as workshops that help students address skill deficiencies in key areas
such as math and reading comprehension before classes begin. Other types of
interventions help students get their lives in order before school starts, or prepare students
to succeed in college. Too few interventions are available to help students during the
phase when most URMs drop off of the health care track––when they take the core
science prerequisite courses required for entry into the most sought after and highest paid
allied health care jobs such as registered nursing.

Once students are enrolled in competitive health care programs (nursing programs
routinely have waiting lists of two to three hundred students) the cost of helping them



                                                                                            3
stay there and succeed inevitably increases dramatically. Nevertheless, for reasons
including funding priorities among donors, most interventions still target this phase of the
health care training path.

CSS researchers identified, documented and assessed thrity-five promising practices that
will be added to the CSS health care website and promoted to health care practitioners
around the state and, we hope, to those who fund and develop legislation that affects
these programs. The promising practices span from intensive marketing efforts that have
alerted low-income residents of Santa Barbara to the opportunities available to certified
nursing assistants, to distance-learning programs that have made health care careers
available to residents of remote and rural communities in central and northern California.
The featured programs also include several examples of community colleges working
with external partners to make case management services and stipends available to low-
income students enrolled in entry-level health care training programs. Another cluster of
promising practices examines the retention gains that can be achieved when programs
fund individuals who provide early intervention and other tutoring and support services to
students at a high risk of failure.

Some of the practices require substantial and continuous investments of time and money.
Others can be achieved with a one-time commitment of funds. Still others are realized
less by money than by the drive and commitment of individuals who are determined to
bring URM students into their programs and to keep them there until they graduate.
Despite the fact that these kinds of leaders can be found in so many of the programs
featured in case studies, there is no question that major progress in recruiting URM
students, preparing them for success in health care programs and retaining them in these
programs, requires a combination of targeted investments, careful measurement of the
impact of these investments, and a willingness on behalf of practitioners and funders to
learn from what is already working. It is our hope that the case studies and the report that
ties them all together will stimulate a discussion of what works and what is required to
replicate, support and take ―what works‖ to scale.




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                                                        TABLE OF CONTENTS


EXECUTIVE SUMMARY .......................................................................................................................... 3
WHO SHOULD READ THE REPORT? ................................................................................................... 7
READER’S GUIDE...................................................................................................................................... 7
INTRODUCTION ........................................................................................................................................ 9
METHODOLOGY ....................................................................................................................................... 9
FINDINGS ...................................................................................................................................................11
THE DIVERSITY SCORECARD .............................................................................................................19
RECOMMENDATIONS ............................................................................................................................23
HOW TO SORT THROUGH THE CASE STUDIES..............................................................................25
         Distance Learning LVN Program ...................................................................................................... 28
         Colleges Collaborate on Distance Learning RN program ................................................................ 31
         X-Ray Technician Pilot Program Draws Local Hispanic Community .............................................. 34
         Early Intervention and Remediation in Dental Hygiene Program ..................................................... 35
         Outreach, Orientation, and Retention in Radiologic Technology Program ...................................... 38
         High school Students Enroll in Hands-on EMT Program ................................................................. 40
         Union-College Collaboration Prepares Health Care Workers to Move up the Career Ladder ........ 42
         Innovative Teaching, Tutoring and Team-Work in RN Prerequisite Courses.................................... 44
         Nurse Mentor Identifies and Responds to Under-Performing Students ............................................. 47
         Student Support Services for Respiratory Care ................................................................................. 50
         Word-of-Mouth Draws Diverse Students to Rural Psych Tech Program .......................................... 52
         Allied Health Orientation Courses..................................................................................................... 55
         Outreach Specialist for Allied Health Programs at Foothill College ................................................ 57
         Recruitment Initiative Targets Local Youth and Community Residents ............................................. 59
         College Learning Assistance Center Provides Critical Tutoring Services to Nursing Students ........ 61
         Pre-program Activities Address RN Skills Deficiencies ..................................................................... 64
         Diverse Mentors Serve as Role Models for Medical Assisting Students ............................................ 66
         Innovative High School Recruitment Activities .................................................................................. 68
         Latino Faculty Member Heads Up Outreach Initiative ..................................................................... 71
         Skills Lab Support Services Improve Retention ................................................................................. 73
         Flexible Design, Supportive Faculty, and Support Services Increase the Success of URMs. ............ 75
         Health Academy Prepares High School Students for Success in College Health Programs ............. 78
         Student Advisor Helps Students Plan Their Path to a Health Care Program .................................... 80
         Diversity Among Faculty and Built into Curriculum and Activities .................................................. 82
         Bilingual Recruiter............................................................................................................................. 84
         LVN & Psychiatric Tech Retention Strategy ...................................................................................... 86
         Employer Support for Porterville College Health Programs............................................................. 89
         Nursing Education Resource Specialist ............................................................................................. 90
         Collaboration With Local Employer to Train Nursing Home Workers to Become LVNs. ................. 93
         Student Success for Nursing Students at San Joaquin Delta College ................................................ 95
         CNA program prepares highly diverse student population for work in nursing facilities. ................ 97
         Student-Focused CNA Program is a Popular Choice for Local Job Seekers .................................. 101
         Hospital and College Partner to Recruit and Grow Local Health Care Workers. .......................... 103
         Faculty Diversity Provides Role Models in Respiratory Therapy.................................................... 106
         Distance Learning Brings Radiologic Technology Program to Rural Area .................................... 108




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SPONSORSHIP AND RESEARCH TEAM

This study was funded by The California Wellness Foundation in 2004 and was
implemented by the Center for Student Success (CSS) between March 2004 and January
2006.

The CSS is the research and evaluation arm of the California Community Colleges
Research & Planning Group. The CSS’s mission is to conduct statewide research and
evaluations on issues that are of high priority to the California Community College
system and to the one hundred and nine community colleges it comprises.

CSS is largely staffed by members of the California Community Colleges Research &
Planning Group.


RELATED CENTER FOR STUDENT SUCCESS RESEARCH & CONTACT
PERSONS

The present study is one of several in a series of CSS studies on health occupations
programs and strategies. Information about other CSS studies on the same subject can be
found on the CSS website (http:\\css.rpgroup.org) under CSS projects. You may also
want to review ―We Can Do That,‖ a CSS study on promising practices at work in
community colleges for advancing diversity in:

    hiring of faculty and staff
    the campus climate
    college relations with external stakeholders

To view the complete reports, please go to CSS Projects and select:

       Best Practices in Health
       Best Partnership Development Practices in Health
       Fundraising Tools & Strategies for Health Occupations Training and Other
       Programs
       Best Practices for Advancing Diversity in the Rural Health Care Workforce
       Associate Degree Nursing: Model Prerequisites Validation Study
       We Could Do That! The Promoting Diversity Practices Project


Questions about this report or the CSS should be directed to Robert Gabriner at:
rgabrine@ccsf.edu




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WHO SHOULD READ THE REPORT?

This report was written to inform, inspire, and connect individuals across the state who
are directly involved in designing and implementing training programs that prepare
students for jobs in health care. The primary audience is people working in community
colleges. However, the information is also highly relevant to people who partner with
community college health occupations programs, including high school health academies,
baccalaureate institutions, workforce development programs, hospitals and clinics.
Another audience is funders who allocate and earmark resources to health occupations
training programs and those who write and decide on legislation that affects these
programs.

The report will help health occupations planners and program implementers learn what
colleagues are doing across the state to recruit and retain underrepresented minority
students. The hope is that they will get ideas for how to augment and improve their own
programs through partial or full replication of practices described here.

Funders and legislators of programs that train tomorrow’s health care workforce will be
challenged to think about how and where to best invest their money. A key question that
the research team hopes this audience will consider is whether enough funds are being
allocated to support projects and activities that prepare students to enter and successfully
complete health occupations training programs.



READER’S GUIDE

The report begins with an introductory section that explains the history and purpose of
the project, the methodology used by the research team, and the major findings that
emerged from the research. This is followed by the Diversity Scorecard, a simple
instrument that practitioners can use to determine how well they are doing to advance
diversity in their health occupations programs.

The second part of the report features thirty-five case studies of promising and effective
practices. The case studies are organized into three categories that are mirrored in the
Diversity Scorecard. Practitioners who score low in a particular category can review the
relevant case studies and decide if they can replicate some of the best practices.

The case studies are written to provide snapshots of particular practices or strategies.
Each begins with a brief summary of the practice, name of the college that offers the
program, the type of program, and a contact person. The introduction also includes a
timeline with three phases: the first covers the time when students and community
residents develop interest in a health care career and a training program. The second
covers the period during which students are actively preparing to get into a health
occupations program. The third covers the period when students are enrolled in a
program.


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The body of each case study begins with a brief description. This is followed by
evidence that directly or indirectly suggests the method or strategy works. The next
section reviews resources that are required to replicate the project. The case study
concludes with additional contact information for a project representative who has agreed
to talk with colleagues about the project.

It is possible to skip the narrative report and proceed directly to the case studies.
However, it is recommended that those involved in designing programs review the report
so they can place their own initiatives into a statewide context.

The information presented in this report is also available on the CSS website:
http://css.rpgroup.org. For the full report, please go to the tab labeled ―CSS Projects.‖
For the case studies, click on the tab labeled health occupations.




                              ATTENTION
                DO YOU HAVE A BEST PRACTICE TO SHARE?
          The research team strongly encourages those who believe they have practices
                that could serve as additional case studies to register CSS online at
           http://css.rpgroup.org and follow the simple guidelines on the section called
                                       Submit your project.




                                                                                            8
INTRODUCTION

California’s one hundred and nine community colleges operate approximately two
hundred and fifty health occupations programs and train more allied health care workers
than any other educational or workforce institution in California. Many community
college students in health occupations programs struggle through demanding courses
while simultaneously trying to manage complicated lives that often involve raising
children without the support of a spouse, taking care of elderly parents, and working part-
time or even full-time jobs. Further, since so many community college students come
from lower-income families, they often have had limited educational opportunities, and
therefore frequently struggle to qualify for and/or start difficult health care programs
without the proper preparation in math, science and English.

For all these reasons, community college health occupations programs struggle to alert
potential students to the opportunity of health care careers, to help them succeed in
difficult prerequisite courses and, once they have reached the health occupations
programs, to provide them with the support services they need to graduate. The difficulty
these challenges represent can often be seen in high attrition rates and low pass rates on
licensing exams (such as the NCLEX).

On the other hand, major gains could be made if community college health occupations
programs were able to retain more students. In fact, even a 5 percent across the board
reduction in attrition rates in the largest community college health occupations programs
would significantly increase the diversity of California’s health care workforce,
particularly in: nursing (RN, LVN, CNA), radiologic technology, respiratory therapy,
dental hygiene, medical assisting, and psychiatric technology.

One of the most economical ways to achieve such gains in effectiveness is to find the
programs that are most successful and to encourage others to review and replicate some
or all of their strategies. This is what the research team set out to do.


METHODOLOGY

CSS worked with the chancellor’s office of the California Community Colleges to access
data on student participation in the ten occupational areas that are generating the largest
number of community college health care graduates. These include, in order of size:

      RN                                               Dental Assistant
      EMT                                              Certified Nurse Assistant
      LVN                                              Respiratory Care Therapist
      Medical Assistant                                Psychiatric Technician
      Radiologic Technologist                          Dental Hygienist




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CSS used the data to identify the programs at community colleges that had achieved the
greatest increase (considering both absolute and relative gains) in the participation of
underrepresented minority (URM) students between 1996/97 and 2002/03. The research
team next compared the changes that had occurred in each program to the changes that
had taken place in the college during the same period. If both the program and the
college had achieved a significant and comparable increase in diversity, it was assumed
that demographic changes or interventions affecting the college as a whole had led to the
increase in the enrollment of underrepresented minority students. If, on the other hand,
the health occupations program had achieved a much faster rate of increase in diversity
than the rest of the college, it was assumed that the program had taken actions that the
research team would be interested in studying. In addition, CSS identified programs that
have always been highly diverse and that have consistently maintained high pass rates on
state and national licensure examinations such as the NCLEX.

Based on these two approaches, the research team identified six to ten programs from
each occupational area. A phone protocol was developed and the research team
conducted preliminary interviews with a representative from each program, in most cases
the program director.

The interviews had five goals:

      determine if the program was or was becoming diverse compared to the host
       college and surrounding community.
      get information about retention rates, especially for underrepresented minority
       students.
      identify and explore strategies and approaches the program had developed to
       recruit and retain underrepresented minority students.
      assess what was required to implement one of the successful interventions, and
      assess whether the practice or method the program had developed could be
       replicated by others.

After the preliminary round of interviews, the research team selected about fifty
programs for in-depth research. This involved semi-structured phone interviews with
three to five individuals who could provide different perspectives on the program such as
a faculty member, a counselor, a student, a graduate, an employer supervising program
graduates, a representative from a partner high school or employer and other
stakeholders. In five cases, the research team conducted site visits to colleges that
appeared to have an especially rich array of best practices. The half or full-day site visits
included one-on-one interviews, meetings with groups of faculty, and focus groups with
students.

After the phone interviews and site visits, the research team developed the forty case
studies featured in this report. Each project had the opportunity to review and revise the
case.




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FINDINGS

The research team divided the forty case studies into three categories that correspond to a
student’s path into and through the programs. Each program in the report does one or
more of the following:

    Develop interest in or access to health occupations programs
    Prepare students to enter health occupations programs
    Enroll and retain students in health occupations programs

Within each category, the research team identified different strategies the programs have
developed to generate interest, prepare students for entry, and enroll and retain students.

Strategies for developing interest or access

    Distance learning programs that make health care training accessible to
     residents of rural and remote parts of the state.
    K-12 outreach that informs students, especially in high school, of health care
     career opportunities and, in some instances, prepares them to enter health
     occupations training programs.
    Community outreach to inform local residents about career opportunities in the
     health care sector, especially unemployed or underemployed residents.
    Targeted outreach to ethnic groups that are underrepresented in local health
     occupations programs. Often, these efforts are planned and implemented by one
     or more representatives from the target group.
    Career ladder opportunities that help prospective students envision how they
     could gradually work their way up the health care career ladder while working at
     least part-time, and that encourage incumbent health care workers to get the
     training they need to advance.

Strategies for preparing students for entry into health occupations programs:

    Counseling and testing to help students identify skills and competencies they
     need to strengthen prior to enrolling in a health occupations program and to
     encourage them to get enough hands-on experience in the field to determine if
     their occupational target is a good fit.
    Support services and other interventions that help students complete the science
     requirements for the most demanding health occupations programs and that
     change students relationship with and perception of their ability to understand
     math, biology, physiology, etc.
    Pre-program workshops, modules, and other instructional activities that target
     basic skills and competencies that students must be able to master before
     enrolling.
    Life-management support services and training that help participants ―get their
     life in order‖ before the first day of classes.




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Strategies to promote student retention in health occupations programs:

    Create a supportive and student-centered environment where faculty are
     deeply committed to student success and where diversity is embraced in the
     curriculum and in the recruitment of new faculty
    Academic support and early intervention services that identify and address
     student skills deficiencies through tutoring, mentoring and automatically triggered
     remediation activities
    Support services that help students respond to and address life management
     issues while they attend demanding health occupations programs.
    Built in flexibility that accommodates the difficulties so many community
     college students confront in juggling school, work, and family responsibilities. In
     some instances the flexibility lies in students’ ability to re-take a class or to drop
     out for a semester to take care of a family emergency. In other instances, it refers
     to programs’ willingness to help students work around child care and work
     schedules

The following table organizes the case studies according to where each program
intervenes on a student’s path into and through the program and the particular strategies
that programs use to improve outcomes.


                                  Developing Interest
Program Goals          Strategies for improving outcomes    Case Studies by
                                                            College and Program
Create access          Offer distance learning              Antelope Valley (LVN)
                                                            Bakersfield (RN)
                                                            Fresno (Radiologic
                                                            Technology)
                                                            West Hills (Radiologic
                                                            Technology)
Reach                  Conduct K-12 outreach                Bakersfield (RN)
underrepresented                                            Chaffey (Radiologic
groups                                                      Technology)
                                                            Crafton Hills (Respiratory
                                                            Care)
                                                            Foothill (Allied Health)
                                                            Fresno (Allied Health)
                                                            Moorpark (Allied Health)
                                                            Palomar (Allied Health))
                                                            Porterville (LVN, Psychiatric
                                                            Technician)
                                                            Siskiyous (Allied Health)
Reach                  Conduct community outreach           Chabot (Dental Hygiene)
underrepresented                                            Chaffey (Radiologic
Groups                                                      Technology)
                                                            Crafton Hills (Respiratory



                                                                                            12
                                      Developing Interest
Program Goals              Strategies for improving outcomes     Case Studies by
                                                                 College and Program
                                                                 Care)
                                                                 Cuesta (Psychiatric Technician)
                                                                 Foothill (Allied Health)
                                                                 Fresno (Allied Health)
                                                                 Porterville (LVN, Psychiatric
                                                                 Technician)
                                                                 Santa Barbara (CNA)

Reach                      Conduct targeted outreach             Foothill (Allied Health)
underrepresented                                                 Porterville (LVN, Psychiatric
groups                                                           Technician)

Make career                Promote career path instead of        Long Beach (CNA to LVN/RN)
opportunity or             one/first step on ladder              CCSF (Bridge to LVN/RN)
advancement real and                                             Mt. San Antonio (PT)
tangible                                                         Santa Barbara (CNA to
                                                                 LVN/RN),
                                                                 Sequoias (CNA to LVN/RN)



                                Preparing to get into program
Program Goals              Strategies for improving outcomes     Case Studies
Ensure there is a good     Counsel students on course to take,   Chaffey (Radiologic
fit in terms of interest   skills to develop, experiences to     Technologist)
and requirements           seek out                              Foothill (Allied Health)
                                                                 LA Harbor (RN)
                                                                 Palomar (Allied Health)
                                                                 Porterville (LVN, Psychiatric
                                                                 Technician)
                                                                 Siskiyous (CNA, LVN)

Help students get          Core science faculty                  Contra Costa (RN)
through core science       develops/implements strategies that
curriculum                 increase probability of success in
                           core sciences and that prepare
                           student for challenges ahead in
                           health care program.
Get academic and           Create pathways/bridges to program    City College of San Francisco
other key skills to        (high school to program or entry      (CNA to LVN)
required level prior to    level to mid-level)                   Moorpark (Allied Health)
program start-up

Get life management        Referral to college                   Antelope Valley (LVN)
issues in order prior to   academic/support services             Porterville (LVN, Psychiatric
program start-up                                                 Technician)




                                                                                                 13
                           Enrolled and retained in program
Program Goals          Strategies for improving outcomes        Case Studies
Minimize attrition     Create welcoming and supporting          Antelope Valley (LVN)
                       environment                              Chabot (Dental Hygiene)
                                                                Long Beach (CNA to LVN)
                                                                Modesto (Medical Assisting)
                                                                Mt. San Antonio-(PT)
                                                                Pasadena (Dental Hygiene)
                                                                Porterville (LVN, Psychiatric
                                                                Technician)
                                                                Skyline (Respiratory Therapy)
Prepare students for   Offer academic support services/early    Antelope Valley (LVN)
workplace              intervention                             Bakersfield (RN)
responsibilities                                                Cabrillo (X-ray technician)
                                                                Chabot (Dental Hygiene)
                                                                Contra Costa (RN)
                                                                Crafton Hills (Respiratory
                                                                Care)
                                                                Cuesta (Psychiatric
                                                                Technician)
                                                                Moorpark (RN)
                                                                Palomar (RN)
                                                                Porterville (LVN, Psychiatric
                                                                Technician)
                                                                San Joaquin Delta (RN)
                                                                Siskiyous (Allied Health)
                       Offer life and financial                 Antelope Valley (LVN)
                       management/support                       Bakersfield (RN)
                                                                Crafton Hills (Respiratory
                                                                Care)
                                                                Porterville (LVN, Psychiatric
                                                                Technician)
                                                                San Joaquin Delta (RN)
                       Offer flexibility required to complete   Long Beach (CNA)
                       and succeed                              Mt. San Antonio (Psychiatric
                                                                Technician)
                                                                Porterville (LVN, Psychiatric
                                                                Technician)
                                                                Sequoias (CNA)


The following section details the research team’s findings:

Developing interest in or access to health care programs
The research team found that the challenge of developing interest in or access to health
care programs differs considerably for different health occupations programs. Because of
intense media attention on workforce shortages in nursing and the great earnings potential
RNs enjoy, almost everybody is aware of this career option. The critical missing piece of


                                                                                          14
information is, as one high school outreach counselor explained to the research team, that
many students think becoming an RN is an unattainable goal. ―This starts to change
when I explain to them that they can approach it step-by-step, starting with getting a
CNA, then an LVN and then the RN. Then I tell them that they can work part-time
while they are working their way up this career ladder and that they can get an RN at a
community college. So many think you need to go to an expensive four-year college to
become a nurse.‖

While ―everybody‖ knows about nursing, there is much less awareness of health
occupations such as radiologic technology, psychiatric technology and respiratory
therapy, although graduates of these programs are in high demand. ―The employers are
hunting us,‖ one recent graduate of a psychiatric technician program explained with
pleasure. Several of these programs used to conduct intensive community-based
outreach, but many are now at a point where the word is out and enrollment is way up.
The reason, most often, is that a chain-reaction will start when one person in a close-knit
community completes a training program and gets a good job. ―I see the neighbors of
former students, their cousins and even parents,‖ one psychiatric technician program
instructor explained. ―Right now, we are seeing a huge influx of African immigrants.
Many of them live in a small community around here and after one person completed the
program and got a job, everybody else started coming.‖

Other strategies that help generate interest and awareness include collaborative
partnerships between K-12 and community colleges, and outreach efforts that use
students and faculty from underrepresented minority communities to get the message out.
One medical assisting program deployed recent graduates to a high school career day
where they engaged students by offering to take their blood pressure. The same program
hosts afternoon teas where parents and their high school sons and daughters can hear
about opportunities in medical assisting.

Another college has all its health occupations programs collaborating on outreach. They
jointly host high school and other groups at the health care building. The college has a
striking, new facility that houses all its health care programs in one place—something
that is hard to replicate for departments whose programs are housed in several different
locations. However, the health sciences department at the college also takes the show on
the road and has booths ―where potential participants and their parents are likely to go.‖
Furthermore, the delegations that recruit at shopping malls, large sports events, or at
street fairs include a changing group of representatives from the health sciences
department, a counselor, and a person from the college’s financial aid program.
Participants who become interested in a health occupations program can get immediate
advice about prerequisites from the counselor and a sense of the financial assistance they
may be able to apply for from a representative of student services/financial aid.

Advertising that highlights diversity is another obvious, but frequently under-used,
strategy. For example, a respiratory therapy program reported that they saw an increase
in applications from underrepresented minorities after they revised their outreach material
to include students of color. A video from the American Association of Respiratory Care



                                                                                         15
also helped, as it showed a highly diverse group of individuals working in the profession.
The program played the promotional video on the college television station with good
results.

A rural program also bears mentioning for extending to local under-employed individuals
the opportunity of pursuing entry-level health care careers. The initiative, which resulted
from a collaboration between a hospital and a community college, recognized that the
local community was experiencing high unemployment rates and, at the same time,
almost desperate shortages in the supply of qualified health care workers. Leaders from
the hospital and college responded by ―bombarding the local community with
information about health care job opportunities.‖ As the community college health care
dean said: ―Not a week went by without another feature in the local paper about the great
jobs available in health care.‖ The strategy—which also involved the two partners
successfully applying for a WIA grant that provided case management services and
stipends to health care students—paid off. From having too few applicants to its LVN
program, the college now has so many that it has added a second class.

Finally, awareness is not enough if there is no access, and this is the problem in many
rural and remote areas. An innovative and highly cost-effective—if difficult to
implement—strategy is distance learning. The case studies feature four projects and
highlight how these have provided residents of rural and remote parts of the state with the
opportunity to study nursing (LVN or RN) and radiologic technology. The programs
save money because the didactic part of the instruction is broadcast to students in the
rural and remote areas so that one instructor can serve twice as many students as would
otherwise be the case (although these programs often require additional staffing at the
satellite location). The challenge for many of these programs is to find local clinical
training opportunities that are necessary to provide students with the required experience.

Strategies for preparing students to enter health care programs
The research team found several health sciences departments that offer students the
opportunity to survey a number of different health care careers before deciding if a field
is right for them and, if so, which occupational specialty to pursue. One particularly
outstanding introduction to health care is offered as a two-tiered course that includes a
lecture and a practical component. In the former, students are introduced to the health
occupations careers they can pursue at the college, briefed on the prerequisites they have
to complete to enter each program, and offered a detailed introduction to each health
profession. The class, which regularly attracts more than a hundred students including a
large number of underrepresented minorities, is offered both at the college and on-line.
In the practical component of the class, participants join an incumbent student on a tour
of a clinical setting. For example, a student who thinks he may be interested in a career
as a dental hygienist will visit a dental clinic accompanied by a student in the college’s
dental hygiene program. On these site visits, the college seeks to match underrepresented
students with a guide from the same race or ethnic group so that, in addition to a hands-
on experience, the student spends time with a role model.




                                                                                        16
Another feature that makes this college’s health occupations programs so accessible to
incoming students is that the counselors at the college are assigned to specific disciplines
(in most colleges, counselors are available to a much wider group of students and they
therefore don’t have the same connection to or the knowledge of particular departments
and programs). If somebody enters the college and says they are interested in a particular
health occupations field, they are referred to a counselor who is an expert in that field.

In the highest paid health occupations that the team studied — dental hygiene, registered
nursing, and radiologic technology — one of the best strategies for increasing diversity
would be to improve student outcomes in the core science prerequisite classes
(physiology, anatomy, and microbiology). This is where most under-prepared and
underrepresented students fail, because they enter these courses without the proper
training in math and science. The research team found only one promising practice where
biology instructors have developed special modules (including several that feature group
work) that help under-prepared pre-nursing students catch up and overcome what, in
many cases, has been a life-long conviction that they ―cannot do math and science.‖ In
addition to innovative instructional strategies that work for different kinds of learners, the
instructors have an open door policy that makes many hours of additional tutoring
available to struggling students.

While most pre-program activities are directed at nursing students, the researchers found
some innovative initiatives that prepare prospective students to succeed in LVN
programs. One such program, hosted by a hospital, pays CNAs to job shadow LVNs.
Another program offers a ―summer bridge‖ to prepare incumbent health care workers to
succeed in the LVN program at a local community college. The bridge program, which
was developed by a union representing the incumbent workers and college instructors,
provides participants with the study, math, medical terminology, clinical and other skills
they need to successfully complete the first semester of the LVN program. In a focus
group, one of the CSS researchers conducted with students who were about to graduate
from the LVN program, participants agreed they would ―never have made it to graduation
without the bridge‖ and the case management services that the union provided for the
duration of the three-semester LVN program.

Nursing programs, especially, offer a variety of pre-program services to help students (a)
decide if nursing is the right career for them; (b) identify and address their skills and
deficiencies before the program starts; (c) learn how to be a successful student; (d)
identify general college programs or courses that can help them develop critical skills or
address potential problem areas; and (d) participate in workshops or modules in
foundation subjects such as math, pharmacology, and dosage calculations. Several such
pre-nursing programs are featured in the CSS case studies.

Enrolling and retaining students in health care programs
Once students enroll in a health professions program, the stakes increase significantly.
For the student, failure means not just major disappointment, but also the loss of a
substantial investment of time (getting through the prerequisites) and money (the cost of
text books, uniforms, etc easily exceed $1,500 for several programs). For the college,



                                                                                           17
the failure means the loss of a large investment (health care programs are more expensive
than any other community college program) and a lower graduation rate. For the
community, each dropout means that there will be fewer much-needed health care
professionals available to local employers.

Because of the cost and other implications of failure, many programs (and funders) target
this phase of the ―health care training passage.‖ One strategy that almost always seems to
be highly effective is for programs to have a competent and compassionate person in
place to help students individually or in groups with anything from (but especially) math
to time management, test taking skills, critical thinking, reading, etc. In some programs
this person is from another department; in others, it is a person who is a non-teaching
member of the instructional team; or, it may be a former instructor who is not quite ready
to retire.

Making stipends and loans available to students is also a good approach to retention if the
money actually enables the recipient to cut down on work hours. However, individual
health occupations programs almost never have access to stipend money. The research
team found that such funds were only available in instances where the health care
program partnered with a hospital or a grant-funded workforce development agency. A
more feasible strategy for many programs is to help students find study-related work and,
in the best cases, get paid for more hours than they work. The research team found
several examples of psychiatric technician and nursing programs that partnered with
health care providers that paid students, for example, thirty to forty hours for working
twenty hours. The health care providers’ incentive is two-fold. They have the
opportunity to pre-screen new talent and they can custom-train future hires for the duties
and routines that prevail at the particular health care institution.

The research team also saw good results in cases where community college health
occupations programs collaborated with outside workforce development agencies to
provide students with a comprehensive range of support and case management services.
Examples include a WIA-funded local workforce development initiative that provides
CNA and LVN students with financial assistance and case management services. The
same system is in place in the bridge program mentioned earlier. In this case, the
partnership that provides case management services to incumbent students includes the
college, the health care employees’ union and the local private industry council. Another
example is a pilot project in a new discipline, x-ray technician, that offers students
financial assistance, tutoring, and other types of support. The curriculum for this new
program and the services available to students were both funded by a local workforce
development grant.

In addition, the research team identified a large number of programs that seek to increase
retention through special tutoring services, peer support, instructor-managed study
groups, mentoring, and other support services. A particularly effective intervention that
helps increase success in the most difficult programs is the ―early alert system.‖
Although implemented in various ways around the state, the common denominator is that
students who fail a test or score below a certain minimum standard meet with an



                                                                                        18
individual who is assigned to help them improve. Some strong programs engage both a
student mentor, the instructor in the problem-subject, and the student in the task of
developing an improvement plan. The mentor or instructor monitors the student’s
progress in implementing the plan.

Finally, it appears that some students are failing health occupations programs because
they never learned to read. The problem is not that the students cannot understand the
words they read, but rather they don’t know how to identify the most important
information in a text or how to take notes that will help them recall information when
they are studying for a test. The research team found some programs that seek to address
this potentially devastating deficiency, but none that have developed a comprehensive
approach to solving the problem.


THE DIVERSITY SCORECARD

The research team developed a diversity scorecard to provide programs with a simple
tool they can use to:

(a) assess how well they are doing to promote diversity among students who enter and
complete their program

(b) measure their progress in strengthening their performance in areas that need
improvement.

The scorecard is, at this time, just a tool programs can use to ―take their own diversity
pulse.‖ It has the potential to become a more important tool if key funders decide to use
it in their selection or evaluation of grantees. For example, a program that scores low in
the area of preparing students for entry could apply to a funder for a grant to strengthen
its performance in that area. The grant activities would be one or more of those
identified in the scorecard, or innovative strategies that further the same goal of preparing
students for entry into the program. One of the expected grant outcomes would be a
change in the program’s diversity profile (see below) as more underrepresented minority
students enter and complete the program.

It is very difficult to compare statistics on diversity across the state, and the Diversity
Scorecard takes this into account by leaving it up to each program to determine which
groups they want to identify as being underrepresented. It could be Hispanics/Latinos
and African American students. But it could also be very low-income students or
individuals who are the first in their family to go to college. Basically, it is up to each
program to look at the local demographics, the college population, the needs of local
health care providers, and the current students and ask: What do we mean by diversity in
this particular environment? The program can translate its answer to this question into a
profile of what a diverse student population would ideally look like and use the profile to
measure future progress toward achieving this ideal.




                                                                                          19
In addition to developing a profile for a student pool that reflects the ultimate diversity
goals and a time line by which these will be achieved, each program needs a baseline as a
starting point against which progress will be measured. The baseline should include the
following information:

 The representation of underrepresented minorities (URMs) in the most recent
  applicant pool.
 The representation of URMs in the most recent group of students enrolled in the
  program.
 The representation of URMS in the most recent class to graduate as compared to the
  representation of URMs among the group that started the program as part of the
  graduating class.

As comparative markers, the program may also want to compare these baseline measures
to the representation of URMs in the college as a whole and in the local population
(meaning in the counties that the college is serving).

The baseline could also include the number and percentage of URMs on the faculty at the
time that the effort to promote diversity begins (for example, how many full-time, how
many part-time, how many among those hired within the past five years). Corresponding
to this baseline would be a profile of what a faculty would look like that reflects the
diversity in the current student population and in the more diverse student population the
program is seeking to develop. The following is a sample diversity profile:

                                 DIVERSITY PROFILE
 Date: January 15, 2006
 Indicators:
 URMs in applicant pool       6 percent African American; 20 percent Latino; 20
                              percent first in family in college
 URMs in class of spring 2006 3 percent African American; 7 percent Latino; 10
                              percent first in family in college
 URMs among those graduating 3 percent African American; 5 percent Latino; 12
 in fall 2005                 percent first in family in college
 URMs initially enrolled in   9 percent African American; 12 percent Latino; 20
 class that graduated in fall percent first in family in college
 2005
 URMs among FT faculty        1:5 Latino; 1:5 first in family in college
 URMs among PT faculty        1:10 African American; 2:10 Latino
 URMs in college              8 percent African American; 20 percent Latino
 URMs in community            10 percent African American; 35 percent Latino

The following is the actual scorecard that programs can use to assess their success in
developing interest and access, helping students prepare to get into the program, and
supporting students once they are enrolled. The three categories of student progress into
and through a health professions program have several activities identified that can



                                                                                        20
promote diversity. Use the scorecard to give your program points for planning, or
partially or completely implementing each activity.

Programs can compute their overall scores (maximum possible is fifty-four) and their
scores within each category. They can review case studies in this report or on the CSS
website to determine what their colleagues are doing in the area(s) where their scores are
low. For example, a program that scores low in the ―supporting students enrolled‖
category can review the range of post-enrollment case studies presented in this report and
contact the representative for a strategy they believe is suitable in their environment and
for their URM population.




                                                                                         21
                              Activity to promote diversity
             Give your program three points if fully implementing the activity         Points
         two points if partially implementing and one point if planning the activity
                                    Developing Interest
URMs are featured in brochures, on website and in other outreach material
URM students participate in outreach and recruitment activities targeting their
own communities
Program reaches out to and engages students in local high schools that have
high concentrations of URMs
Program conducts outreach in the local community that targets URMs
Program extends opportunities for enrollment to residents of remote areas
through distance learning
Program conducts recruitment at hospitals and clinics to encourage incumbent
health care workers to go back to school
               Preparing students to enter health occupations programs
Program provides counseling to help students assess and validate their health
occupations career goals and develop a realistic plan for how to get started
Program works with the science departments to make tutoring and other
support available to help under-prepared students succeed in the required
science courses
Program gives potential students an opportunity to experience the health
occupation first hand in a hospital or clinic setting
Program offers students pre-program diagnostic testing and uses the results to
direct students to workshops and courses where they can address their
weaknesses
Program offers pre-program modules and workshops on skills and
competencies that students need when they enter the program
Program offers orientation sessions that help potential students understand
whether the program is a good fit and the challenges the program will present
Program helps students understand the career opportunities that are available to
graduates and the career path they can pursue with additional education
            Supporting students enrolled in health occupations programs
Program has assigned faculty or other team members to be primarily
responsible for delivering tutoring, counseling and remediation services to
students.
Program offers case management services to students who need this kind of
support
Program has an early intervention system that catches students as soon as they
start to show signs of academic or other problems
Program has a big-brother/sister or other type of mentor system
Program offers flexibility so that students with complex lives can take time out
to deal with personal problems




                                                                                            22
RECOMMENDATIONS

Based on extensive research conducted for this and related projects and on the resulting
findings, the CSS has developed two sets of recommendations. The first is for those who
design and implement health occupations training programs; the second for those who
fund and/or make policies that target funding to California’s health occupations training
programs


Recommendations for practitioners:

    Develop a recruitment-for-diversity outreach plan that targets groups that are
     underrepresented in the program to become part of the applicant pool and to
     enroll in the program. This should be done even if the program has more
     applicants than available spaces as is presently the case with most RN, radiologic
     technology and dental hygiene programs.

    As part of this outreach, target recruitment efforts to incumbent health care
     workers, including those who work in the least-skilled jobs in hospitals and
     clinics.

    Address common deficiencies in student preparation with pre-program
     workshops, modules and courses.

    Work with the science department at the college to expand tutoring and other
     support services to help students complete courses required for entry into many
     health occupations programs such as physiology, anatomy and microbiology. If
     possible, try to get resources to pilot science courses that are smaller and designed
     for different learning styles (the authors recognize this is an extremely difficult
     proposition as funds are limited, demand high, and faculty in short supply for
     these courses. Also, faculty in biology and other science department may not want
     to make special accommodations for students interested specifically in health care
     careers.)

    Promote internal collaboration among the college’s health occupations programs
     and organize joint outreach efforts that orient potential participants to a range of
     different career opportunities. Consider including financial aide and counseling
     staff in outreach efforts.

    Have all health care programs at a college share the cost of a part-time person to
     help all students who express an interest in health care to evaluate their
     commitment, assess their skills, and plot a path through the prerequisite and other
     courses into the health care program of choice.

    Identify courses and services at the college that are delivered by departments
     other than health sciences and that address student needs both before and during


                                                                                        23
      enrollment. These may include tutoring in basic skills subjects, financial aid,
      child care, internships and part-time job placement assistance. Develop
      relationships with those who provide these services, ideally establish one contact
      person in each place, and make sure this person understands the entry
      requirements and dynamics of the health occupations program(s).

    Develop an early-intervention system and work with underperforming students to
     develop a step-by-step remediation plan. Provide support services to ensure that
     the remediation plan is implemented.

    If possible, have a non-teaching faculty member work at least part-time to provide
     tutoring services to students, conduct workshops, and review tests.

    Document outcomes and develop simple tools to measure the impact of
     interventions such as new pre-program activities and tutoring services. For
     example, how many students participated in the intervention and how much did
     they participate? How large a percentage of those who participated passed the
     test compared to those who did not? How is the intervention working for
     underrepresented minority students?

    Track retention and clarify how the program defines retention.

    Engage faculty in discussing evaluation findings and in identifying what works
     and what doesn’t.

Recommendations for funders:

    Direct more resources to activities that prepare students to enter health
     occupations programs. Many funders place a strong emphasis on supporting
     health occupations programs only after students are enrolled. For example,
     Governor Schwarzenegger’s $30 million commitment to support increased
     retention and expansion in community college registered nursing programs did
     not fund any pre-program activities. Programs that don’t have access to
     alternative funding for pre-program interventions cannot bring the reading and
     math skills of under-prepared students up to acceptable levels before the students
     start very intensive programs. The result is often high levels of attrition,
     especially for students from underrepresented groups.

    Make more support available to programs other than registered nursing (which
     has recently received considerable infusions from the state), and especially to
     programs that have the potential to serve as the first stepping stone for getting
     more underrepresented minority students onto the health care professions track.

    Support projects that bring practitioners together to review best practices and to
     attend workshops conducted by those who developed these practices.




                                                                                          24
HOW TO SORT THROUGH THE CASE STUDIES

Use the following lists to search the case studies in this report by college, by health care
program, or by student timeline.
                                      Sort by College

College                                                         Program
Antelope Valley College                                         Licensed Vocational Nurse
Bakersfield College                                             Registered Nurse
Cabrillo Community College                                      X-ray Technician
Chabot College                                                  Dental Hygiene
Chaffey College                                                 Radiologic Technology
City College of San Francisco                                   Bridge to Licensed Vocational Nurse
                                                                Emergency Medical Technician
Contra Costa College                                            Registered Nurse
Crafton Hills College                                           Respiratory Care
Cuesta Community College                                        Psychiatric Technician
Foothill College                                                Allied Health Programs
                                                                Dental Hygiene
                                                                Radiologic Technology
Fresno City College                                             Allied Health Programs
Long Beach City College                                         Nursing Programs
Los Angeles Harbor College                                      Registered Nurse
Modesto Junior College                                          Medical Assistant
Moorpark Community College                                      Registered Nurse
                                                                Allied Health Programs
Mt. San Antonio College                                         Psychiatric Technician
Palomar College                                                 Allied Health Programs
                                                                High School Connection
Pasadena City College                                           Dental Hygiene
Porterville College                                             Licensed Vocational Nurse
                                                                Registered Nurse
                                                                Psychiatric Technician
Riverside Community College                                     Registered Nurse
                                                                Licensed Vocational Nurse
San Joaquin Delta College                                       Registered Nurse
Santa Barbara City College                                      Certified Nursing Assistant
Sequoias Community College                                      Certified Nursing Assistant
Siskiyous Community College                                     Allied Health Programs
Skyline College                                                 Respiratory Therapy
West Hills College                                              Radiologic Technology





    Please notes that some colleges have more than one entry.


                                                                                              25
                               Sort by Health Care Program

Health Care Program                               College
Allied Health Programs                            Foothill College
                                                  Fresno City College
                                                  Moorpark Community College
                                                  Palomar College
                                                  Siskiyous Community College
Certified Nursing Assistant                       Long Beach City College
                                                  Santa Barbara City College
                                                  Sequoias Community College
Dental Hygiene                                    Chabot College
                                                  Foothill College
                                                  Pasadena City College
Emergency Medical Technician                      City College of San Francisco
High School Connection                            Palomar College
Licensed Vocational Nurse                         Antelope Valley College
                                                  City College of San Francisco
                                                  Long Beach City College
                                                  Porterville College
                                                  Riverside Community College

Medical Assistant                                 Modesto Junior College
Nursing Programs                                  Long Beach City College
Psychiatric Technician                            Cuesta Community College
                                                  Mt. San Antonio College
                                                  Porterville College
Radiologic Technology                             Chaffey College
                                                  Foothill College
                                                  West Hills College
Registered Nurse                                  Bakersfield College
                                                  Contra Costa College
                                                  Los Angeles Harbor College
                                                  Long Beach City College
                                                  Moorpark Community College
                                                  Porterville College
                                                  Riverside Community College
                                                  San Joaquin Delta College
Respiratory Therapy                               Crafton Hills College
                                                  Skyline College
X-ray Technician                                  Cabrillo Community College




                                                                                  26
                                            Sort by Timeline

Timeline                                                        College
Develop Interest                                                Chaffey College
                                                                City College of San Francisco
                                                                Crafton Hills College
                                                                Cuesta Community College
                                                                Foothill College
                                                                Fresno City College
                                                                Modesto Junior College
                                                                Moorpark Community College
                                                                Palomar College
                                                                Porterville College
                                                                Santa Barbara City College
                                                                Siskiyous Community College

Prep to Get Into Program                                        Antelope Valley College
                                                                City College of San Francisco
                                                                Contra Costa College
                                                                Foothill College
                                                                Los Angeles Harbor College
                                                                Palomar College
Enrollment & Retention                                          Antelope Valley College
                                                                Bakersfield College
                                                                Cabrillo Community College
                                                                Chabot College
                                                                Chaffey College
                                                                Contra Costa College
                                                                Crafton Hills College
                                                                Cuesta Community College
                                                                Foothill College
                                                                Long Beach City College
                                                                Modesto Junior College
                                                                Moorpark Community College
                                                                Mt. San Antonio College
                                                                Pasadena City College
                                                                Porterville College
                                                                Riverside Community College
                                                                San Joaquin Delta College
                                                                Santa Barbara City College
                                                                Sequoias Community College
                                                                Siskiyous Community College
                                                                Skyline College
                                                                West Hills College


    Please note that some colleges have more than one entry.


                                                                                                27
Title: Distance Learning LVN Program

College: Antelope Valley College
Program: LVN
Contact: Karen Cowell
Email: kcowell@avc.edu
Summary: Distance learning at Antelope Valley College brings an LVN program to students in
isolated Native American communities and remote rural towns in the Owens Valley of
California. Program staff advise applicants on the need to identify adequate support systems
and help enrolled students manage home and work responsibilities while they complete the
nursing program.
                                            Prep to get
Student Timing: Develop                                              Enroll and stay in
                     Interest               into program             program



Description: Antelope Valley College (AVC) and the Owens Valley Career
Development Center (OVCDC) joined forces in 2003 in a collaborative distance learning
effort to bring the college’s LVN program to isolated communities in the eastern Sierra
Nevada. The OVCDC is a tribal organization located on the Bishop Piute Reservation in
Bishop, California. It serves tribal groups along a one hundred and eighty-nine mile
corridor in the eastern Sierra. The AVC campus in Lancaster is two hundred miles from
Bishop. The project began when the Executive Director of OVCDC approached AVC
about enrolling students from Bishop in the LVN program. The LVN program was
already subscribed to capacity and had a waiting list of one hundred students for thirty
program slots. Both parties agreed to try distance-learning technology to expand the LVN
program by creating a satellite site for students in Bishop.

The OVCDC views the program with AVC as a transition from their Certified Nurse
Assistant program to vocational nursing. The OVCDC is responsible for advertising the
program to the local community and recruiting students for their site. They look for
students with drive and commitment who have sufficient family and work support
systems in place. OVCDC helps applicants think through their entire support system and
identify issues that might impede their success in the program before they apply. They
take a preventative approach rather than wait until the students have so many non-
academic interferences that they cannot succeed. For example, they discourage people
from enrolling in the program until they have adequate child care.

The OVCDC provides academic and personal support to the students, most of whom are
parents and working at least part-time. The program provides financial support to the
Native American students, though it is open to all students in the region. The OVCDC
provides students with additional tutoring, and helps with transportation and books.
OVCDC also makes the prerequisites for the LVN program available on-line at their site
in Bishop or transports students to AVC so they can complete prerequisites. The local


                                                                                     28
facilitator provides ―whole life support‖ to the students – whatever they need to succeed
in the program. Because there are limited medical facilities in Owens Valley, students do
have to spend some time on the AVC campus in Lancaster to complete their clinical
training. They also travel to Lancaster a few times each semester so students at both sites
can get to know each other and build camaraderie as an LVN class.

Evidence of Impact/Success: Attrition and student achievement are similar on the
Antelope Valley campus in Lancaster and at the site in Bishop – about 50 percent. There
has been no difference in student pass rates on the NCLEX. Seven students graduated
from the first class in Bishop and all passed the licensing exam. The distance-learning
program has changed the demographics of the LVN program and increased the number of
Native American students attending the nursing program. The intention of OVCDC is to
train students who will stay in the community and help relieve the extreme shortage of
nurses and other health care personnel in Owens Valley. So far, that is the result. Of the
first seven students who graduated in 2004, one left to work at a Piute reservation in
Oregon. The rest remained in the local community. Five additional students graduated in
December 2005.

The project has made nursing education available to students who otherwise would not be
able to pursue it. One student, typical of the Bishop group, is married with four children
and works full-time. The program allowed him to maintain his family and work
commitments and pursue his desire to advance beyond his CNA training. He intends to
remain working at a local hospital. Prior to the distance-learning project, his only option
to further his nursing education was a six-hour round-trip drive to the AVC campus in
Lancaster. Another positive result of the program is that students on the AVC campus
are being exposed to rural life and Native American communities, about whom they had
little knowledge prior to the program. All students must learn to adapt to a new way of
learning using technology.

Resource Requirements: The Piute Nation has made a large financial and personnel
commitment to this project. There is a clinical instructor at the Bishop site and an LVN
serves as moderator for the classes at the site. The moderator tutors the students in
nursing content and maintains close contact with instructors at AVC. AVC provides
instructors, clinical supervisors, and the program coordinator. The project was possible
initially because the OVCDC and the college already had video conferencing systems in
place, with each site having made an investment of about $100,000 in video equipment.
When the project first began, the college received a lot of technical support from
consultants working with the OVCDC. The OVCDC provides extensive technical
support to the distance learning facility and maintains all equipment. Technical staff at
the college maintain their system. They also videotape every lecture and send copies to
Bishop, in case there are technical problems that cause the Bishop students to miss part of
a lecture. The program has worked out technical problems that plagued the first group of
students and reports little down time with the conferencing system now.




                                                                                        29
The project required a tremendous time commitment initially from personnel in Bishop,
the AVC faculty, and the project coordinator. Instructors had to learn how to use the
equipment and adapt their teaching styles and material to the video conferencing.


Contact Information:

Name:             Karen Cowell
Title:            Dean of Allied Health
Organization:     Antelope Valley College

Work Phone:       661-722-6402

Email:            kcowell@avc.edu




                                                                                    30
Title: Colleges Collaborate on Distance Learning RN program
College: Bakersfield College
Program: RN
Contact: Cindy Collier
Email: ccollier@bakersfieldcollege.edu
Summary: Collaboration between Bakersfield, Porterville, and Cerro Cosso Colleges expands RN
training opportunities in central California. Strong support from the faculty and site coordinators
ensures good student retention.
                      Develop               Prep to get               Enroll and stay in
Student Timing:
                      Interest              into program              program




Description: In 2003, Bakersfield College launched a distance education program to
bring its four-semester RN program to multiple sites in central California. During the first
year, thirty students enrolled through Porterville, Delano, and West Hills Colleges. Due
to lack of funding, West Hills dropped the program after the first year. The program
started its second cohort of thirty students at Porterville and Delano Colleges in fall 2004.
In fall 2005, the project added a site at Cerro Cosso Community College that will allow
up to ten LVN students to join the third semester of the program. Students from Delano
can enroll either at Bakersfield College or Porterville College.

Applicants to the distance education program must meet the same criteria, including all
prerequisites, as applicants to the traditional program. Bakersfield now admits forty
distance education students and forty traditional program students every semester,
effectively doubling the number of students who can graduate with RN degrees from
Bakersfield College every semester.

Each site contributes a faculty member who was initially coached by experienced faculty
from Bakersfield College’s RN program. The Bakersfield RN faculty team also ensures
that the curriculum is consistent across the distance learning sites and fully aligned with
Bakersfield’s traditional, on-campus RN program. To support high-risk students, the
program director created a two-unit early-intervention course that is taught at each site.
The course is also offered for one unit for RN students at Bakersfield College. It is
highly recommended for students who fall below 78 percent in didactic training subjects
or who have problems with the clinical training. At the satellite sites, students in the
remedial courses meet weekly with the local instructor. ―It is like a study hall where each
student can sit down with an instructor who can answer their questions and help them
move in the right direction,‖ says Director Collier. While the entire group reviews
subjects such as study skills, critical thinking and clinical skills, each student also has
many opportunities to address individual weaknesses. The students have adapted well to
the teaching style of distance learning technology. They have to be self-starters more than


                                                                                           31
if they have a teacher readily available. Cohort members at the satellite sites rely on each
other more and engage in more cooperative learning.

Evidence of Impact/Success: While the distance learning program has not improved
over-all retention in Bakersfield College’s Nursing Program, it has increased diversity by
making nursing education available to ethnically diverse rural communities. Because
they have the option to bring LVN students into the second year of the four-semester RN
program, the colleges have been able to maintain full enrollment. The dropout rate for
students at the satellite sites has been between 25 and 30 percent, while it is about 7
percent on the main campus at Bakersfield. Applicants to the satellite sites get priority if
they are from the local community. There are four applicants for every space in the
program.

In the first cohort of students in the distance education program, twenty-two students
graduated at the satellite sites and thirty-six on the main campus. The program director
does an exit interview of all students graduating from the satellite sites, and so far 90
percent indicate that they plan to stay and work in their local communities. The program
makes it possible for students to remain in the local community, close to family and jobs
and still pursue a demanding four-semester program. Without an RN program available at
the satellite sites, few if any of the students in these communities would enroll in an on-
campus program that requires commuting over an hour to Bakersfield College. The
program continues to grow in popularity. At Porterville, there were sixty-four applicants
for twenty slots in fall 2005. There are also twenty students on the Bakersfield campus in
the distance-learning project, in addition to forty in the traditional RN program.

Resource Requirements: The distance learning program began with grants from the
chancellor’s office of the California Community Colleges and private grants. The grants
paid for instructors at Porterville and West Hills Colleges, and for the administration of
the program at Bakersfield College. Grant funding also helped build the technical
infrastructure and support new faculty positions. Bakersfield funded their RN faculty.
During the second year of the project, the costs for the Porterville site were funded by
Sierra View Hospital and Porterville College committed a full-time tenure-track position
to the RN program.

A program coordinator is based at Bakersfield College but travels regularly to the other
sites. Her job is to make sure there are instructors at the sites. She handles scheduling,
resolves technical issues, and secures the clinical sites for the distance-learning students.
According to the program director, coordination among the sites is the greatest challenge.
The faculty members at the satellite sites joined the program with experience teaching
LVN, but not RN students. Most of the faculty also lacked experience teaching using
distance education. The program director has spent considerable time on the project and
the assistant director for distance education at Bakersfield College travels to each satellite
site weekly.




                                                                                           32
Contact Information:

Name:           Cindy Collier
Title:          Director of Nursing
Organization:   Bakersfield College

Work Phone:     661-395-4282

Email:          ccollier@bakersfieldcollege.edu




                                                  33
Title: X-Ray Technician Pilot Program Draws Local Hispanic Community
College: Cabrillo Community College
Program: X-Ray Technician
Contact: Dr. Tom McKay
Email: tomckay@cabrillo.edu
Summary: Partnership secures funding to pilot an x-ray technician program that provides
advancement opportunities for incumbent workers and increases medical services available to
rural population.

Student Timing:     Develop               Prep to get              Enroll and stay in
                    Interest              into program             program



Description: In 2004, Cabrillo Community College collaborated with three local
employers and community partners to launch the Bay Area Workforce Funding
Collaborative. The partnership proceeded to design and seek funding for an x-ray
technician program that would provide graduates who passed state certification with a
permit to work as x-ray technicians in clinics or in doctor’s offices. The area around
Cabrillo Community College is rural and having a supply of job-ready x-ray technicians
would enable small medical offices and clinics that cannot afford to have a radiologic
technologist on staff to offer x-ray services. The collaborative’s request for Workforce
Investment Act funding administered through the San Francisco Foundation was
successful and grant funding was secured to support curriculum development and
implementation of a pilot two-semester x-ray technician training program. At the time,
the program was the only one of its kind at a California community college and provided
local residents with an alternative to the more expensive private education programs that
had been the only option for those interested in an x-ray technician certificate.

Twelve participants were incumbent workers, mostly medical assistants, recruited by
employers. Others came from the general population around the college. A total of
twenty students were accepted from among many more applicants (see below). Twelve
students were Hispanic/Latino; seven White; and one Asian. Students’ ages ranged from
twenty to fifty-five years. Sixteen students were female. Most of the medical assisting
participants did not have the college preparation their peers brought to the program. This
created what the instructor described as ―an interesting challenge‖ in the classroom. For
example, students who had not taken anatomy found it very difficult to position the body
parts they were about to x-ray.

The grant enabled the program to offer participants a comprehensive range of support and
case management services. These included: tutoring services, access to a place on
campus to study and make phone calls; help with learning skills difficulties; access to
counseling and child care; and stipends to cover transportation, tuition, books, uniforms,
shoes and other program-related expenses. The case management and other support


                                                                                        34
Title: Early Intervention and Remediation in Dental Hygiene Program
    services were, according to the lead instructor, ―critically important‖ in maintaining a 100
    percent retention rate. The services were delivered by FastTrack, a nonprofit organization
    with offices at the college that provides case management services to students in several
    workforce development programs.

   Evidence of Impact/Success: Interest in the program was very strong. The partners
   hosted three orientations that attracted forty to fifty people. The retention rate for the
   twenty students who were accepted has been 100 percent. The program succeeded in
   recruiting and enrolling a large number of Hispanic/Latino students (60 percent of
   participants). Students who worked as medical assistants before and while in the program
   will enjoy a $2.00 to $4.00 per hour increase in pay after they complete the program and
   pass the certification test.

   Resource Requirements: The program would not have been possible without Workforce
   Investment Act (WIA) funding. At this time, Cabrillo Community College is trying to
   get funding from the Department of Labor to offer a second class. The goal would be to
   enroll a new group of students in eighteen months when the college estimates that more
   x-ray technicians will be needed in local clinics and doctors’ offices.

   The program design phase was labor-intensive as is often the case when multiple partners
   are involved. The implementation phase also required more time and resources than
   anticipated. One of the main challenges was finding clinical training sites for the
   students. This was especially difficult because the state requires a ratio of one trainee to
   one supervising physician. The case management services made this an expensive
   program if considered on a cost-per-student basis. However, as pointed out earlier and as
   illustrated by many other best practice studies, the case management had a major impact
   on maintaining the retention rate at 100 percent.

   The lead instructor/program coordinator advises that colleagues trying to replicate the
   program, or to launch any other new health care program, should start by familiarizing
   themselves with the state regulations. Another piece of advice is that the planning
   process should include all stakeholders inside and outside of the college.

   Contact Information:

   Name:            Tom McKay, Ph.D.
   Title:           Director of Allied Health & Nursing
   Organization: Cabrillo Community College
   Work Phone: 831-479-6455
   Email:           tomckay@cabrillo.edu


College: Chabot College



                                                                                             35
Program: Dental Hygiene
Contact: Joanne Galliano
Email: jgalliano@chabotcollege.edu
Summary: The program provides early intervention and a remediation process when a student
runs into academic trouble, preparation for licensing exams, and opportunities to gain cultural
competence in preparation for serving a highly diverse client population.

Student Timing:      Develop                Prep to get              Enroll and stay in
                     Interest               into program                 program



Description: The Dental Hygiene Program at Chabot College is small and selective; enrolling
eighteen out of a pool of approximately ninety qualified applicants each year. Applicants are
selected using a system that awards points for overall GPA and grades in anatomy, physiology,
and microbiology courses. Since the program attracts applicants from throughout California,
applicants from the college’s district receive an additional five points. Fifty to one hundred
people attend an information day on campus each fall. Most applicants have completed at least
two years of prerequisite college course work. The program is demanding and requires a full-
time commitment for two years. Applicants are told they should not expect to work while in the
program and very few do.

The diversity of the San Francisco Bay Area population is reflected in the program’s
demographics and it is one of the most diverse programs on the Chabot campus. Since only
eighteen students are admitted each year, a lot of effort goes into retaining them. Each student
receives a mid-term review and another review before finals. The faculty intervene early if a
student is in trouble. If a student does poorly on an exam, a remediation process begins
immediately. Faculty find out what is causing the failing grade and steer the student to
counseling, tutoring, or ESL assistance. The college works to ensure that the students graduate
and pass the licensing exam. They provide mock board examinations for both the state clinical
board exam and the National Dental Hygiene Board Exam to make sure no one lacks the didactic
or clinical skills required to pass. These mock exams give students a good idea of what to study
and how to prepare.

The program also addresses diversity in the curriculum. A number of courses incorporate
information about diversity. There is an oral health class in the first semester that covers topics in
cultural diversity. They discuss different perceptions of dental care and have students from
different backgrounds share their own and their family’s dental care experiences. This gives
students a better understanding of different cultural attitudes than they can get from reading. The
college has a dental clinic, so the students must prepare to serve a wide variety of patients. The
program also prepares students for a diverse patient population through community service at
day care centers, residences for the elderly, and elementary schools.

One student, who entered the program after obtaining a bachelors degree at UC Davis, described
the program as ―more intense than what I expected at a community college‖ and found the


                                                                                                   36
clinical experience to be superior. She felt the college is supportive of students who get into
trouble. Another student described the program as ―like a family‖ that ―doesn’t not want you to
fail‖.

Evidence of Impact/Success: The Chabot program has excellent retention and pass rates on
licensing exams. Typically 100 percent of students graduate from the program, the majority in
four semesters. Chabot has had a 100 percent pass rate on the national board exam for the past
two years. Between 75 and 85 percent of graduates pass their clinical state board exam on the
first try; 100 percent pass by the second time they take the test. Students who don’t pass the
clinical exam on the first try can take a prep course and continue to use the college clinic to keep
up their skills. Almost 100 percent of graduates are ultimate licensed by the state as dental
hygienists. The Dental Hygiene Program at Chabot receives excellent feedback from local
employers about the quality of its graduates.

Resource Requirements: Employers contribute to the Chabot College Dental Hygiene
Education Fund, which is composed of local dentists, dental practices, and hygienists. They give
a book to each student and provide clinical supplies. The local professional organization provides
continuing education courses that serve as fundraisers for the program.

Contact Information:

Name:              Joanne Galliano
Title:             Dental Hygiene Program Director
Organization:      Chabot College

Work Phone:        510-723-6866

Email:             jgalliano@chabotcollege.edu




                                                                                                  37
Title: Outreach, Orientation, and Retention in Radiologic Technology Program


College: Chaffey College
Program: Radiologic Technology
Contact: Andrea Dutton
Email: Andrea.Dutton@chaffey.edu
Summary: Outreach teams at Chaffey College bring a diverse student population to the
Radiologic Technology Program. A strong orientation program and support services help
maintain a nearly 100 percent retention rate.

Student Timing:      Develop                Prep to get               Enroll and stay in
                     Interest               into program              program



Description: The Radiologic Technology Program at Chaffey College is one of the top ten
programs in the country in the diversity of its faculty and students. The program has three full-
time and one part-time Spanish-speaking faculty members. Outreach teams reach deep into the
surrounding San Bernardino County communities to make underrepresented populations aware
of the program and of professional opportunities in radiologic technology, a field that is not as
widely known as others such as nursing. Faculty members go to city career fairs, college days,
and middle and high schools in the region. They also promote the program throughout the
community at social events. The outreach teams include students and professionals from the
clinical affiliates. The website is a major feature of the program’s outreach.

Radiologic technology is a demanding program and considered a high-tech career. The program
goes to great lengths to ensure that applicants understand the demands of the program and the
requirements of the profession. There is an extensive application and orientation process.
Applicants must meet prerequisites in math, biology, and chemistry or physics before they can
apply to the program. Applicants are notified when they’ve met the prerequisites and invited to a
three-hour orientation session with faculty members that covers the program requirements in
detail. Students are told they can work nor more than twenty hours per week while in the
program. Students who are still interested after the orientation apply, and the top fifty applicants
go to a second orientation at one of the affiliate hospitals. The counseling department also
reviews the applications. Students who continue with the application process complete a
questionnaire and meet with the program director. This extensive orientation produces a
committed group of students who are prepared for the rigor of the program and clearly
understand the job of the radiologic technologist.

Evidence of Impact/Success: The program director believes that their aggressive outreach
efforts account for 75 percent of the increased diversity in the program. The rest is a result of
changing demographics in the local communities. Expectations for student performance are
high. Students must maintain a 78 percent average in all classes to remain in the program.



                                                                                                    38
Six years ago there were forty applicants for twenty-eight slots. The program would lose about
one-third of the students before they graduated. Today retention is nearly 100 percent and the
program has nearly five applicants for each of its twenty-eight slots. One hundred percent of
graduates have passed the national board during the past three years. They get the ―cream of the
crop‖ and a student body ―reflective of the substantial Hispanic, Asian, and African-American
populations in the area‖, according to the program director.

Resource Requirements: The college does not have additional funding for any aspect of its
outreach, orientation, and retention efforts. Faculty, students, and local professionals volunteer
their time for the outreach teams. Local clinical affiliates provide access to facilities and
personnel for the orientation sessions before students are accepted into the program.

Contact Information:

Name:              Andrea Dutton
Title:             Radiologic Technology Coordinator
Organization:      Chaffey College

Work Phone:        909-477-8979

Email:             Andrea.Dutton@chaffey.edu




                                                                                                     39
Title: High school Students Enroll in Hands-on EMT Program


College: City College of San Francisco
Program: Emergency Medical Technician
Contact: Peggy Guichard
Email: mguichar@ccsf.edu
Summary: High school students complete a college EMT certificate program during their
senior year, gaining college credit and exposure to health care career opportunities.
                     Develop               Prep to get                 Enroll and stay in
Student
                     Interest              into program                program
Timing:


Description: A group of innovative instructors at City College of San Francisco
(CCSF) recognized that the best way to introduce high school students to career opportunities in
the health care field was to enroll them in the most dynamic and hands-on health care courses the
college has to offer. The strategy, which quickly identified the college’s EMT program as the
best choice for engaging the minds and imagination of teenagers, also had the potential to
increase diversity in the public safety occupations in the San Francisco Bay Area.

CCSF launched a collaboration with local high schools to enroll students who had just begun
their senior year in a two-semester emergency medical technician program for which participants
receive high school credit and credit towards graduation at CCSF. About half of the classes are
delivered at CCSF and in the field. The other half is delivered by one of CCSF’s EMT
instructors at the high school. To date, CCSF has offered the program to students at two local
high schools. The second group, comprising thirty-two high school seniors, graduated in spring
2003. A month before the end of the semester, the instructor estimated that twenty-six to twenty-
eight of the thirty-two students who began the two-semester course would complete with a
passing grade and receive an EMT certificate. He said it was very demanding to teach students
who ―didn’t know how to learn,‖ and that he spent quite a bit of time teaching the students how
to read for content and comprehension. He also noted that he uses multiple approaches to
explain concepts and teaching this class has expanded his instructional repertoire. Further, the
instructor has worked with the department chair of health care technology to integrate into the
program career exploration activities. While these exercises help some students confirm their
interest in health care and perhaps even identify the area in which they want to specialize, other
students conclude that a career in health care is not the right choice for them. The program
considers both a positive and a negative decision to be successful outcomes since the implication
is that students are more likely to focus their education on the right subjects. In addition, the cost
of providing health care instruction is so high that the college wants to make sure that entry is
granted only to students who are fully aware of what to expect in the classroom and in the field.

Evidence of Impact/Success In a focus group, the high school students expressed great
enthusiasm for the EMT program’s ―hands-on‖ approach and mentioned as one of the highlights


                                                                                                   40
a beach rescue exercise at local Baker Beach. The students were able to name a number of
different health care fields and said they did not know what an EMT was when they entered the
program.

A comparison of the student body enrolled in the high school and in the ―regular‖ CCSF EMT
course underscores that the former program is exposing a new population to the field of EMT.
The high school EMT course includes many Asian and female students. The ―regular,‖ adult
EMT class, although it is serving a population that is much more diverse than it used to be, is
still predominately comprised of young, white males. The high school course is thus contributing
to introduce representatives from underrepresented groups to the field of EMT and, more
generally since these students are very young, to the possibility of working in the health care
field.

Resource Requirements: It was labor-intensive to plan and implement the program with the
high school. It is advisable that a community college work with high schools where the principal
and at least one instructor are strongly committed to the initiative.

It is also important to have the right instructor. It is very different to teach high school students
than the traditional adult EMT student. The CCSF department chair emphasizes that ―you need
somebody who can relate to young kids. Our instructor has three boys at home and he likes and
knows how to interact with teenagers.‖

Contact:

Name:                 Peggy Guichard
Title:                Department Chair, Health Care Technology
Organization:         City College of San Francisco
Address:              Health Care Technology, John Adams Campus
                      1860 Hayes Street
                      San Francisco, CA 94117
Work Phone:           415-561-1967
Email:                mguichar@ccsf.edu
Other :               http:// www.ccsf.edu/Departments/Health_Science/




                                                                                                    41
Title: Union-College Collaboration Prepares Health Care Workers to Move up the
Career Ladder


College: City College of San Francisco
Program: Bridge to LVN
Contact: Linda Johnson
Email: ljohnsonsf@att.sf
Summary: Summer Bridge Program and Case Management Services Help Incumbent HC
Workers Succeed in LVN Program.


Student             Develop               Prep to get              Enroll and stay in
                    Interest              into program             program
Timing:


Description: The Bridge Program, aWorkforce Investment Act-funded collaboration between
City College of San Francisco (CCSF) and the Shirley Ware Education Center (SWEC),
recruited participants from among incumbent workers at San Francisco hospitals and enrolled
them in a Summer program that prepared them to enter CCSF’s LVN Program in the fall.
Employers agreed to support the program by providing workers with flexibility to attend the
Bridge and LVN programs and by paying them their regular wages during some of their school
and study time. In some instances, employers also promised participants that they would
advance in their careers if and when they passed the LVN licensing exam after completing the
program.

Students included CNAs, medical assistants, and other entry-level workers. Many had worked in
the same low-paying field for a long time.

The ten-week training emphasized foundation skills such as how to use learning tools and
resources, study techniques and strategies, test taking, and critical thinking as well as
communication in nursing and practical skills essential in vocational nursing.

The skills and confidence students developed during the Bridge program played a key role in
making them successful in the LVN program. In identifying the most important skills they got
from the program, students listed study habits, organizational skills, how to read test questions
and how to develop study groups. Because of their shared summer experience, the students were
also able to enter the LVN program as a community of learners. They knew each other well and
were very supportive of each other. In addition, the Bridge students had access to case
management services provided by SWEC. The students used these services extensively during
the three semesters of LVN training and the knowledge that there was somebody out there to
help them played an important role in helping each student succeed. In identifying important
support services they received from the case managers, students listed ―help communicating with
my employer‖ and ―getting money for books and tuition.‖ The case management also extended


                                                                                              42
into the academic arena. One student noted that, ―They (SWEC) even set up a study group to
review pharmacology for us.‖

Evidence of Impact/Success: Fourteen students who participated in the Bridge program began
the LVN program in fall 2004. Twelve graduated three semesters later. One of the two students
who dropped out had a family emergency.

In a focus group conducted by an outside evaluator, participants praised both the Bridge program
and the case management activities. Many emphasized that both services played a key role in
helping them successfully complete the LVN program. One student who had worked as a
medical assistant for ten years before enrolling in the Bridge and LVN programs recounted that
―I had not been to school for many years when I started the Bridge Program. But I wanted to do
something for myself and I took a chance. I didn’t think I would be able to make it because I
didn’t do well in school in the past. As it turned out, I made it thanks in a large part to Bridge
and the case management services which were always just a phone call away.‖ Several focus
group participants said they had gained so much confidence in themselves from the experience
that they planned to go on to enroll in an RN Program.

Resource Requirements: This program was supported by a grant from the Workforce
Investment Agency of San Francisco that was administered by the San Francisco Private
Industry Council. The start-up costs included development of a customized course outline
named: CNA-LVN Bridge Course VOCN 22EX. Linda Johnson and Judy Inman developed the
outline. They were both involved in teaching the Bridge Program during the summer of 2004.

The students’ employers contributed paid study-time, although the amount varied widely among
institutions. One student got eight hours of pay-to-study leave time a week. He was paid for
forty hours of work each week, but only had to work thirty-two. Another student’s employer
provided thirty-two hours of pay-to-study leave time per week and required only eight hours of
work for forty hours of pay.

Contact Information:

Name:              Linda Johnson
Title:             Vocational Nursing Instructor
                   School of Health & Physical Education, City College of San
Organization:
                   Francisco
Address:           1860 Hayes Street, San Francisco 94117
Work Phone:        415-561-1912
Email:             ljohnsonsf@att.net




                                                                                               43
Title: Innovative Teaching, Tutoring and Team-Work in RN Prerequisite Courses
College: Contra Costa Community College
Program: Courses: Physiology, Microbiology, Anatomy
Contact: Debra Barnes, Ph.D
Email: dbarnes@contracosta.edu
Summary: Biology instructor’s dynamic math-for-science course, hands-on group work in the
core sciences, and open door policy engages and advances students who otherwise tend to get
stuck in prerequisite courses

               Develop                   Prep to get                 Enroll and stay in
Student
               Interest                  into program                program
Timing:


Description: A small group of instructors teaching core biology courses required for entry into
RN, radiologic technology, dental hygiene, and other programs have developed interactive and
innovative strategies for teaching students math for science, microbiology, physiology, and
anatomy.

One activity helps students build a foundation of math skills that they need for the core sciences.
Developed by Dr. Debbie Barnes, a long-time and energetic instructor at Contra Costa College,
the .5 unit lab and lecture course teaches students to use the metric system and to make and
interpret scientific notations. The interactive course includes work in group and teams. Students
who take the course before they enroll in core biology courses gain the skills, enthusiasm and
confidence that so many community college students lack when they enroll in science courses.
In many cases, the attitude the students have to the biological sciences changes markedly as they
realize that ―this stuff is really interesting‖ and ―I am actually able to understand it.‖

The Contra Costa biology team has also changed anatomy—a course most pre-nursing students
struggle to pass— by supplementing the regular lecture-based class with a one-unit, hands-on
class called ―Group Work in Human Anatomy.‖ The course features interactive lectures and
discussions on topics that students often have trouble comprehending such as the autonomic
nervous system, muscles and bony landmarks, and the urinary system. The course outline
promises students that they will work in small groups and ―use models, bones, slides, organs and
cadavers to help understand and deepen their knowledge in anatomy. ― The course accomplishes
several goals. It makes anatomy come to life for students who, in many cases, have bad
memories of high school biology, and it teaches them to work in teams to problem-solve. As one
part of the requirements, students must work with their group to plan and present the landmarks
and joint surfaces of a particular bone or bones. The class also engages students in scientific
journal reading, requiring that they read and summarize three scientific articles.

Physiology, another RN prerequisite that most students fear, also features group work, journal
reviews, oral presentations, lab write-ups and ―problems of the week.‖



                                                                                                 44
In addition to injecting excitement and relevance into the curriculum, the biology team tutors
widely. In addition to regular office hours, Dr. Barnes offers two hours of tutoring per week for
all students. The session, which often ends up as a group activity, provides students with
additional opportunities to review the material, dissect mistakes they made on exams and learn
from them, and ask questions in a supportive and fun environment. The instructor-delivered
tutoring is supplemented by peer tutoring, which is offered in every class.

Evidence of Impact/Success: The popularity of the courses was confirmed in fall 2005 when
Dr. Barnes was unable to teach the group-based anatomy section. Dozens of students tried to
sign up and came to complain about the one semester hiatus (which resulted from Dr. Barnes
having other commitments).

The positive impact of the supplementary courses was suggested in 2004, when Dr. Barnes
taught one anatomy course with the one-unit group work section and another without the
supplementary course. At the end of the semester, those in the group section did better and
learned more than their peers in the ―traditional‖ course.

Another sign of success is the number of students coming for the tutoring sessions and the
interest that students suddenly show in biology. For example, ever larger numbers of students
are using the microscopes in the college’s tutoring center. Before the group work began,
―nobody ever used these resources.‖

Resource Requirements: The two faculty members who are mainly responsible for the
innovation in the prerequisite courses are extremely enthusiastic about their subject and love to
teach. Both emphasize critical thinking and encourage students to ―understand and not
memorize.‖ The instructors see every test as a learning opportunity and spend much time helping
students understand why, for example, one answer is better than another. The instructors are
clearly not just willing but committed to providing tutoring on their own time.

The faculty members who lead the innovation write ―lots of grants‖ and use the proceeds to
support ongoing innovation and improvements. For example, some of the curriculum
development described above was funded by a Pathway to Success in Biology grant. Similarly,
the peer tutoring was originally grant-funded, but became so successful that the college assumed
the cost when the grant expired.

The faculty has also engaged in research that has strengthened the curriculum. Dr. Barnes used
her first sabbatical to visit a large number of hospitals and nursing programs around the state.
She asked the former ―what do you want students to know about anatomy and physiology‖ and
asked the latter how they were teaching these courses. The findings drove one of many
curriculum improvement activities the department has undertaken to ensure that students have all
opportunities to learn not just the skills needed to complete the prerequisites and move on to
nursing and other health programs, but also to develop a way of thinking that mirrors what
employers need.




                                                                                                45
Contact Information:

Name:                  Debra Barnes, Ph.D.
Title:                 Biology Instructor
                       Contra Costa Community College
Organization:
                       Office: HS-100
Work Phone:            510-235-7800, ext. 4287
Email:                 Dbarnes@contracosta.edu




                                                        46
Title: Nurse Mentor Identifies and Responds to Under-Performing Students


College: Contra Costa College
Program: RN
Contact: Dr. Sandra Castillo
Email: SCastillo@contracosta.edu
Summary: An integral part of the RN instructional team, the nurse mentor works with failing
students to develop and implement individualized action plans for success.


Student           Develop                  Prep to get            Enroll and stay in
                  Interest                 into program           program
Timing:



Description: Many RN and other demanding health occupations programs employ a part-time or
full-time nurse mentor who provides academic and other support services to students. In most
instances, this person has a background in nursing, but is not part of the program faculty. This
makes students feel comfortable asking questions and revealing academic as well as personal
concerns.

At Contra Costa College’s RN Program, the nurse mentor was originally hired to promote both
recruitment and retention. With more applications than slots available, however, the emphasis of
the job is on retention and, specifically, on providing early intervention and support services to
struggling students.

The nurse mentor receives test scores from the RN faculty immediately after each test and
contacts every student who scores below 75 percent by dropping a referral form into their mail
box. This prompts a one-on-one meeting where the nurse mentor works with the student to
determine what kind of assistance is needed. A tool in this process is often the exam that got the
student into the nurse mentor’s office in the first place. ―Every exam and every mistake
represents a learning opportunity,‖ the nurse mentor says, echoing the prevailing thinking in the
department. ―You want students to understand why the answers they selected are incorrect and
why the ones they should have chosen are better.‖

Working together, the nurse mentor and the student jointly develop ―an action plan,‖ that
identifies steps the student needs to take to improve. The nurse mentor noted that the action plan
is much like a care plan and that it is formulated using the objectives in the syllabus as a road
map. Often, a key part of the intervention is to help students move away from memorization and
to teach them to actively read and break down their assignments. ―Try to start working on this,‖
the Nurse mentor will tell the student, ―and then come back and tell me how it is going. The
goal is to provide students with a few manageable and highly tangible steps they can take to
begin to address their weaknesses. When they succeed, the next steps become easier to take and


                                                                                                47
so on. The nurse mentor explains: ―When we first meet, they will often try to take copious notes.
They are overwhelmed and sometimes in what can best be described as a panic mode. So I tell
them to put away their pen. We develop a list and then check off a limited number of items the
student will begin working on.‖

To accommodate students who work or live far away from campus, the nurse mentor has
recently begun to offer phone as well as on-site support services.

In addition to working with individual students, the nurse mentor also offers workshops to help
students build skills that many entering nursing students lack, such as time management and test
taking skills. These workshops are available to all students and not just to those who are at risk
of failing.

To be as effective as possible, and in recognition of students’ increasing use of the Web, the
nurse mentor revised the Contra Costa RN program’s website, adding a large number of
resources students can use to ―serve themselves‖ if they have routine questions. For example,
the website includes a ―Survival Guide‖ for nursing students. The nurse mentor also serves as a
source of information and referrals for a host of campus resources that many RN students are not
aware exist.

In addition to serving RN students, the nurse mentor helps students interested in entering the RN
program understand what they need to do to get ready, both in terms of the courses they are
required to complete and in terms of additional work they can do to be as prepared as possible.
The nurse mentor may also advise aspiring students to volunteer at a hospital to see first-hand
what nursing is all about. To encourage such initiative, the nurse mentor has included a large list
of volunteer opportunities on the RN program’s website.

Evidence of Impact/Success: The nurse mentor was hired in fall 2002. At that time, the
attrition in the extremely diverse program was 46 percent. A year later, attrition had been cut to
26 percent and by fall 2004 it was 17 percent. Many variables contributed to this improvement.
They include a high level of faculty cohesion and commitment, an emphasis on critical thinking,
which includes the development by faculty of high level critical thinking questions and an
introductory critical thinking session for all incoming students. Additional factors include
faculty-led test review sessions and the formation of the faculty nursing teams that include all
instructors who teach a particular course. Another variable is that the program increased the
entry requirement GPA from 2.5 to 2.75 for the core science courses.

The program director emphasizes that the great improvements that have occurred result from the
collective work of the whole nursing faculty. The nurse mentor, she explains, complemented
and added to this major effort. The improvements occurred while the program underwent a
significant expansion from accepting forty-seven new students in fall 2002 to enrolling seventy-
seven new students in fall 2004. The program increased retention at the same time that it was
implementing a large expansion.

Resource Requirements: At Contra Costa College’s RN Program, the nurse mentor is a part of
the nursing faculty and participates in the department meetings and activities. The nurse mentor



                                                                                                48
also meets regularly with the nursing teams. The teams meet regularly to review test questions
and to make decisions based on input from all team members. Including the nurse mentor in the
department meetings and on the nursing teams ensures that she gets feedback from the
instructors about individual students and stays up-to-date on student progress. Including the
nurse mentor signals to students and faculty alike that her work is an integral part of the program
and a resource for both groups.

The nurse mentor has a masters degree in nursing. She also has a background working as a
public health nurse, a job that helped her develop strong counseling skills. The faculty and
program director agree that the combination of counseling and nursing skills makes Tate
Matthews, the nurse mentor, ideal for the job. She also brings youth and enthusiasm to the job.
This combination of personal traits make it easy for students to relate to her and to perceive her
as an ally who will help them navigate their way through a difficult program. The nurse mentor
is on campus two days a week. She also makes herself available by email and phone so students
can reach her in an emergency.

The nurse mentor’s position was originally funded by the Enrollment Growth for Nursing Grant
from the California Community College’s chancellor’s office.

Contact Information:

Name:            Sandra Castillo, Ed.D., RN
Title:           Director of Nursing
Organization     Contra Costa Community College
Work Phone:      510-235-7800, ext. 4268
Email:           SCastillo@contracosta.edu




                                                                                                 49
Title: Student Support Services for Respiratory Care


College: Crafton Hills College
Program: Respiratory Care
Contact: Ken Bryson
Email: kbryson@crafton.sbccd.cc.ca.us
Summary: Crafton Hills College reaches deep into the community to inform local residents
about the Respiratory Care Program. Prospective applicants learn about the profession through
a required course. Enrolled students receive tutoring and other support services.

Student           Develop                Prep to get             Enroll and stay in
                  Interest               into program            program
Timing:


Description: The Respiratory Care Program at Crafton Hills College combines outreach
throughout the community and student support services to attract and retain a student population
that ranges between 30 and 30 percent students of color. The program is more diverse than the
student population at the college as a whole. While diversity in the program has improved due to
changing local demographics, program staff still make a strong effort at outreach. Since
respiratory care is not as well known an occupation as nursing and dentistry, the Respiratory
Care program does outreach to local high schools, churches, and community groups to let people
know about job opportunities and the requirements of the Crafton Hills program. Local religious
leaders help get the word out to their parishioners and connect the program with other
organizations for outreach. Word-of-mouth has become an important factor, as successful
students pass information on to friends and relatives. The program director sees multiple
members of extended families inquiring about the program. ―When people see other people of
color in a program, that piques their interest, and that interest carries on through the years‖
observes the program director, Ken Bryson. ―Success breeds success‖ –– a situation reinforced
by a diverse faculty and group of clinical instructors. The program also brings career
information to elementary, middle, and high school students at campus career days. While there
are more applicants than space available in the program, the program director still recruits
actively to maintain diversity and get the best students possible.

Before students can apply for the program they must complete an introductory course that
surveys the respiratory care profession and the specifics of the Crafton Hills program. They go to
hospital respiratory care departments and talk to department heads and staff. The course gives
students a realistic picture of jobs in respiratory care. While this course reduces the number of
people who ultimately apply to the program, it also helps keep attrition from the program low by
eliminating potential candidates who do not have sufficient interest in the profession.

The program’s efforts to provide a diverse workforce in respiratory care for San Bernardino
County do not stop at enrollment. The program director provides tutoring six hours a week for
program courses, and refers students to another campus program is they need to remediate


                                                                                                50
deficiencies in basic skills. The college student success program helps with personal problems
such as financial and child care issues. There are on-campus childcare services. Special ESL
support has not been a particular need for the Crafton Hills students.

Evidence of Impact/Success: The program enrolls thirty-five students each year into the
certified respiratory therapist program out of about fifty applicants and twenty to twenty-five in
the registered respiratory therapist program. The completion rate for the program fluctuates
between 70 and 80 percent. National accreditation requires Crafton Hills to keep program
attrition at 30 percent or less. Students can take the licensing exam when they complete the
Certified Respiratory Therapist program, or they can move on to the college’s Registered
Respiratory Therapist program. Most of the attrition is in the CRT program. The college’s pass
rate is one of the top in the nation, in the mid-80 percent for the CRT program and the low 90
percent for the RRT program. Crafton Hills graduates perform at 130 to 150 percent of the
national average on the licensing exam. Graduates are highly sought after by local employers and
100 percent of graduates find jobs. The local hospitals are great promoters of the program and
refer people who express interest in the profession to Crafton Hills.

Resource Requirements: The program does not have personnel specifically dedicated to
outreach and retention. The program director, faculty members, and professionals from clinical
affiliates all participate in outreach activities by attending college fairs on campus and going into
the community to schools, churches, and other organizations. The program director and faculty
provide six hours of tutoring per week. The program director could use specific funding to
expand the tutoring service.

Contact Information:

Name:            Ken Bryson
Title:           Respiratory Care Program Director
Organization     Crafton Hills College
Work Phone:      909-389-3284
Email:           kbryson@crafton.sbccd.cc.ca.us




                                                                                                   51
Title: Word-of-Mouth Draws Diverse Students to Rural Psych Tech Program



College: Cuesta Community College
Program: Psychiatric Technician
Contact: Susan Jones
Email: Prefers calls
Summary: State hospital and college collaborate on recruiting and training psych tech
students.

Student                Develop             Prep to get          Enroll and stay in
                       Interest            into program         program
Timing:


Description: For the past several years, Cuesta Community College and Atascadero State
Hospital have collaborated to recruit and train psych tech students. Their efforts have made many
local residents aware that (a) there is a job category called psychiatric technician; (b) those who
are trained in this field are in very high demand; and (c) the pay and benefits are good. Cuesta
Community College offers a three-semester psychiatric technician program that can be
completed in one year (plus whatever time it takes to complete the prerequisites). Students in the
program can work at Atascadero State Hospital while they study and the program offers child
care and other support services.

The college does outreach by annually hosting twelve program information meetings that brief
would-be applicants to the program on what the position requires, job opportunities in the field,
pay, hours, the need for background checks, and support services available to students. Public
notices of the meetings are mailed to a large number of organizations including hospitals,
women’s health networks, high schools, colleges, and employment organizations that serve
underrepresented populations.

Equally important to getting the word out is the word-of-mouth reputation of the program. As
one or two members of a small, tight-knit community graduate from the program and obtain a
good job, word quickly gets around. The program sees this when the relatives, neighbors, and
friends of current students and graduates of the program come to enroll.

The participants are highly diverse in terms of race, ethnicity, age and past experience. Lately,
more Hispanic applicants are coming from the area south of the college. The program is also
seeing more African Americans and Filipinos. The students range in age from young adults to
individuals in search of a second or third career.

Hospital employees who enroll in the program include those in lower-paid jobs such as janitors
and food service workers. Another group is psych tech assistants. Overall, each new group of
forty to forty-five students typically includes four or five food serve workers and janitors.


                                                                                                    52
The program’s support services play a key role in helping students stay in the program. Most
importantly for many students, is the opportunity to work up to thirty-two hours a week (most do
twenty) at Atascadero State Hospital while they are in school. As part-time hospital employees,
they receive health care and other benefits. Another key service that makes enrollment and
retention possible, especially for single mothers, is the college’s child care center. Child care is
provided at no charge students are in school.

Another strategy that helps increase retention is early intervention. If a student is doing poorly,
the instructors will jointly consider the problem, identify the results they want to see, and
develop a correction plan for the student who will ―buy into the plan, take it home, and get to
work.‖ To further assist students and to remedy a common weakness, the program has
augmented its critical thinking curriculum and developed workshops that train students to take
tests.

Evidence of Impact/Success: The program enrolls forty-five students each semester. As a
result, a total of about one hundred twenty students participate at any one time. On average,
forty students graduate from each class of forty-five. This is a very good outcome, as psych tech
programs often have high attrition. In addition to the services identified above, program staff
believes that the information meetings help retention because students know more about the
program before they enroll. Incoming students know what to expect and almost no students
enter the program only to withdraw after discovering that it was not ―what I had expected.‖

In 2004, 87 percent of graduates passed the licensing test. This compares favorably with the
statewide average of 67 percent.

Resource Requirements: The program’s collaboration with the state hospital is key to the
success, but it is a win-win situation. The program attracts students because it can offer them
paid training opportunities at the hospital. The hospital gets extra help and a chance to custom-
train individuals they may hire within a year. And although graduates are qualified to work in a
variety of settings, the program emphasizes employment at the state hospital. For support
services, the program relies mainly on general college services such as DSPS, the ESL program,
and child care services.

Another key resource is the state hospital’s psych tech coordinator who helps screen students for
the program and coordinates hiring of full-time psych techs for the hospital. The overlap of
these duties results in smooth transition from the training program to the workplace as most
psych tech graduates are hired by the state hospital.




                                                                                                  53
Contact Information

Name:           Susan Jones
Title:          Director of Psychiatric Technology
Organization:   Cuesta Community College
Address:        Atascadero State Hospital Psychiatric Technician Training
                Program
Work Phone:     805-468-3175




                                                                            54
Title: Allied Health Orientation Courses


College: Foothill College
Program: Radiologic Technology and Dental Hygiene
Contact: Eloise J. Orrell and Phyllis Spragge
Email: orrelleloise@foothill.edu and spraggephyllis@foothill.edu
Summary: Required courses provide prospective applicants an overview of health professions
and a specific introduction to several programs and careers. Dental hygiene and radiologic
technology students complete a required summer introductory course before advancing to the
full-time program.


Student            Develop                  Prep to get             Enroll and stay in
                   Interest                 into program            program
Timing:


Description: Foothill College’s Division of Biological and Health Sciences has a set of required
orientation and introductory courses for the allied health programs. These courses give
prospective applicants a good understanding of each health program’s academic requirements
and time commitment along with the reality of the profession and workplace. One course, AHS
200, provides a general orientation to allied health careers and the college’s programs. The
course gives prospective students an overview of the various health care professions in
preparation for applying to a specific program. The course covers professionalism, ethics, legal
issues, death and dying, medical terminology, infection control, government regulations, cultural
diversity, and academic skills. Prospective applicants must complete this course before applying
to any of the allied health programs.

Several programs have a specific orientation course that is required of applicants. These courses
help prospective applicants discover if a particular allied health career really interests them
before they apply. In DH200L,―Introduction to the Profession of Dental Hygiene‖, students
learn dental terminology, communication skills, licensure requirements and clinical and lab
techniques related to dental hygiene clinical practice. In "Radiologic Technology as a Career‖,
prospective students get an introduction to radiological science and the profession’s role in
health care. The course also discusses the requirements for the college’s Radiologic Technology
Program, and includes six hours of observation in a local hospital.

Some of the allied health programs require all admitted students to take an introductory course
during the summer before they begin their full-time program course-work. These courses meet
for several weeks and include lecture, lab, and site visits to hospitals and clinics. The courses test
students’ aptitude for the subject material, interest in the profession, and suitability for the work
environment. By taking the introductory course, a student may even realize that a particular
health care field is not the career for them. If an admitted student fails or drops the introductory
course, which is a requirement for continuing in the program, the program directors can fill in



                                                                                                   55
from the wait list and begin the fall semester with a fully enrolled program. This helps programs
keep attrition down once the full-time program starts. Each year, the Dental Hygiene and
Radiologic Technology programs admit students from the wait list after the summer orientation
courses.

Evidence of Impact/Success: Inevitably some students will not complete their program, but
attrition from the Dental Hygiene and Radiologic Technology Programs at Foothill is low. Each
year Dental Hygiene enrolls twenty-four new students in the two-year program, from a pool of
one hundred qualified applicants. In 2005, twenty-four students graduated; twenty will graduate
in 2006. Radiologic Technology has over two hundred applicants each year and accepts about
thirty-seven students. The attrition rate from this program has dropped from 30 to 18 percent
over the last four years.

With limited space in Dental Hygiene and Radiologic Technology, the programs work hard to
enroll the most prepared and motivated students. They do not waste valuable slots in their
programs by enrolling students who don’t know anything about the fields. Students who aren’t
familiar with the demands of the programs or the professions they are preparing to enter are
much more likely to drop out during the first semester. Once the programs begin their full-time
course work in the fall semester, they cannot replace students who drop out. Therefore, the
programs are diligent about preparing students for what’s ahead so they can keep their attrition
rates to 0 if possible. The orientation and introductory courses give students more information,
time to prepare, and time to screen themselves out.

Foothill’s approach to orienting students to allied health programs before they begin demanding
full-time course work pays off with excellent graduation and licensing rates. Dental Hygiene has
a 100 percent pass rate on national and state boards. All students will pass the state board by the
time they’ve taken the test a second time. Failure on the state board after the first attempt is
usually an issue of patient selection. Radiologic Technology has an equally impressive
graduation and licensing record. As the program directors said, ―Students do not graduate from
these programs unless they are competent. We are not sending out people to work in the field
that we would not let work on us or our families.‖ Graduates of the Foothill programs are well
prepared and highly sought after by local employers.

Resource Requirements: The college covers the cost of instructors for the introductory and
orientation courses. There is no additional college or outside funding for these courses.

Contact Information:

Name:              Eloise J. Orrell and Phyllis Spragge
Title:             Directors, Radiologic Technology and Dental Hygiene
Organization:      Foothill College

Work Phone:        650-949-7469 and 650-949-7335

Email:             orrelleloise@foothill.edu and spraggephyllis@foothill.edu



                                                                                                 56
Title: Outreach Specialist for Allied Health Programs at Foothill College


College: Foothill College
Program: Allied Health
Contact: Eloise J. Orrell and Phyllis Spragge
Email: orrelleloise@foothill.edu and spraggephyllis@foothill.edu
Summary: A full-time outreach specialist for allied health programs at Foothill College
increases enrollment of underrepresented minorities by 40 percent. The specialist conducts an
extensive program of high school, community, and on-campus outreach activities and
individual counseling for prospective applicants.
Student           Develop                  Prep to get         Enroll and stay in
                   Interest                into program        program
Timing:


Description: In the late 1990s, the Division of Biological and Health Sciences at Foothill
College received a multi-year grant from the Partnership for Excellence of the California
Community Colleges to improve the recruitment and retention of students in the allied health
programs. At that time, some programs did not have sufficient applicants, and the division as a
whole had inadequate diversity among the student population. The division established a goal to
increase the percentage of underrepresented students 40 percent by 2002. The division used PFE
funding to hire a full-time outreach specialist to inform the wider community about the college’s
programs, counsel potential applicants, and track students after they enrolled in the college.

The outreach specialist visits many high schools throughout the San Jose and Silicon Valley
region. She targets high schools with large numbers of students whose families are unfamiliar
with allied health careers and don’t have a tradition of college attendance. The programs have
brochures and other marketing materials that show ethnic and gender diversity. Some materials
are available in Spanish. The outreach specialist holds special information nights for each
program and brings groups to the Foothill campus to hear presentations by current students. She
visits high schools frequently and brings a diverse panel of students and faculty to career fairs.
Some presentations are conducted in Spanish. The outreach specialist maintains a database of
people who inquire about the programs and regularly sends them information about events.

Even after attending presentations and career fairs, students will come to the college interested in
an allied health program, but without a clear idea about how to proceed. The outreach specialist
devotes considerable time to counseling students through the different phases of applying to the
college, completing prerequisites, and applying to the allied health programs. She also advises
them on the differences among the allied health careers. The counseling appointment desk at the
college refers students who are not yet enrolled at the college to the outreach specialist. She
advises them on every step of the application process and directs them to other college resources.
She helps students create plans for completing prerequisites and realistic timelines for gaining
admission to the health programs. The outreach specialist created a club for pre-allied health


                                                                                                 57
professions students and uses current students from the various programs as guest speakers.
Before they apply to a health program, the outreach specialist counsels students on the academic
demands of each program and the time commitment required, so they are as prepared as possible
for entering the program if accepted. Consequently, the programs have many more qualified
applicants than they can accept.

Evidence of Impact/Success: The outreach specialist has had a dramatic effect on improving the
diversity of the allied health programs. The division was able to meet its goal to increase the
enrollment of underrepresented students by 40 percent by 2002. One program director describes
their classes as ―like a little UN. We have students from all over the world, all the time.‖ The
faculty and program directors in the allied health programs feel strongly that the division needs
an outreach person. They cannot devote time to outreach, marketing, and recruiting because they
must concentrate on retaining students once they enroll in allied health programs. The outreach
specialist is an essential part of Foothill College’s ability to maintain diversity in its allied health
programs.

 Resource Requirements: The original PFE grant was for $200,000. The division allocated
$80,000 for the full-time outreach specialist position and $50,000 for recruitment and retention
activities. The grant funds no longer pay for the outreach specialist, but the college has assumed
the cost of this staff position. Without PFE grant funds to start the position and establish it’s
effectiveness in diversifying student enrollment, the division could not have hired an outreach
person. The grant funds were essential in establishing the need for the position. The outreach
specialist also obtained additional funding through mini-grants to produce bilingual recruiting
materials.

Contact Information:

Name:               Eloise J. Orrell and Phyllis Spragge
Title:              Directors, Radiologic Technology and Dental Hygiene
Organization:       Foothill College

Work Phone:         650-949-7469 and 650-949-7335

Email:              orrelleloise@foothill.edu and spraggephyllis@foothill.edu




                                                                                                     58
Title: Recruitment Initiative Targets Local Youth and Community Residents


College: Fresno City College
Program: Allied Health Sciences Programs
Contact: Paul Gonzales
Email: paul.gonzales@scccd.com
Summary: Representatives from multiple health occupations programs and college financial
aid and college relations participate in joint outreach efforts targeting K-12 and community
Student           Develop                  Prep to get               Enroll and stay in
                  Interest                 into program              program
Timing:


Description: Fresno City College’s (FCC) K-12 outreach is extensive, although relatively new.
It started almost on a fluke in 1997 when a faculty member got a call from a local high school
inviting him to make a presentation about career opportunities in the health care sector. Nine
years later, the department has a strong and expansive recruitment component that includes road
shows, campus and health facility tours, presentations at schools and hospitals, weekly
informational orientations at FCC, and outreach to employees at health care facilities that are
interested in upgrading their skills. The recruitment component is implemented and driven by
the allied health recruitment team, which is spearheaded by the directors of radiologic
technology, nursing, and respiratory therapy. They are supported by and work collaboratively
with representatives from the financial aid and college relations departments, who have
developed a high level of expertise on the health occupations programs and prerequisites. This
team attends high school career fairs and other events and hosts a large number of K-12 students
who tour the impressive FCC health sciences facility. At these events, the outreach team
adheres to its credo that ―no student should walk away without information in his or her hand.‖

The team effort, both with the Allied Health Department and among the Allied Health, College
Relations and Financial Aid Departments, seems to drive and energize the outreach and
recruitment project. At outreach events, the financial aide representative told the research team
that ―he has a booth right next to the health sciences booth.‖ Within the department, the three
leaders of the outreach effort – a Latino, an African-American and a Caucasian male – seem to
take great deal of pride and enjoyment in what they do. One of them pointed out that ―If I can’t
go to an event I ask ….(one of the others).‖ The college is receiving many requests for tours and
on-site presentations from K-12, adult schools and other institutions that serve individuals who
may one day enroll in FCC’s health occupations programs. The allied health recruitment team
members plan each activity so that its content matches the audience. Hence, a group of
elementary school students will get a different tour from the one offered to a group of local high
school seniors

Evidence of Impact/Success: The sheer number of prospective students--some of them in their
pre-teens—participating in the tours of the new facility suggests that local schools and other


                                                                                                59
feeders have responded to Fresno’s outreach efforts. FCC’s collaboration with an increasing
number of schools allows the program to expose young students to the range of career
opportunities in the health care field. Enrollment statistics suggest that FCC health occupations
programs are attracting more young students (age eighteen to twenty-four) since 1997, perhaps
an indicator that the K-12 outreach is having an impact.

Resource Requirements: This kind of project requires a high level of collaboration between
key individuals in the participating health occupations programs. In addition, the project has
benefited from the good relationship the health occupations programs, and the leadership figures
who run them, have with financial aide and other student services programs. Many program
directors and instructors are willing to volunteer time to, for example, make sure that ―somebody
is out there representing the college at the large local mall on Saturday morning.‖

Contact Information:

Name:                      Paul N. Gonzales
Title:                     Director, Radiologic Technology Program
Organization:              Fresno City College
Work Phone:                559-244-2652
Email:                     paul.gonzales@fresnocitycollege.edu
Other :                    http://www.fresnocitycollege.edu/healthscience




                                                                                                60
Title: College Learning Assistance Center Provides Critical Tutoring Services to Nursing
Students


College: Long Beach City College
Program: RN, LVN, CNA
Contact: Mary Cavalier
Email: mcavalier@lbcc.edu
Summary: Learning assistance center instructional presenters improve nursing students’ math,
study and other foundation skills and thereby their retention and success rates.


Student            Develop                Prep to get            Enroll and stay in
                   Interest               into program           program
Timing:


Description: An increasing number of successful RN programs have on staff an individual—
often referred to as a nurse mentor—who provides students with tutoring and other support
services. In most cases, the nurse mentor has a background in nursing but is not an instructor in
the program.

At Long Beach City College, nursing students urgently need the support services that nurse
mentors provide. The dean of the School of Health, Science and Math recounted that 80 percent
of entering students lack basic math and English skills and that 80 percent receive financial aid.
In addition, the college serves a very large number of limited English speakers who struggle with
language challenges that make programs such as nursing even more difficult than they are for
native English speakers.

To start the skills remediation process early and to make it as effective as possible, students are
required to complete skills assessment tests immediately after they are admitted to the CNA,
LVN or RN programs. The Test in Adult Basic Education is used to determine student’s math
and reading comprehension levels. The results are translated by the program instructors into
recommendations for attendance at workshops in math, reading, writing, critical thinking, and
test-taking that are offered by the college learning assistance centers. Students with low reading
comprehension skills are encouraged to attend note taking and study skills workshops.

In addition, students in all three nursing programs are referred to or can choose to get assistance
in math skills from an instructional presenter who provides tutoring, workshops and other
support services. For example, the instructional presenter offers a math for medications
workshop each week at the beginning of the semester to help students pass the mandatory math
for medications test that is given during the first weeks of each semester. If nursing students
need more help than what is offered within this time frame, the instructional presenter arranges
for additional assistance from the college career and technical education center, known as the
tech center.


                                                                                                  61
In the CNA program, all students with low math scores are required to spend two hours
developing their math skills in the tech center. This arrangement was incorporated into the
course after recent test scores upon admission revealed that most of the incoming students had
math skills below the seventh or eighth grade level.

Evidence of Impact/Success: In the RN program, the assistance provided by the instructional
presenter has played a key role in increasing pass rates on the first-semester math test. Recent
statistics gathered by the faculty indicate the correlation between RN math scores and students’
use of the math support offered by the instructional presenter. The data shows that the pass rate
is 80 to 100 percent for students who attend the workshop compared to 44 to 57 percent for those
who do not. The data also indicates that even students with very low assessment scores pass if
they attend enough workshops. For example, seven out of eight students with assessment scores
between twenty and seventy passed the math test after taking three workshops. By contrast, six
students with assessment scores between ten and fifty who did not take any workshops failed.

As another indication of the value that the instructional presenter’ services add to the program,
students in focus groups conducted by the research team praised this resource and talked
repeatedly about the wonderful help they are getting from Kathy (the instructional presenter from
the tech center).

Resource Requirements: The instructional presenter is a professional paid by grant funds. The
tech center, where the nurse mentor /instructional presenter is based, is totally supported by
VTEA funds and provides services that are additional to the college funded learning and
academic resources centers that are available on each campus.

The tech center instructional presenter has an M. A. in education and no background in nursing.
The impact her work has had on increasing student success underscores that the nurse
mentor/instructional presenter does not necessarily have to be recruited from nursing. Indeed,
―we wanted to work with the instructional presenter,‖ one of the nursing faculty members
pointed out, ―precisely because she knows nothing about nursing and therefore provides a fresh
perspective.‖

In searching the college and district to find needed resources, the School of Health, Science &
Math followed a route that is different from the one that so many health occupations programs
choose —that is to develop the resources inside of the department and to have support services
provided by somebody with at least an RN. In addition to the math assistance, a majority of
nursing students take learning center workshops to boost their general college success skills. For
example, nursing students are regulars in workshops on test anxiety at the learning center.

Recently, as the nursing programs have been confronting an increase in the number of students
who need improvement in verbal and receptive English skills, the department looked once again
to college resources. The programs have been referring an increasing number of students to the
ESL department for enrollment in accent reduction classes and vocational communication
classes. Both nursing programs are presently searching for ways to require students to attend
these classes before they fail a nursing course.



                                                                                                 62
Contact Information:

Name:           Mary Cavalier
Title:          Vocational Nursing Program Director
Organization:   Long Beach City College

Work Phone:     562 938 4160

Email:          mcavalier@lbcc.edu




                                                      63
Title: Pre-program Activities Address RN Skills Deficiencies



College: Los Angeles Harbor College
Program: RN
Contact: Wendy Hollis
Email: Wendy_Hollis@laccd.cc.ca.us
Summary: Attrition reduced with targeted interventions that address a range of shortages in
student preparation.


Student              Develop                Prep to get            Enroll and stay in
                     Interest               into program           program
Timing:


Description: Some years ago, Los Angeles Harbor College’s ADN Program began to conduct
exit interviews with students who were leaving the program. ―We wanted to decrease an
attrition rate that we felt was too high. To do so, we needed to understand why students were
failing,‖ Nursing Director Wendy Hollis explains.

The program found that lack of preparation was one major reason for failure. Another reason
related to students’ problems with money and family responsibilities, but it was not quite as
simple as that. While some students are able to cope with multiple and conflicting demands in
academic, personal and work-life without much support, others cannot. If students who belong
to this latter category don’t get the support they need, they tend to give up and fail.‖

The program used the findings to develop a series of interventions, including several that
respond to students’ lack of preparation. These include development of courses students can
take while they are waiting to get into the nursing program. Nursing Math and Nursing
Pharmacology—both three-unit courses developed by the nursing faculty—help students develop
fundamental skills they will need to be successful in the nursing program. In addition, the
program developed three one-unit ―Introduction to Nursing‖ courses.

The first of these is required for all students applying to the nursing program and recommended
for all those who ―lean toward nursing.‖ The course introduces students to the roles and
responsibilities of nurses and explains skills they need to complete the program. The other two
courses, still not required, cover critical thinking, nursing study skills, communications and test-
taking strategies.

Enrollment in the three introduction to nursing courses is increasing. The first course, which is
required, has already contributed to reducing attrition. It has helped some students screen
themselves out before entering the program and others develop the foundation skills and life
management skills they need to succeed.


                                                                                                    64
To address the other success inhibitor—unmet need for support—Director Hollis hosts monthly
group counseling sessions for students who are interested in entering the program. For those
already in the program, she is trying to increase tutoring services.

Evidence of Success: Three years after Director Hollis and her faculty members launched their
campaign to increase student success, the attrition rate has dropped from 40 to 25 percent.
Director Hollis is pleased with this accomplishment, but wants to continue to take action to get
the attrition rate down even further.

Contact Information:

Name:              Wendy Hollis
Title:             Director, Health Science Division
Organization:      Los Angeles Harbor College

Work Phone:        310-233-4360

Email:             Wendy_Hollis@laccd.cc.ca.us




                                                                                               65
Title: Diverse Mentors Serve as Role Models for Medical Assisting Students



College: Modesto Junior College
Program: Medical Assisting
Contact: Shirley Buzbee
Email: Buzbees@yosemite.cc.ca.us
Summary: Hospital Program Matches Diverse Hospital Mentors with Diverse Medical
Assisting Students
Student           Develop                 Prep to get            Enroll and stay in
                  Interest                into program           program
Timing:


Description: In 2002, Sutter Hospital launched a mentor program that matched employees with
students enrolled in Modesto Junior College’s (MJC) Medical Assisting Program. Interested
hospital employees are screened and those who are selected receive formal training and
structured guidelines to participate in the program. The mentors receive no extra money for their
time and participate because they love to teach. The criteria for mentorship selection include the
ability to serve as an excellent role model. The mentors represent a similar level of diversity as
the students in terms of ethnicity, race, age, and first language. The mentors supervise the
students’ learning, especially as they begin to work directly with patients. The externships are
twelve months, and with a mentor/mentee ratio of 1:1 the two parties almost inevitably develop
close relationships.

Evidence of Impact/Success: The mentoring provides the diverse medical assisting students
with social support and with the opportunity to work with diverse professionals and role models
in the field. According to students and program staff, the mentoring has a very positive impact
on retention which at 80 percent, is very high for medical assisting programs.

The evaluations of the mentors/mentees also suggest that the program works. In an interview a
student identified the mentorship as the best part of the medical assisting program, describing it
as ―good training to speak to and work directly with patients.‖

The mentorships help the hospital assess the mentees so they know which ones are the best to
hire. Hospital reports suggest that the quality of the graduates has improved and many are hired
right after graduation. In addition, the mentorships help the hospital assess the quality of work of
all the students so they know which ones are the best to hire.

Resource Requirements: To launch a program like this, a leader—preferably somebody inside
the hospital—is needed to recruit mentors. Once the program has started, each mentorship
assignment must be tracked and supported.




                                                                                                 66
In looking back at the program, the director advised that organizations wishing to replicate her
model develop a formal mentoring training program. In addition, they should schedule regular
meetings with mentors to get feedback and to quickly address any problems that come up.

Contact Information:

Name:              Shirley Buzbee
Title:             Director of Medical Assisting Program
Organization:      Modesto Junior College
Address:           435 College Ave. Modesto CA 95350
Work Phone:        209 575-6377
Email:             Buzbees@yosemite.cc.ca.us




                                                                                                   67
Title: Innovative High School Recruitment Activities


College: Modesto Junior College
Program: Medical Assisting
Contact: Shirley Buzbee
Email: Buzbees@yosemite.cc.ca.us
Summary: High school outreach efforts alert underrepresented groups to job opportunities in
medical assisting and to MJC’s affordable and supportive MA training program.


                      Develop               Prep to get            Enroll and stay in
Student
                      Interest              into program           program
Timing:


Description: Working in partnership with a motivated high school instructor, the director of
Modesto Junior College’s Medical Assisting (MA) Program developed and implemented a series
of outreach activities that increased local high school students’ awareness of the occupational
field of medical assisting and the fact that they can pursue this a job in medical assisting after
completing two to three semesters of training at the community college.

The impetus for the outreach was that a high school instructor, Judy Kensho, realized that many
of her students were afraid to embark upon the college application process. She responded by
bringing them on a field trip to Modesto Junior College and by helping them complete their
college application forms. She also invited Shirley Buzbee, director of the medical assisting
program, to come to the high school to talk about the program.

As the next step, the high school invited the community college program to the Occupational
Olympics, an event offered annually to its students and recent graduates. At this event, recent
MA graduates staff an career information booth. They engage the high school students in
innovative ways that include offering to measure the body fat or take the blood pressure of
students shopping around the occupational olympic event. Another outreach effort is ―teas‖
where students and their mothers/guardians are introduced to the medical assisting program
while receiving refreshments. Throughout the outreach activities, students are informed that a
medical assisting degree, in addition to offering good job opportunities, represents ―a foot in the
door‖ to higher-level medical occupations such as RN.

Once students are enrolled, the medical assisting program offers a series of support services that
are designed to maximize retention. There is an emphasis on group work and the instructor has
developed activities that help students build a strong support network. For example, phone-trees
are established early in the program to encourage students to communicate outside of class.
Student learning also often occurs in pairs (weaker and stronger student) to encourage interaction
and provide social support. Since classes meet from 8:30 am to 2:00 pm, this process allows
students to get to know each other. There is also an effort to have a book lending program.


                                                                                                 68
Students are informed about the financial requirements early in the program. Students and
faculty share information as to where the least expensive uniforms and other equipment can be
purchased. Shirley Buzbee believes that these strategies help improve retention in the program,
as they help decrease the stress among students. The strategies were implemented to improve the
program and lead to program growth. Many students rely on the college-provided support as
described above (day care, financial aid, book lending).

From the outset, the strength of diversity is emphasized to the highly diverse students. Hence,
although students are strongly encouraged to improve their English, they are also taught that
being bilingual is an asset and informed that they may be asked to help with translation issues at
work. To further emphasize the value of diversity, students are asked to contribute input to case
studies that describe health related behaviors from their cultural background.

Special activities are also included in the program to encourage cultural exchange, such as
―cultural feast‖ days. Students are expected to bring a dish from their cultural background to
share with others. Then students exchange stories about cultural beliefs and behaviors related to
medicine. According to the director, this exercise is both enjoyable and educational, as cultural
differences in medical beliefs are important to be aware of for anyone in the medical field in
such a diverse community.

Student support continues throughout the program and has even included taking students
shopping to find appropriate clothes to wear for job interviews. The program director also helps
ensure student success through academic advising. If a student registers for a course and appears
weak in one or more areas, she calls the student to discuss how the weakness may result in poor
academic performance.

Evidence of Impact/Success: The program has a retention rate of approximately 80 percent and
an 82 percent passing rate for the board exam. These are high numbers for a program that serves
young students who, a couple of years before entering the program, most likely had no idea what
a medical assistant does. The program director believes that part of the success can be attributed
to the very structured and organized nature of the program. At this stage in their learning, the
students need for the instructor to be very clear about what they need to do and to break
information down into small and easily digestible bites.

Resource Requirements: The partnership between the high school and program director played
a key role in launching the outreach initiative. The key ingredient was probably two very
enthusiastic individuals who were willing to put in extra hours and much energy to help local
youth recognize and pursue a good first career move.

The high school instructor advises others to ―get out of the ivory tower and find out where
students are coming from. One must target the correct student population at the high school
level, and a good way to begin is to speak with high school counselors. The program has also
successfully recruited from a high school science elective course and from health fairs.




                                                                                                69
Contact Information:


Name:           Shirley Buzbee
Title:          Director of Medical Assisting Program
Organization:   Modesto Junior College
Address:        435 College Ave. Modesto CA 95350
Work Phone:     209 575-6377
Email:           Buzbees@yosemite.cc.ca.us




                                                        70
Title: Latino Faculty Member Heads Up Outreach Initiative


College: Moorpark Community College
Program: Health Sciences
Contact: Karen Jensen
Email: kjensen@vcccd.net
Summary: Bilingual, Hispanic radiography instructor conducts outreach on behalf of the
college’s health sciences programs.
                    Develop          Prep to get              Enroll and stay in
Student
                     Interest        into program             program
Timing:


Description: Moorpark Community College is located in an affluent area that has been growing
rapidly during the past year. The local high schools offer many advanced placement courses, so
their graduates tend to enter college well prepared. The health care programs at Moorpark are
still predominantly White, but more diverse than the college as a whole. During the past years,
they have seen an increase in the enrollment of Hispanics and Asians.

Several years ago, to increase the recruitment of underrepresented minority students, the Health
Sciences Department used grant funds to support an outreach effort targeting primarily local high
schools and students already enrolled at Moorpark.

During the past few years, the initiative was spearheaded by a full time faculty member from the
college’s radiography program. She attended career fairs at the local high schools, conducted
seminars at the college for high school students and participated in college academic fairs for the
local high schools. She also spoke at seminars for high school career counselors.

In describing what kind of advice she would give to somebody starting out as an outreach
coordinator, she responded that she would tell them to introduce themselves to the leadership at
each local high school. During these visits, they should make a special effort to meet with the
career specialist and those involved in second language programs. Next, she would recommend
that the college plan and deliver career fairs whose featured jobs coincide with what the college
is offering.

Evidence of Impact/Success: Several college health care programs report seeing an increase in
the enrollment of underrepresented minorities. There is no data that specifically links these
trends to the work of the outreach coordinator, but it is likely that the effort paid off and will
continue to do so as the targeted high school students move through the system.

The radiography instructor says students come to her department from time to time to say "You
came to my high school". She explains that she tries to follow students but that once they come
into the college it is too time-consuming to continue tracking them.


                                                                                                 71
Resource Requirements: The radiography instructor is no longer doing outreach and reports
that it was very difficult to fit her recruiting schedules in with her teaching. The outreach work
she did was paid by the hour with grant funds. During 2005, the initiative was allotted forty
hours; the year before one hundred hours. The instructor advises that someone working ten hours
per week would be able to ―do a good job.‖

She advises that programs considering hiring an outreach person should search for somebody
with knowledge of health careers as well as educational tracks. A degree is a big plus, as
―students want to know how you got to where you are.‖ The person should be able to counsel
students on different career tracks. It is important that the department support the recruitment
expert so that s/he can schedule seminars and recruit speakers for larger events and so that
students who visit the college find in the health sciences department and individual programs the
same welcoming attitude that the recruiter projects. The Moorpark recruiter also emphasizes
that: ―Having a bilingual recruiter is a big plus.‖

Contact Information:

Name:                Karen Jensen
Title:               Coordinator of Health Sciences
Organization:        Moorpark Community College
Work Phone:          805-378-1400 (1830)
Email:               kjensen@vcccd.net




                                                                                               72
Title: Skills Lab Support Services Improve Retention


College: Moorpark Community College
Program: RN
Contact: Karen Jensen
Email: kjensen@vcccd.net
Summary: Skills lab remedial specialist uses computerized and hands-on skills lab to improve
students’ skills in key areas.


Student                   Develop                                  Prep to get                     Enroll and stay in
                          Interest                                 into program                    program
Timing:


Description: The RN skills lab remedial specialist (SLRS) works with students five days a
week, eight hours a day. Failing students are referred to the SLRS by RN instructors so the
SLRS knows the background and needs of students before they come to her. All students can
use the lab, but a direct referral requires that the student spend three hours a week in the lab
working under the direction of the SLRS on targeted skills and competencies. The skills lab has
both a computerized and a hands-on-skills section. The SLRS spends most of her time in the
former.

The SLRS works with students individually and, if many students have the same needs, delivers
workshops to groups of students. For example, if the SLRS sees that many students are asking
for help with a particular subject, she will schedule one or two workshops on that topic. The
SLRS monitors carefully student attendance in the lab so she can document the lab’s impact on
improving student achievement (see below).

Evidence of Impact/Success:

                            Skills Lab Usage by Whole Semester

       60

       50

       40
                                                                                               Mean Usage: passing
   Hours
                                                                                               students
       30
                                                                                               Mean Usage: Failing
                                                                                               students
       20

       10

            0
                Fall 01   Spring   Fall 02   Spring     Fall 03*   Spring   Fall 04   Spring
                              02                 03                    04                 05


                                             Semester




                                                                                                                        73
Skills Lab
Usage by        Fall                      Fall                    Fall                    Fall
Semester         01        Spring 02       02         Spring 03   03*         Spring 04    04         Spring 05

Mean Usage:
passing
students          25             32              43         54           44         34           41           41

Mean Usage:
Failing
students               7         13              35         50           22         26           31           20

Prepared by the SLRS, the chart and table above depict the positive relationship between use of
the lab and student success.

Resource Requirements: The SLRS position is supported by the Southern California Hospital
Association which, in recognition of the impact the position has had on strengthening the
Moorpark program, recently agreed to support a similar position at Ventura College.

The Moorpark SLRS is a recent graduate of Fresno City College’s RN Program. She is an Asian
American woman in her mid-twenties and highly energetic. She is, according to her colleagues
who teach in the RN program, ―a born teacher and students really relate to her.‖

The SLRS identified the following skills and competencies as being important for somebody in
her job: high level of organizational skills; a calm, friendly and supportive disposition (the
SLRS works with more than a hundred students); knowledge of the curriculum (she uses the
schedule from each course to determine which subjects to cover); knowledge of technology and
how it can be used to enhance the RN curriculum; and the ability to work with different types of
learners in individual as well as workshop settings.

Contact Information:

Name:                      Karen Jensen
Title:                     Coordinator of Health Sciences
Organization:              Moorpark Community College
Work Phone:                805-378-1400 (1830)
Email:                     kjensen@vcccd.net




                                                                                                         74
Title: Flexible Design, Supportive Faculty, and Comprehensive Support Services Attract
and Increase the Success of URMs

College: Mt. San Antonio College

Program: Psychiatric Technician
Contact: John Gardner
Email: jgardner@mtsac.edu
Summary: From childcare to early morning tutoring and remediation opportunities Mt. Sac’s
student-focused PT program prepares students for high-demand, well-paid jobs with excellent
benefits and high job security.


Student             Develop              Prep to get                Enroll and stay in
                    Interest             into program               program
Timing:


Description: Students in Mt. San Antonio College’s (Mt. SAC) Psychiatric Technician Program
are highly diverse in terms of ethnicity, gender, and country of origin. The program director
explains that psych tech programs tend to have different constituencies in different regions of the
country. In the case of Mt. SAC., West African students are ―on to the program‖ in a big way
and commuting all the way from their Carson area community to attend the program. Other
larger groups represented in the program include African American, Hispanic, and Filipino
students. The average age is thrity-two. Women outpace men, but not by much.

Mt. SAC’s psych tech program has a total enrollment of about one hundred forty students. Most
of them have been out of school for a long time when they start the program and many enter with
reading skills that are at the pre-junior high school level.

The program works closely with the college’s tutorial services to help students improve their
basic skills. In addition, faculty works hard with students, volunteering many hours to help them
through the program. For example, many instructors will offer early-morning tutoring from
7:15 am to 8:00 am. The commitment of the faculty, the program director explains, plays a key
role in the program’s success.

To help failing students get back on track before it is too late, the program has an early alert
system. Students who score less than 75 percent on a test receive a faculty advisement form and
are required to meet with the instructors who teach the subjects in which they are failing. In
these meetings, each student will review with the instructor the test question or material s/he
missed and learn from the wrong answer or other mistake made.

Students are allowed to repeat one class along the way. Before their second try, they will be
directed to complete a remediation plan that faculty members have jointly developed to get them
back on track. This may involve connecting with Disabled Student Services, re-taking reading or


                                                                                                75
basic math courses at the college, completing a time management and study skills class, or taking
(more) ESL classes.

The program also offers support services that are vitally important to some students. One is
access to the college’s childcare center where students can place their children while they are in
lecture or studying.

Also contributing to making the program comfortable for the diverse student participants is the
instructional team of nine full-time instructors: two Hispanic women, one Filipino man, one
South African woman and five Caucasians. The hourly instructors include a Filipino woman and
an African American man. The diversity of the instructional team results from a deliberate effort
that began thirty years ago when most of the instructors were Caucasian.

The program also participates in Health Occupational Student of America (HOSA), a statewide
competition that plays a key role in improving student determination and success. This past
year, twelve psych tech students went to the state competition where they competed in areas such
as demonstration of best practices and problem-solving. To prepare, they also had to brush up on
their CNA skills, medical math and medical terminology skills.

Evidence of Impact/Success: The program has many more applications than spaces available.
They currently accept sixty students per semester from one hundred to one hundred ten
applicants. Typically, seventy will come to the orientation, including ten from the waiting list.
The first day of classes, there will be sixty-five students. Among these, around forty-five will
survive the first semester.

The state average pass rate on the licensing exam is about 70 percent. Mt. SAC’s most recent
success rate was 79 percent.

A recent graduate of the program explained with obvious pride that ―employers are hunting for
me.‖ Her husband was enrolled in the class that would graduate after her. ―You have so many
choices, you don’t even know which ones to choose from.‖

At the HOSA competition, all twelve Mt. Sac psych tech students won medals and qualified to
continue to the national competition in Tennessee. Here the winners will get scholarships and
thereby major resume boosters.

Resource Requirements: The faculty is highly committed and volunteers many hours to tutor
students outside of class. One student commented that the instructors ―try every way they can to
help people stay in program.‖ In the student’s case, they made changes in her clinical schedule to
enable her to get childcare.

Overall, the instructors ―know their students and the challenges they are likely to encounter,‖
from transportation to childcare to difficulty with basic skills – and sometimes family and other
external problems. They give students their home numbers and listen to them when they need
help.




                                                                                                 76
The student-oriented approach is particularly important because of the population the program
serves. Many students are nervous and come with vivid memories of not having done well in
school in the past. The faculty’s commitment to their success and the team spirit that the
instructors deliberately generate by encouraging students to work together and by having events
that promote the development of informal relationships help students gain confidence. This, in
turn, gives them the impetus to work hard and to set high goals for themselves.

Contact Information:

Name:             John Gardner
Title:            Program Director
Organization:     Mount San Antonio College

Work Phone:       909-594-5611 X 4916

Email:            jgardner@mtsac.edu




                                                                                              77
Title: Health Academy Prepares High School Students for Success in College Health
Programs


College: Palomar College
Program: Health Sciences
Contact: Dr. Judy Eckhart, Palomar College
Len Judd, Director of Special Programs, San Marcos Unified School District

Email: jeckhart@palomar.edu; ljudd@smusd.org
Summary: High school district, community college, state university, and local health care
providers collaborate to launch a high school health academy.


Student           Develop                Prep to get             Enroll and stay in
Timing:           Interest               into program            program



Description: The director of special programs at San Marcos Unified School District (SMUSD)
has worked for the past two years to provide high school juniors who are not necessarily college-
bound with the opportunity to enroll in a health academy. The high school that hosts the project
is brand new and highly diverse with 45 percent of students Latino, 45 percent Caucasian, and 10
percent ―other Non-White‖

The project is a collaboration between the SMUSD, Palomar College, California State University
San Marcos (CSU-SM) and Palomar Pomerado Health, a local hospital. The first year of the
program provides high school juniors with a general introduction to the health care field, using
curriculum that incorporates college material from advanced first aid and medical terminology
courses. The second year course incorporates college material from Clinical Assisting: Patient
Care and Adult Health Assessment. When students have completed both years they will have
earned twelve units towards medical assisting certification and they will have developed an
appreciation of the diverse field of healthcare occupations. They will also have earned 12.5 units
of credits at Palomar College.

The curriculum was developed by the high school, Palomar College and CSU-SM with grant
support from the hospital. The instructor for the first year course (which is currently being
delivered) is an RN.

Evidence of Impact/Success: There was strong interest in the health academy from the outset.
To support the recruitment effort, Palomar College asked fourth semester Filipino and Hispanic
RN students to represent the health sciences department at a high school registration fair that
highlights the different occupational academies students can join in their junior year. At that
year’s meeting, students had the option to sign up for the new health academy. The RN students
arrived dressed in their nursing uniforms and were warmly received. At the end of the


                                                                                                78
registration fair, more than one hundred students had signed up for the new program. ―We had
expected quite a bit of interest, but this was remarkable. We were very surprised,‖ the director of
special programs commented.

The first cohort started in fall 2005 with an enrollment of one hundred four students. Several
months into the first semester of classes, reports suggested that the program is going very well.
Students were actively engaged in the hands-on curriculum (for example, at a field trip to the
partner hospital students were equipped with scrubs and stethoscopes) and many had expressed
strong interest in pursing a health care career. Although the students’ interests covered a wide
range of occupational specialty areas, most still identified nursing as their number one career
goal. In the spring of 2006, many students will be starting internships where they will be paired
with college student interns at Palomar Pomerado Health. The internships will be coordinated by
Community Outreach for Prevention and Education.

Parents have also become actively involved through an advisory group that Palomar Pomerado
Health formed. The group meets monthly to discuss the program and the program director
reports that the parents are enthusiastic and supportive of the work of the teacher and the partner
agencies.

As a key indicator of the program’s early success, several local school districts are planning to
use the curriculum and begin their own health academies in fall 2007.

Resource Requirements: The high school is using ROP money to pay for the classes. The
participating hospital contributed $20,000 to support curriculum development. The hospital also
donated some and secured a $4,000 grant for additional equipment.

The project brought together a high school district, a community college, a university, and a
hospital. These parties solicited additional input from the local community, clinics and other
school districts. The principal of the new high school originally conceived the project. His
strong support has been a key factor in moving the project forward.

Contact Information:

Name:             Judy Eckhart                                  Len Jud
Title:            Chair, Health Sciences                        Director of Special Program
                                                                San Marcos Unified School
Organization:     Palomar College
                                                                District
Work Phone:       760-744-1150 X2583                            760-752-1270
Email:            jeckhart@palomar.edu                          len.judd@smusd.org




                                                                                                    79
Title: Student Advisor Helps Students Plan Their Path to a Health Care Program



College: Palomar College
Program: Health Sciences
Contact: Dr. Judy Eckhart
Email: jeckhart@palomar.edu
Summary: The student advisor conducts orientations and helps individual students identify
and prepare for entry into appropriate health occupations programs.


Student      Develop                  Prep to get             Enroll and stay in
             Interest                 into program            program
Timing:


Description: The student advisor (SA) is a point person for anybody requesting information
about Palomar College’s health occupations programs. College counselors are aware of the SA
and the services she provides to potential students interested in a health care career. As a result,
they refer students interested in this occupational area directly to her.

The SA says people come through her door for information and advice non-stop throughout the
day. Many need help in developing a game plan on how to get ready for the health occupations
program of their choice. Others need assistance matching their skills and interests to a specific
health occupations career. The SA often advises individuals interested in the RN program to
become a CNA first and see what it is like to work in the field. She will also advise potential
applicants on how to navigate their way through the college’s other departments and programs to
build critical skills in English and math and to, for example, enroll in workshops on how to study
and organize themselves.

The SA holds orientations for students interested in attending the health care programs offered
by the college. These sessions are offered once a month for nursing and five times a year for
dental assisting. In addition, the SA conducts outreach to local high schools and participates in
job fairs. Before attending these events, she will determine who is likely to be in the audience.
If it is mostly male and the subject is nursing, she will bring along an articulate male nursing
student. If the audience has a lot of Latinos, she will bring along a Spanish-speaking Latino
student.

Once the connection is made, the SA proceeds to develop relationships with potential applicants
to the college’s health programs. She promptly responds to students who have questions or want
information and is highly effective at connecting potential students with the right person on
campus whether they are in nursing or financial aid.

Evidence of Impact/Success: Given the high student/counselor ratio, it is virtually impossible
for regular counselors to keep up with ever changing admissions requirements to health


                                                                                                    80
occupations programs and to know enough about the ever more complex health care field in
order to guide students toward a good career choice. Having the SA inside the department
changes this dynamic and provides each interested person with knowledgeable, customized, and
specialized counseling services. The result is that students are guided toward the most direct
route to the health care program of their choice. They are also provided with the advantage of
reviewing their career goals with somebody who has a high level of knowledge on each possible
choice they can make and knows what kind of personality, for example, is required in nursing as
compared to other health care fields.

Resource Requirements: The position was introduced fifteen years ago when Palomar’s health
programs had trouble recruiting enough students. It is paid out of general funds with the
Departments of Nursing, Dental Hygiene, and Medical Assisting contributing 70, 20, and 10
percent respectively. The SA works four days a week in the nursing office and one day a week
in the dental. Hygiene office. One day a month is allocated to medical assisting.

The SA, when asked to identify the skills, competencies, and personality required for her
position, listed the following priorities:

    outgoing personality
    multi-task oriented
    compassionate, positive and calm (students get upset about being wait-listed)
    ability to talk with students in a way that they can relate to and understand
    high level of familiarity with the college and especially with those departments and
     programs that deliver prerequisite classes, supplementary instruction in subjects such as
     math and reading, and support services
    ability to work with the college counseling department (which refers students to her)
    ability to work as a team member with health program instructors

The SA noted she has worked at the college for more than twenty years, but that she has no
background in health care. The SA explained that while her comprehensive knowledge of how
the college works is a tremendous asset, her lack of formal training in a health care field has
never been a problem.

Contact Information:

Name:                                       Judy Eckhart
Title:                                      Chair, Health Sciences
Organization:                               Palomar College
Work Phone:                                 (760) 744-1150, ext. 2583
Email:                                      jeckhart@palomar.edu
                                            Cathy Hawkins, Health Programs
Other :
                                            Specialist, (760) 744-1150, ext. 2279




                                                                                              81
Title: Diversity Among Faculty and Built into Curriculum and Activities

College: Pasadena City College
Program: Dental Hygiene
Contact: Tom Neiderer
Email: tpneidere@pasadena.edu
Summary: This program has made a special effort to recruit a diverse faculty and to create a
culturally diverse environment that makes every student feel comfortable.


Student           Develop                Prep to get              Enroll and stay in
                  Interest               into program             program
Timing:


Description: Pasadena City College’s Dental Hygiene Program is highly diverse. In the
graduating class of 2005, there were many Hispanic students, several Armenians and a number
of other non-White students.

To create a multicultural environment, the program has made a major effort to recruit a diverse
faculty, a difficult goal in an occupational area that remains predominantly White. The program
beat the odds by actively recruiting as instructors, people who work part-time or even full-time in
industry.

The personal experiences of the former director, Jeanne Porush, contributed to deepen the
program’s commitment to diversity. While an adjunct instructor at USC’s School of Dentistry,
Porush’s classes included a large number of international students. The experience deepened her
understanding of how differently dental care is approached in different cultures.

Similarly, one of the PCC dental hygiene instructors was heavily influenced by a cross-cultural
conference she attended at her son’s school and has since then brought the message of diversity
directly into the PCC dental hygiene classroom. The instructor thus routinely engages students
in discussions of how different cultures view, for example, touch. She also teaches students to
consider patients’ cultures and backgrounds when they work on their teeth and make suggestions
for home treatment.

The same instructor routinely asks all her students to write a poem about where they are from. ―I
try to get them to understand that everybody is from somewhere,‖ she explained. ―We will
discuss how food patterns in different countries and areas affect dental health, how dental
hygiene varies and is approached differently across cultures, and how dental myths such as the
tooth fairy means little to somebody who comes from a place where you throw the old tooth over
the roof.‖

 The program’s commitment to maintaining a diverse and community-minded environment is
advanced through its emphasis on community dental health. In these classes, students are


                                                                                                82
assigned to sites such as the VA, a children’s clinic, and dental education programs. As they
practice in these environments, students develop a first-hand understanding of what it is like to
work in diverse settings.

Evidence of Impact/Success: The faculty includes several Hispanics, two Middle Easterners,
and one African American.

In terms of student outcomes, this is a successful program with low attrition and pass rates of 90
percent or more on the state board.

Resource Requirements: The key ingredient here is the willingness to go the extra mile to
recruit individuals from underrepresented minority groups from among industry (often dental
hygiene programs search for new faculty among their own alumni and/or among graduates from
nearby community colleges). To accommodate these faculty members, the program is
considering offering more evening classes so the instructors can work during the day and teach
in the evening.

Contact Information:

Name:                  Tom Neiderer
Title:                 Director, Dental Hygiene
Organization:          Pasadena City College
Work Phone:            (626) 585-7545
Email:                 tpneidere@pasadena.edu
Other :




                                                                                                    83
Title: Bilingual Recruiter


College: Porterville College
Program: LVN and Psychiatric Technician
Contact: Valerie Lombardi
Email: vlombard@portervillecollege.edu
Summary: A bilingual (Spanish-English) recruiter at Porterville College educates a largely
rural population about health careers at schools, career fairs, and community events. Individual
counseling helps prospective students navigate admission to the college, secure financial aid,
and plan for personal and job support to pursue health careers.
                   Develop                Prep to get               Enroll and stay in
Student
                    Interest              into program              program
Timing:


Description: The Health Careers Division at Porterville College employs a full-time Spanish-
English bilingual recruiter to inform county residents about health professions programs and help
applicants navigate both admission to the college and to the specific programs. The division
offers programs in vocational and registered nursing, psychiatric technology, and human
services. The recruiter’s job involves extensive outreach activities throughout Tulare County and
beyond. He goes to all high schools in the Porterville school district, to schools throughout the
county, and in Bakersfield and Fresno. He attends many career fairs and community events ––
during one semester he might attend thirty career fairs. He distributes information on college
admissions and financial aid, program prerequisites, and requirements for graduation or
certification. He talks about job shortages in various fields and discusses alternatives to the
popular programs, like nursing, that most people have heard about. Part of his goal is for people
to see that they can remain in the area and make a good living in a health care profession. His
goal is to spread the word about higher education and health careers in general, and the
Porterville programs in particular, throughout this largely rural agricultural area in central
California.

Anyone who is interested in one of Porterville’s health programs, whether currently enrolled at
the college or not, can make an appointment for one-on-one counseling with the recruiter. At
these sessions, he goes over the requirements for the various programs, the process for applying
to the college, testing requirements, and financial aid. Many local residents are not exposed to
higher education opportunities and fearful about starting college, so he follows his meetings with
phone calls to help shepherd applicants into the college. Although the Porterville programs are
not offered in Spanish, the division director feels that the recruiter’s ability to speak Spanish in a
community that is over 50 percent Hispanic makes a huge difference in people’s comfort level.
This is especially true when potential students and their families are gathering information or
first learning about college opportunities.




                                                                                                   84
The recruiter takes a personal interest in the applicants and helps them develop a strategy for
getting through prerequisites and program classes while juggling family and work
responsibilities. He’s made an extra effort to provide information on scholarships beyond what
the college itself can offer. He is both encouraging and realistic in explaining to students what
they need to complete to apply for a health program and how long it will take them. For
example, for aspiring LVN students, he tells them they will wait at least two years before they
can enter the program if they come to Porterville College without completing any college
courses. He also explains the impact that college has on personal and work lives and stresses that
students in the health programs need good support from their families and employers. The
majority of people inquiring about Porterville’s programs have never been to college. Many are
young women with children and no career path.

Evidence of Impact/Success: The division director feels that the recruiter has dramatically
changed the diversity of the applicant pool for the health programs. Prior to hiring the recruiter,
about 11 percent of the division’s students were underrepresented minorities. Now about 60
percent of applicants and students are underrepresented minorities. The recruiter has also had a
dramatic effect on increasing enrollment in the programs in general. Before he was hired, the
college had trouble filling its thirty-student psychiatric technician class each semester. Their goal
now is to enroll forty-five students each semester, and they are getting about seventy-five to
eighty applicants per enrollment period. When the recruiter started, the college also had trouble
filling its LVN class. Now they have one hundred thirty-five applicants for fifteen LVN slots
each semester.

There is such a demand for psychiatric technicians in the area that the college has applied to the
Workforce Investment Board to offer the program in Visalia. The demands on the college’s
program will continue to increase due to a planned expansion at the Porterville Developmental
Center, the major employer of the college’s psychiatric technician graduates. A state hospital is
opening in Coalinga and will also rely heavily on the Porterville College’s graduates for
employees.

Resource Requirements: The recruiter’s position was initially paid for with a grant, then with
Carl Perkins funds. The college is seeking grant funds to continue the position and also has
obtained some funding from the Porterville Development Center for the recruiter’s salary.
Porterville College is small and has little discretionary money to apply to a position that does not
benefit the entire college. The recruiter’s position is not likely to become part of the college’s
general budget in the foreseeable future.

Contact Information:

Name:              Valerie Lombardi
Title:             Health Careers Division Director
Organization:      Porterville College

Work Phone:        559-791-2321

Email:             vlombard@portervillecollege.edu


                                                                                                  85
Title: LVN & Psychiatric Tech Retention Strategy


College: Porterville College
Program: LVN and Psychiatric Technician
Contact: Valerie Lombardi
Email: vlombard@portervillecollege.edu
Summary: A required introductory course at Porterville College helps prospective applicants
decided if nursing or psychiatric technician are suitable career choices for them. The faculty
pro-actively identify students in trouble. A formal remediation process identifies and tries to
correct academic, clinical, and personal problems that affect student performance.
Student           Develop                  Prep to get            Enroll and stay in
                  Interest                 into program           program
Timing:


Description: Porterville College’s Health Careers Division offers programs in vocational and
registered nursing, psychiatric technology, emergency medical technology, and human services.
The division’s programs attract students primarily from Tulare County, a largely rural,
agricultural area in central California. Many of the students have no family history of college
attendance and are fearful of college. They enter college with a variety of academic deficiencies
and heavy family and work responsibilities. Because the demand for admission to the LVN, RN,
and psychiatric technician programs at Porterville College is so high, the college works hard to
retain students once they are accepted into one of these programs.

Retention really begins with outreach and recruitment. The division’s bilingual recruiter meets
individually with prospective students for frank discussions about what they will need to gain
entry to and remain in a health program. He reviews prerequisite requirements, discusses English
and math remediation if students are weak in those areas, and urges students who are working
full-time to find other sources of financial support so they can reduce their workload while in
school. Everyone in the program agrees that working full-time is an enormous barrier to
underrepresented students enrolling in and completing health professions programs, particularly
when those students are also parents. Though his role with students officially ends when they
enter the college, the recruiter’s welcoming approach keeps students returning for advice and
support after they’ve started their health professions programs.

A course in nursing fundamental concepts is required of all applicants to the LVN and
psychiatric technician programs. The course introduces students to the professions and to
concepts, processes, critical thinking and math skills, and medical terminology that students will
encounter in the nursing and psychiatric technician programs. The course helps eliminate
potential applicants who have misconceptions about the professions that make them more likely
to drop out.




                                                                                                  86
The Health Career Division intervenes early when a student gets into trouble. A formal
remediation process identifies academic, clinical, and non-academic issues that are
compromising a student’s academic performance. The student fills out a self-evaluation
questionnaire to see where they are having difficulty, how many hours they are working, if they
study alone or with a group, learning style issues, child care issues and other family problems. A
faculty member assesses the questionnaire and looks for problems for which there is a realistic
solution. The faculty member and student write a plan that documents the factors that are
contributing to the problem and the steps that the student will undertake to improve academic
success. The student writes a formal remediation plan that can cover academic and non-academic
problems and solutions. The division director is involved in every remediation plan and meets
with every student who is in formal remediation.

The programs are pro-active in identifying and solving problems that keep the students from
being successful. Students are strongly encouraged to talk with the faculty about any issue that
might affect their performance, because faculty have seen solutions to many different kinds of
problems. They are on the lookout for students with problems and intervene early, referring
students to other campus services. For example, if faculty suspect a student has an undiagnosed
learning disability, they strongly encourage the student to seek help from the college’s Disabled
Student Services. One student in the RN program went from an average in the low sixties to the
eighties after she was diagnosed with a learning disability and given       audio books and extra
time on tests.

Students agree that the faculty members are very supportive and ―really care and want everyone
to succeed‖. Teachers make themselves available after hours and by phone at home. The teachers
want to know what is going on with their students and work diligently to help them solve
problems. One RN student who entered the program after ten years working as a certified nurse
assistant feels she is well prepared for her nursing career because ―teacher’s don’t just want you
to pass. They want you to know what you’re doing when you leave.‖ One faculty member who
had come from another community college feels that the faculty at Porterville are ―warm,
friendly, and approachable. The teachers are out in and involved in the community and generous
with their time.‖ This extra commitment to student success makes the Health Careers Division at
Porterville College an especially welcoming place for underrepresented minorities who aspire to
careers in health care.

Evidence of Impact/Success: Porterville’s success at retaining, graduating, and preparing
students for health professions is apparent in the attrition rates and pass rates on the state
licensing exams. Out of fifteen students in each LVN cohort, the college loses only one or two
students. The pass rate on the state board for LVN graduates is 85 percent. The psychiatric
technician program has a 15 to 18 percent attrition rate. The pass rate for psychiatric technicians
is 80 percent, considerably above the state average of 61 percent. One hundred percent of the
college’s graduates obtain employment. Employer feedback indicates that the students are well
prepared and job retention is good.

Resource Requirements: Other than time devoted by the recruiter, the college has no extra
funding to support its retention effort. Faculty participation in the remediation program is in
addition to their regular teaching, advising, and committee workload.



                                                                                                  87
Contact Information:


Name:           Valerie Lombardi
Title:          Health Careers Division Director
Organization:   Porterville College

Work Phone:     559-791-2321

Email:          vlombard@portervillecollege.edu




                                                   88
Title: Employer Support for Porterville College Health Programs


College: Porterville College
Program: RN, LVN and Psychiatric Technician
Contact: Valerie Lombardi
Email: vlombard@portervillecollege.edu
Summary: 20-20 programs at Sierra View Hospital and the Porterville Development Center
give employees a chance to pursue or advance in health careers while receiving full-time pay
for part-time work. Other employees receive reduced or flexible work schedules to pursue
health programs while retaining their employment status with benefits.
                  Develop                 Prep to get            Enroll and stay in
Student
                   Interest               into program           program
 Timing:


Description: Porterville College collaborates with Sierra View Hospital and the Porterville
Developmental Center to provide employees at both facilities an opportunity to pursue degrees
while working a reduced schedule at full salary. Both Sierra View and PDC also contribute
significant funding to the college’s Health Careers Division.

Sierra View Hospital has a flexible 20-20 program that allows employees to work half time
while retaining a full-time salary and full benefits. This program is available to employees to
pursue degrees at community colleges and four-year institutions. At Porterville College, Sierra
View supports students in the LVN and RN programs. The hospital is also supporting students in
respiratory therapy and cardiac ultrasound programs at other schools. In addition to a full-time
salary for half-time work, the hospital will pay for tuition, books, gas and mileage, and uniforms.
Employees sign a contract that obligates them to return to work full-time at the hospital for two
to five years upon graduation, depending on the length of time they received support to attend
college. On occasion, the hospital has released people to attend school full-time while retaining
their full salary and benefits.

The Porterville Developmental Center also has a 20-20 program and actively encourages
employees to return to school. PDC accommodates employees with alternate and reduced work
schedules. Employees must work at the center for a minimum of one-year full-time to be eligible
for the 20-20 program. Once they complete their educational program, they must return to PDC
and work for the same amount of time as the 20-20 program supported them. For psychiatric
technicians, support is usually for two years.

Sierra View District hospital is a full service one hundred sixty-three-bed acute care facility. It is
the only hospital in Porterville and is responsible for serving the needs of 110,000 residents a
largely rural agricultural area in central California. It is one of the largest employers in the
Porterville area. The Porterville Developmental Center is a state funded residential center for




                                                                                                    89
 Title: Nursing Education Resource Specialist
people with developmental disabilities. The center has about seven hundred fifty clients. It is the
largest employer in Porterville and the second or third largest employer in Tulare County.

Evidence of Impact/Success: Sierra View Hospital started funding the Porterville College
nursing program because, like most hospitals, it has an acute shortage of nursing staff. The
hospital is committed to cultivating a local work force that cares about the community and wants
to remain in the area. So far, the Education Director believes that over 90 percent of nursing
graduates are staying in the area because all have family and roots in the community. These
students understand that they can make a good living as a nurse in Porterville, while impacting a
facility that they and their families use. The hospital also serves as a major site for clinical
placements for Porterville College’s LVN, RN, and psychiatric technician students.

The Porterville Developmental Center currently has twenty people supported by its 20-20
program and could enroll more with additional funding. Only one person has dropped from the
20-20 program in four years. PDC relies heavily on the Porterville College psychiatric technician
program to generate new staff for the facility, particularly because veteran staff are beginning to
retire. PDC competes with other employers, like the prison system, for psychiatric technicians
and other health professionals.

Resource Requirements: In addition to supporting employees in the 20-20 program, both the
hospital and PDC contribute funds to the college’s health programs. Sierra View Hospital
contributes $300,000 a year to support Porterville College’s participation in a joint distance-
learning RN program with Bakersfield College. The Porterville Developmental Center
contributes $600,000 a year to the Porterville College’s psychiatric technician program, which
includes the salary of the health program recruiter.

Contact Information:

Name:              Valerie Lombardi
Title:             Health Careers Division Director
Organization:      Porterville College

Work Phone:        559-791-2321

Email:             vlombard@portervillecollege.edu




College: Riverside Community College


                                                                                                  90
Program: RN and LVN
Contact: Susan L. Robson
Email: susan.robson@rcc.edu
Summary:



Student              Develop                Prep to get            Enroll and stay in
                     Interest               into program           program
Timing:


Description: The nursing education resource specialist (NERS) is a full-time faculty member
who spends 80 percent of her (paid) time working with associate degree nursing (ADN) and
vocational nursing (VN) students who need clinical and/or academic remediation. The NERS
conducts sessions on test anxiety, refers students to counseling, facilitates group work and
presents information in ways that make sense to different types of learners. She also plays a key
role in the program’s system of early intervention. The remediation process begins with the
faculty referring a student to the NERS either because their test scores are less than 73 percent at
mid-term time (the cut-off point used to be 75 percent at midterm time) or because they have
performed in a less than satisfactory manner in a clinical setting. The faculty member who
makes the referral first meets with the student. The NERS and the student then meet and jointly
develop a remediation plan that is shared with the instructor. As the remediation plan is
implemented, the student and the NERS assess progress achieved and the NERS conducts follow
up meetings as needed after each test (if the problem is with test scores) or on a weekly basis if it
is a clinical performance problem. In working with each student, the NERS uses a student
questionnaire to help diagnose why a student is underperforming and to identify appropriate
intervention strategies. The questionnaire is based on Maslow’s hierarchy of basic human needs
and includes questions about students’ physiologic needs, their roles and responsibilities,
psycho-social influences and study habits.

At the time the research team visited the program, the NERS estimated that the academic
probation roll (students receiving less than 73 percent in course work) included five or six first
semester, ten second semester, and five or six third and fourth semester students. The NERS
works individually with each student and with anybody else who requests an appointment. She
also mentioned that students stop her many times each day in the hallways to ask for advice or to
get help with something they didn’t quite understand in class. The NERS, and several of her
colleagues, said they could use two more people to do her job and that she is a lot busier than she
used to be. She estimates that 50 percent of her one-on-one sessions address problems related to
test-taking and study skills, 30 percent focus on counseling and communication related issues,
and 20 percent are spent on care planning and clinical issues.

Evidence of Impact/Success: Both students and faculty expressed enthusiasm about the NERS
and identified the services the position provides as central to the program’s success and as an
especially vital resource for students at risk of failing.


                                                                                                  91
In focus group sessions, students mentioned both the individual help and the workshops the
NERS provides as extremely important resources. The students also commented on the attitude
of the NERS and other faculty involved in remediation. Being on academic probation in the RN
Programs feels like a process that is focused on ―How can we get you up to the right level?‖
instead of ―How can we kick you out of the program?‖
When asked to identify the most important support services, the NERS got the largest number of
votes. Further, thirteen of seventeen faculty survey respondents identified the most used support
services as the NERS.

Resource Requirements: By staffing the NERS position with a full time faculty member, the
program ensured that the NERS would have first hand knowledge of the program requirements
and—by choosing an individual who was an established and dynamic member of the faculty
team—that her efforts would be fully supported by her colleagues. In interviews, several
students noted how the NERS and their instructor were ―working together to help them catch
up.‖ That this partnership is both formally built into the remediation process and informally
achieved through the NERS’ good relationship with her colleagues seems critical to the good
results that RCC has achieved with the NERS position. Another reason the NERS position is
such an asset may well be that the entire faculty is working like a team and that they are able to
work together to determine what is the best way to deploy the NERS resource.
The choice of a full-time faculty member to staff the position meant that a vacancy had to be
filled and that funding had to be developed for one more faculty position. In RCC’s case,
funding to increase the position to 80 percent came from a US Department of Labor Employment
and Training Administration that is supporting 50 percent of the position. The program has been
so successful that RCC is committed to continue the NERS role after the grant funding has
ended.

Contact Information:

Name:              Susan L. Robson
                   Nursing Instructor and NERS
Title:
                   Nursing Education Programs
Organization:      Riverside Community College

Work Phone:        909-222-8817

Email:             susan.robson@rcc.edu




                                                                                                 92
Title: Collaboration With Local Employer to Train Nursing Home Workers to Become
LVNs.


College: Riverside Community College
Program: Career Ladder to LVN
Contact: Phyllis L. Rowe
Email: phyllis.rowe@rcc.edu
Summary: Motivated, but academically underprepared workers form learning community and
with the help of a highly committed teacher and a range of support services overcome the odds
to graduate from LVN program.
Student              Develop              Prep to get              Enroll and stay in
                      Interest            into program             program
Timing:


Description: The Riverside Community College Vocational Nursing Program collaborated with
a local nursing home chain on a project that invited all employees interested in becoming LVNs
to enroll in the Riverside Community College program. The group started working on their
prerequisite courses in February 2001 and most of the successful participants graduated in spring
2003. The students were, according to the lead instructor, academically underprepared, but
clinically quite strong. They were experienced in working as a team and attendance and
professional behaviors were never a problem. While this program was a success, it faced a
number of challenges. Many participants had not graduated from high school and had to go back
and get GEDs in order to participate in the program. The students’ lack of experience taking
science courses also meant that most had difficulty passing prerequisite courses and only
succeeded in the end because they had the will to spend long hours engaged in self-initiated and
formal remediation.

In the end, twenty-one of twenty-six students graduated and two of the remaining five are
planning to return to complete the program. This remarkable outcome was achieved because the
employer was strongly invested, the college faculty was deeply committed to the students and
the goals of the program, and the students themselves were highly motivated, forming an almost
family-like cohort. The product is a group of graduates who are almost all students from
underrepresented minority groups with 60 percent bilingual in Spanish and English and many
bicultural.

Evidence of Impact/Success: Most participants were CNAs but some had been trained in other
countries. Among the students, 42 percent were English language learners, 43 percent had not
finished high school, and many were single mothers (including one single mother with eight
children and no car). Despite these challenges, the project achieved a remarkable 81 percent
completion and graduation rate. Each graduate received a letter of congratulations from the
governor! A number of graduates have taken the licensing exam and to date, the pass rate is 100
percent.



                                                                                                93
Resource Requirements: The funding for this program came from a California State Caregivers
Training Initiative grant to Riverside County Local Workforce Investment Area. The grant is
meant to help develop innovative methods for increasing the number, quality, and wages of
entry-level caregivers in long-term care facilities through specialized training programs. This
program is meant to encourage collaboration among public, non-profit and private organizations
to find solutions to the shortage of long-term care workers.

The grant bought students’ books, uniforms and stethoscopes. It also paid for students to work
with an RCC instructor on NCLEX review for four hours a week for two months, as well as a
three-day intensive NCLEX preparation course. The employer contributed the tuition fees and
paid students who worked twenty hours a week and went to school twenty hours a week for a
forty hour workweek. In addition, the employer provided a meeting space for classes. The grant
paid for equipment and supplies and installed remedial software on computers at each of the
nursing homes so students could practice on the job.

Contact Information:

Name:                      Phyllis L. Rowe
                           Associate Professor, Nursing/Assistant Director, Vocational
Title:
                           Nursing Program
Organization:              Riverside Community College, Nursing Education Program
Work Phone:                909-222-8336
Email:                     phyllis.rowe@rcc.edu
Other :                    http://www.rcc.edu/academicPrograms/nursing/staff.cfm




                                                                                             94
Title: Student Success for Nursing Students at San Joaquin Delta College


College: San Joaquin Delta College
Program: RN
Contact: Mary Neville
Email: mneville@deltacollege.edu
Summary: A mentoring program at San Joaquin Delta College pairs new nursing students with
an experienced RN. The nursing program provides individual counseling, workshops, referrals,
and a formal remediation process to retain nursing students.

Student             Develop                 Prep to get            Enroll and stay in
                    Interest                into program           program
Timing:


Description: San Joaquin Delta College offers an associate nursing degree with eighty new
students accepted into the program each semester. Full enrollment in the program is three
hundred twenty. Students come to the program with a variety of financial, social, psychological,
and academic needs. To improve retention, the nursing and health science department started a
student success program in fall 2002. The program provides mentoring to approximately 25
percent of each entering class and a variety of other services to help students achieve the
academic performance they need to remain in the program.

The mentoring program matches a new student with an RN in the community. Students are
selected for the mentoring program based on a questionnaire that looks at family, financial,
employment, commuting, and other issues. Based on the results of the questionnaire, ten to
twenty students each semester are paired with an RN. Mentors provide moral support and social
and psychological advice, and draw on their own experience as nursing students to help students
resolve problems. Students take the ATI Test of Essential Academic Skills (TEAS) when they
start the program and additional ATI tests each semester. Students do a self-assessment during
their initial ATI testing. The director of health science and nursing and the project coordinator
review the self-assessment and TEAS results to identify at-risk students for the mentor program.

Other aspects of the student success program include English 33A, a test taking and study skills
course (offered before the first semester), study and review sessions, coordination with course
instructors, individual tutoring, and remediation for students who are at risk of failing. The
faculty make Cds of course material that students can use at home. The project coordinator
provides referrals for financial aid, and works one-on-one with students on personal issues such
as time management, tutoring, and other issues. The project coordinator develops specific
workshops based on the students’ self-assessments. These include time management, goal
setting, stress management, test taking strategies, test anxiety, dealing with change,
communication skills, money management, financial aid, and conflict management. Students are
expected to seek out these services, though faculty are encouraged to refer students to the project
coordinator and resource faculty. Faculty refer students to a tutor if a student receives 72 percent


                                                                                                  95
or lower on a course exam. However, word is spreading among the students about the services
and they tend to self-refer when they receive exams grades near 72 percent.

There is a formal remediation process students fail a course. If they did not take English 33A
before they started the nursing program, they must take and pass it before then can continue in
the program. They must also retake the class they failed before they can move on in the program.
Due to limitations on clinical placements, class size has to remain constant, so it can take a
student nine weeks to a year to get back into the program.

Evidence of Impact/Success: The college changed the admission criteria for the nursing
program from a lottery to a ranking system for the class that entered in spring 2005. The third
class admitted under the new criteria began in January 2006. The new admission criteria are:
cumulative GPA in lower division course (excluding basic skills and non-credit courses),
cumulative GPA in biology courses, grade in English 1A, and the number of times the student
repeated a core biology course. Applicants are ranked numerically and 75 percent must come
from the college’s district.

It is too early to tell what impact the student success program will have on students admitted
under the new criteria. The scores on the ATI TEAS are being correlated to the students’
rankings in the admission process. The program is also tracking exam scores and correlating
them to the ATI scores and admission rankings.

Currently the NCLEX pass rate is 78 percent for students taking the test for the first time. The
departments’ goal is a 90 percent pass rate for first-time test takers.

Resource Requirements: A project coordinator supervises the student success program,
including the mentoring program. The college has a grant from the California Nurse Education
Initiative. The project coordinator’s position is funded by grants from a hospital partnership, the
state chancellor’s office and the California Nurse Education Initiative. Two faculty members
have three hours per week release time to serve as resource people. This funding comes from the
department’s general budget.

Contact Information:

Name:              Mary Neville
Title:             Interim Director of Nursing and Health Sciences
Organization:      San Joaquin Delta College

Work Phone:        209-954-5441

Email:             mneville@deltacollege.edu




                                                                                                   96
Title: CNA Program Prepares Diverse Student Population for Work in Nursing Facilities


College: Santa Barbara City College
Program: CNA
Contact: Kelly Graves
Email: graves@sbcc.edu
Summary: Innovative community outreach and high school partnership triple enrollment in
CNA program that offers flexible training options and strong support services.


Student             Develop                Prep to get             Enroll and stay in
                    Interest               into program            program
Timing:




Description: In 1996, a CNA program administered by the regional occupational program
(ROP) was transferred to Santa Barbara City College (SBCC). The ROP had operated the
program for fourteen years, admitting fifteen students twice a year, while turning many away for
lack of space. After the transfer to SBCC, a part-time instructor ran the program for five years,
again averaging fifteen students every two semesters. In fall 2000, a full-time position was
created with donor support. Two years later, the position became tenured when the donor made
another commitment to an instructor's salary.

The full-time instructor, who was also the program director soon launched a comprehensive
community-based outreach initiative, posting announcements about the program in grocery
stores, laundromats, Spanish language papers, and everywhere else she thought interested
candidates might see them. She also placed public announcements on the local radio stations and
participated in employment fairs. The message she emphasized was: ―Here is a job that can be
very satisfying and that will put you in a position to help others. We will help you get ready for
this job and you will then have a career. ―

In the outreach, the director talked about the opportunity for CNAs to move to the next level of
the health care career ladder, but she also made sure she appealed to those who would be
interested in becoming and remaining CNAs.

Meanwhile, the program gained word-of-mouth momentum as 50 percent of the incumbent and
graduating students (according to a survey) encouraged family and friends to enroll. The
reputation of the program thus spread throughout the community where it became known as a
student-centered training initiative whose graduates almost always passed the state written and
skills exam on the first try. At the same time, referrals from SBCC counselors increased and
soon enrollment reached thirty students per semester.




                                                                                               97
Then, with the addition of another full-time instructor in January 2005, enrollment was increased
again to forty-five students a semester. Summer school was offered for three summers with full
enrollment. A $500,000 grant in February 2006 will allow CNA students to attend the college
for free for the next five years.

In 2000, a dual enrollment arrangement with the local San Marcos health academy was launched,
with a capacity of fifteen high school seniors. The high school students attend CNA classes
three times a week from 7:00 am to 9:15 am and also participate in a clinical training every
Saturday for five months.

With strong roots in the community, the program’s student population includes immigrants from
around the world and individuals ranging from sixteen to eighty-two years of age. The
educational background of program participants is also highly diverse: some enter without
having completed high school while many have baccalaureate, masters, and even doctoral
degrees. Yet another strand of diversity is the many languages spoken by participants. Most
students whose first language is not English come from Spanish-speaking countries, but the
program also serves Russian-speaking Ukrainians, Asian immigrants and international students
who plan to return to their own country with a nursing degree.

Also contributing to a successful recruitment effort is the follow-through and the program’s
attitude toward students. Faculty put in extra time to follow-up with phone calls to students
when applications come in. ―This makes a difference,‖ the program coordinator emphasized. In
addition, the program stresses in every interaction with the participants the professional nature of
the program and the high expectations it has of all the students. For example, the admissions
secretary takes time to talk with each applicant and makes sure she answers all their questions.
Further, students are provided with typed name tags, new application folders, and all assignments
and communication are conveyed in a highly professional and respectful manner. Letters and
phone calls from students are always returned in a timely manner and the instructors respond to
students’ requests for recommendations within a day or two. As another indication of the way
the program signals to students that they are part of a professional group of learners that is
equally important to those in other nursing programs, the program bought a large bulletin board
in which all student group photos were placed. This took place after the CNA students noticed
that RNs and LVNs each had their own bulletin board.

The program is continuously assessing and reinventing itself. For example, they make sure to
provide students with opportunities to experience first-hand—in the clinical training setting—the
different jobs they can attain with additional training. They also have an ongoing speakers’
program that features professionals who discuss the different types of work the students will be
able to pursue with a CNA – for example, restorative nurse assistant, and medical records.

The program recognizes that many of its students have difficult life situations and the instructors
put in lots of extra time supporting them. Their willingness to offer many extra hours of tutoring
for free is key to the program’s success. Further, the program has a system in place where
students that score below 70 percent on a test are automatically referred to tutoring.




                                                                                                 98
To help students get their family members to understand how much time and energy they need to
dedicate to their school work, the program regularly hosts an open house for family members.
These sessions feature program graduates who describe the benefits current students will derive
when they complete the program. At that time they will have ―not just a job, but also a career
and a profession. ―

Evidence of Impact/Success: Since its inception five years ago, fifty-nine students have
enrolled in the high school component of the CNA program. During the first semester, only
seven of the eleven participants completed the program with certification because testing was
optional. Later, the students who didn't test but needed certification could not move to the next
level. Therefore, testing became mandatory for all students and the pass rate has been steady at a
remarkable 100 percent.

The program is highly diverse. Forty percent of students are Hispanic; 10 percent Asian; and 50
percent Caucasian. The program, which is an integral part of the high school partner’s health
academy, was deliberately designed to serve students with different academic backgrounds. ―We
wanted to make sure the academy was not just for high academic achievers,‖ High School
Coordinator Dachenhaus noted. ―Some of the CNA students are at the C-level in other areas of
their school work, but they are very good with people and love the CNA field.‖ Dachenhaus
added that: ―The collaboration with SBCC has turned around students who looked like they were
not going to make it to graduation, and most of the CNA graduates have stayed in some area of
the medical field.‖

The program is also successful in encouraging its graduates to step-up the career ladder and in
spring 2005, sixteen of the thirty-nine students who successfully completed SBCC’s LVN
Program were SBCC CNA graduates. This included eleven Hispanics, one American Indian, two
Eastern Europeans, and two Caucasians.

Among the new students entering SBCC’s LVN program in spring 2006, almost half came from
the CNA program. One reason for this is that a CNA certificate requirement was added for
admission to the LVN class in 2003 and that the program therefore attracts more students who
from the onset intend to continue on to the next level.

Resource Requirements: In fall 2005, at the height of the budget crisis, the program had its
second tenure track position approved. The CNA program was able to achieve this because it
enjoys strong support from the academic senate and the college administration and because it has
been highly successful in recruiting and graduating ever more students. Another major asset is
the highly energetic directors the program has been able to recruit. All three women who have
led the program to date have been extremely dedicated and innovative in the way they reached
out to the community and continuously expanded the program.

Another source of support is the program’s special relationship with Representative Lois Capps,
(D-Santa Barbara), an RN herself, who is deeply interested in health care. Lois has for years
checked in regularly with the program. For example, she speaks to the graduating class, an event
that generates great publicity for the program. This is particularly true because SBCC is the only




                                                                                                99
educational institute for health care programs in Santa Barbara. Accordingly, everybody knows
it is SBCC when there’s a news story about local nursing.

Additional resources are generated through the program’s partnership with the high school health
academy and through the college’s excellent relationship with local health care providers. For
example, CNA graduates who want to work in a hospital setting are able to get three weeks of
training working with an SBCC associate degree nursing program partner. The program
coordinator warns that it took a lot of time and energy to establish the partnership with the high
school. She advises that it is important to have sessions in advance with both the potential
students and their parents so that both parties understand what is required to succeed.

One of the greatest challenges to program expansion has been finding instructors. The program
coordinator looks for potential candidates in the facilities that host the program’s clinical training
component. This way, she has found several part-time instructors who have been with the
program for several years.

In the summer, before school starts, they will have a pizza party for the fall CNA class and bring
them into the nursing lab where they will meet the teachers and get to know each other. Students
who successfully complete the CNA Health Academy Program will, once they have completed
all requirements for the very popular SBCC RN program, go straight to the top of the waiting
list. They are just now beginning to see the first high school CNA students in this program.

Contact Information:

Name:             Kelly Graves, RN. DNSc
Title:            CNA Program Director
Organization: Santa Barbara City College
Work Phone:       805. 965-0581 Ext. 2738
Email:            Graves @sbcc.edu




                                                                                                  100
Title: Student-Focused CNA Program is a Popular Choice for Local Job Seekers


College: Sequoias Community College
Program: CNA
Contact: Cindy DeLain
Email: cindyd@cos.edu
Summary: Scheduling options, support services, CNA-to-LVN-Bridge Program, and strong
labor market result in word-of-mouth referrals and high demand for available slots.


Student             Develop               Prep to get              Enroll and stay in
                    Interest              into program             program
Timing


Description: The CNA Program at Sequoias Community College offers two sections each
semester, or four classes per year. One of the two sections is a semester-long class that meets
Saturdays and Thursday evenings. The other section is a six-week class that meets four days a
week from 8:00 am to 4:00 pm.

The program serves many recent immigrants, including students who just arrived from Mexico
and speak little English. Yet, one instructor noted that, while ESL is becoming less of a problem
for Hispanics, it remains a major challenge for the local Asian population. In addition to ESL,
major obstacles to student success include basic skills deficiencies.

The program was originally launched as a Welfare-to-Work Program. It still serves individuals
from this group, but also attracts many students who want to enter the Sequoias LVN/RN
programs. The CNA certificate is required for entry into the LVN program and the director
estimates that 20 to 25 percent of students have this goal in mind when they start the CNA
program

The instructors report that the main determinant of student success is motivation. If they really
want it, they tend to succeed, even if this means struggling through great language barriers. ―I
have seen a lot of students who have been out of school for a while and want something different
from what they had before. They come here when they have learned to organize their lives. By
then they are often good students,‖ one of the instructors commented.

The program makes a big effort to encourage CNA students to consider the next steps on the
nursing career ladder. One program graduate recalled: ―The instructors tell us that we can work
in so many areas. ―The program also emphasizes to its many Spanish-speaking students that
being bilingual in Spanish can be a big plus in nursing and can result in higher pay.

Evidence of Impact/Success: The instructors offer a lot of individual tutoring. They are highly
committed to the program and to the population they serve. Students interviewed commented:


                                                                                              101
―The instructors’ offices are always open for questions.‖ One instructor noted that her training at
CSU Fresno taught her to identify different learning styles. Early on in class she will sit down
with students and, if it seems appropriate, assign them to a fellow classmate who is stronger in
key areas. She will also suggest they tape the lecture and listen to it afterwards

Resource Requirements: Many new students come to the program because of word-of-mouth
recommendations. The instructors told stories of training first the mother, then one of the
daughters, and then other members of a local family. One instructor is presently training the
third of three sisters to become a CNA. Because of this and other outreach efforts, the program
has many more applicants than it can accept. They would love to expand, but need additional
funding to pay for more classroom space and to set up and support the clinical training.

Employers recruit in class before the students graduate. Still, an increasing percentage of the
CNA graduates continue onto the college’s LVN and RN programs.

Contact Information:

Name:                        Cindy DeLain
Title:                       Director, Nursing and Allied Health
Organization:                College of the Sequoias
Work Phone:                  559-730-3732
Email:                       cindyd@cos.edu
Other :                      http://www.cos.cc.ca.us/nursing/




                                                                                                  102
Title: Hospital and College Partner to Recruit and Grow Local Health Care Workers.


College: College of the Siskiyous
Program: Health Sciences
Contact: Dennis DeRoss
Email: derossd@siskiyous.edu
Summary: Local, rural healthcare workforce expands significantly in response to intensive
marketing campaign promoting health care jobs and career ladder program for incumbent
health care workers.
Student              Develop            Prep to get              Enroll and stay in
                     Interest           into program             program
Timing:


Description: For many years, Mercy Medical Center (Mercy) in Shasta, California recruited the
vast majority of its health care workers from outside of the community. All too often, however,
the recruits viewed Mercy as a training ground and left after only a couple of years on the job.
The result was that Mercy’s investment in these employees offered a limited return and, even
worse, the hospital had to dedicate an increasing amount of time and other resources to on-going
recruitment.

After seeing this pattern repeat itself over and over, Mercy decided to change direction. As
Morris Eagleman, VP of Patient Services at Mercy explains: ―When I arrived at Mercy the
hospital was struggling to fill especially nursing positions with outside recruits. You’d meet them
and know instantly that they would be gone in a few years. Meanwhile, outside our door, local
residents were unable to find jobs. The unemployment rate up here is always higher than the
state average. So we thought: Why not address both problems at the same time by recruiting
local job seekers to the health care sector.‖

In partnership with College of the Siskiyous, Mercy launched a major campaign to promote
health care careers to the local population. Led by Mercy’s vice president of patient services and
College of the Siskiyous’ dean of technical and career education, the two institutions inundated
the local community with information about careers in health care. They jointly participated in
career fairs, piloted a job-shadowing program that invited prospective health care workers to
experience the daily activities and routines of various jobs, and made sure the media was fully on
board. ―Every week, there was a new story about opportunities for RNs, medical assistants, etc,‖
says Morris Eagleman, VP of Patient Services at Mercy Medical Center.

The hospital opened its doors to residents interested in health care careers, providing them a
$7.50 per hour incentive to job shadow incumbent health care workers. If someone was
interested in nursing, they could receive $7.50 an hour to job shadow a CNA, LVN or RN for
two days to se what the job involves and ask incumbent nurses questions about the day-to-day
work, and its challenges and opportunities. The job shadow initiative extended to existing health



                                                                                               103
care workers so that CNAs were paid to job shadow LVNs and LVNs to job shadow RNs. To
date, eighty or more local residents have participated in the job-shadowing program.

Another part of the recruitment campaign focused on identifying and addressing obstacles that
prevent local residents from pursuing health care occupations. The best way to pinpoint these
barriers, Mercy decided, was to survey local residents. The survey findings identified the most
important obstacles as lack of awareness of job opportunities, the cost of health care training
programs, and anticipated financial problems resulting from being a full time student with no
income.

To address these obstacles Mercy partnered with College of the Siskiyous to offer a work-study
program. It is available to students enrolled in college health care programs and to those taking
classes that are required to enter these programs. To date, Mercy has made a $50,000
contribution to this program.

Recipients of the work-study support included fifteen CNAs who were just getting started in
their health care careers. During Summer 2004, the work-study funds supported the CNAs while
they spent several months in a job-shadowing rotation at Mercy. The experience exposed the
new CNAs to a wide range of hospital departments and health care careers and provided them
with opportunities to meet professionals from different health care occupations.

In addition to the work-study funds, Mercy made a $6,000 to $8,000 scholarship donation that
over the past several years has helped thirty to forty health care students at College of the
Siskiyous pay registration fees and related instructional supplies.

Evidence of Impact/Success: When the outreach began, College of the Siskiyous was struggling
to recruit enough students to its CNA and LVN programs. Since the outreach initiative began,
the College has expanded and remodeled its nursing classrooms to accommodate the new and
large influx of students. The expansion has been fully underwritten by Mercy.

College of the Siskiyous nursing program receives over one hundred LVN applications a year
competing for about thirty slots. Most recently, for the fall 2004 LVN program, there were fifty-
eight complete applications from one hundred fifty individuals who expressed strong interest in
the program. From this applicant pool, the LVN program selected what is by far its largest class
ever with thirty students and three alternates.

The CNA program has been enrolling twenty-four students, the maximum number it can handle.
When compared to the ten to twelve students who enrolled two years ago, it is clear that the
outreach has paid off.

Resource Requirements: The fast expansion in enrollment generated a need for more nursing
faculty. Here again, partner hospitals (Mercy and Fairchild Medical Center) helped out by
encouraging their nursing staff to teach part-time. As an incentive, the nurses can cut back on
their work hours and maintain full benefits. This offer made it possible for the college to hire
from the hospital three new part-time clinical instructors.




                                                                                               104
Another factor that has contributed to the successful expansion of College of the Siskiyous’
nursing programs, Dean DeRoss noted, has been the addition to the team of two counselors—one
full-time and one who stepped in as necessary. The counselors are employees of the service area
Workforce Investment Act provider, the Siskiyous Employment Training Program. They are
assigned to the training program to help participants address the long list of obstacles that all too
frequently interfere with adult students’ ability to study. Specifically, they provide counseling to
students with problems at home, help students find child care, problem-solve with the students if
their cars break down, etc.

The LVN students also benefit from having access to special tutoring provided by working
nurses who in many cases are graduates of the program. Finally, students who qualify to enter
the nursing program are provided with financial assistance to cover the cost of the program. This
funding is provided by STEP and federal student financial aide.

From an institutional perspective, each project leader enjoyed the support of their supervisor and,
in the case of the hospital, the board of trustees. The college president is also providing
important leadership to the project, which fits into his long-term goal of building community
support for a rural healthcare institute.

Contact Information:

Name:                      Dennis DeRoss
Title:                     Dean of Technical and Career Education
Organization:              College of the Siskiyous
Work Phone:                530-938-5511
Email:                     derossd@siskiyous.edu




                                                                                                 105
Title: Faculty Diversity Provides Role Models in Respiratory Therapy


College: Skyline College
Program: Respiratory Therapy
Contact: Raymond Hernandez
Email: hernandezr@smccd.net
Summary: The highly diverse faculty in Skyline College’s Respiratory Therapy Program
provide good role models and mentors for students in the demanding program. Maintaining
each group of entering students as a cohort builds mutual support and a sense of being part of a
professional community.
                    Develop                Prep to get              Enroll and stay in
Student
                     Interest              into program             program
 Timing:


Description: Skyline College’s commitment to creating a faculty that reflects the diversity of its
student population is evident in the Respiratory Therapy Program. While the college serves a
highly diverse part of California (northern San Mateo County), it has made an extra effort to
support diversity among the faculty and staff. For example, the college has been sending groups
of employees to the Museum of Tolerance for training twice a year for five years. The
Respiratory Therapy Program’s full-time director is Hispanic and the full-time clinical director is
African American. The program has a diverse, twelve-member faculty and tries to have
someone on the faculty for students from various ethnic groups to emulate. These individuals
serve as good role models for students of color and inspire them to enter the rigorous four-
semester program. The diversity of the faculty has improved over the past five years, as has the
size and diversity of the applicant pool.

Students are admitted into the program once a year in the fall. In fall 2004, the program
increased its enrollment from twenty-five to thirty students admitted per year. While the program
does not have the resources to do outreach to high schools or community groups, the faculty
recruit in the science courses that are prerequisites for the program. There is strong
representation of Hispanic and Asian American students in the program. The program director
feels that the diversity of the faculty has played an important role in attracting a diverse student
body because the field of respiratory therapy is not as well known as other health care
professions, such as nursing. The program also makes diversity a key element of its recruitment
literature and uses graphics that depict a diverse group of people.

The program director also believes that they retain a diverse student population because they
maintain the students as a cohort. The students who enter the program together get to know each
other and build relationships early. Second-year students mentor first-year students, which
fosters a sense of community. Students are exposed early to professional organizations and their
developing sense of being part of a professional community gives them a sense of direction and




                                                                                                106
purpose. Second year students are required to complete eight hours of community service,
though typically one-third to one-half of each class exceeds this requirement.

Evidence of Impact/Success: Graduates of the program pass the state licensing exam at a rate
above the national average for people who take the exam the first time or repeat once. One
member of the program’s advisory committee feels that the outcomes reflect the commitment
and hard work of the faculty and that the diversity of the graduates reflects the community that
Skyline serves, which was not the case a few decades ago. The attrition rate is comparable to
other programs in the Bay Area and on average the program loses one or two students per class
each year. Interest in the program has increased dramatically in the past few years. The program
director estimates they have a 95 percent retention rate once students are past the first semester,
and 92 percent pass rate on the licensing exam. Attrition during the first semester is improving.
Of the twenty-five students who entered in fall 2004, twenty-three continued into the second year
of the program. Of the fall 2005 entering class of thirty, all but one completed the first year of
the program.

Resource Requirements: The college does not have extra resources to devote to recruitment
and retention in the Respiratory Therapy Program.

Contact Information:

Name:              Raymond Hernandez
Title:             Director, Respiratory Therapy program
Organization:      Skyline College

Work Phone:        650-738-4457

Email:             hernandezr@smccd.net




                                                                                               107
Title: Distance Learning Brings Radiologic Technology Program to Rural Area


College: West Hills College
Program: Radiologic Technology
Contact: Dave Bolt
Email: davebolt@westhills.com
Summary: Local hospitals in need of radiologic technologists support Fresno City College
distance learning program at West Hills


Student             Develop                Prep to get            Enroll and stay in
                    Interest               into program           program
Timing:


Description: In 2003, six hospitals in central California formed a consortium to overcome a
serious regional shortage of radiographers. The consortium members had a long history of
competing with each other, but recognized that they needed to collaborate to address a common
problem: they were all investing considerable resources in recruiting and training radiographers
from outside of the area only to see them leave again after a very short time on the job. The
answer to the problem, the hospital leaders realized, was to recruit and train local residents who
had family and other ties in the area to become radiographers. To do so, the hospitals realized
they would have to collaborate with one another and with a local training institution. They
identified local West Hills College, which did not have a radiologic technology training
program. They contacted Fresno City College (FCC), which did have such a program, to initiate
a satellite program via teleconferencing. They established a distance learning training program
that would broadcast FCC’s successful and established radiological technology (RT) training
program to students at West Hills College.

The parties developed and signed a memorandum of understanding stipulating that the hospitals
would pay the costs of running the program. Specifically, the employers would pay
approximately $150,000 per year to support 1.5 RT instructors and the administrative cost of
running and coordinating the program, including outfitting the video center. The hospitals would
be responsible for clinical rotations. Students rotate through all of the hospitals during the
internship process. However, the students do not have to agree to work for the hospitals for any
length of time. This, a program representative suggested, would serve as an incentive for the
hospitals to do a very good job recruiting the new graduates.

Evidence of Impact/Success: The program is in its second year of implementation with the first
group of sixteen West Hills students scheduled to graduate in June 2005. The first year had a
steep learning curve and involved a number of adjustments both at the Fresno City College site
and at the (West Hills) satellite site. Specifically, there were challenges fine-tuning the
technology, including a lag time in the video telecast to Visalia. After two years of fine-tuning,



                                                                                               108
however, the program has many more applicants than it can accept and all parties—students,
hospital employers, Fresno and West Hills Colleges—appear happy about the program.

Resource Requirements: The new training program benefited greatly from the support it
received from Fresno City College’s experienced RT program leadership. FCC RT program
director, Paul Gonzales, warns that it took a lot of time to work out the logistics. He advises that
other programs considering adding a distance education satellite may think about launching
several programs at once to spread out the cost of the associated administrative and clerical time.

Another key ingredient of success for this particular program was the hospital consortium
partners’ willingness to pay the entire cost, including start up and operating expenses. The initial
investment included the video set up and the time that went into testing and later fine-tuning the
linkages. The operational expenses run about $150,000 per year. The current capacity of the
satellite program is thirty-two students.

Name:              Dave Bolt
Title:             Dean of Educational Services
Organization:      West Hills College

Work Phone:        559-925-3222

Email:             davebolt@westhills.com




                                                                                                109
                                      College Contact Information


Antelope Valley College                                Linda Johnson
Karen Cowell                                           Vocational Nursing Instructor
Dean of Allied Health                                  School of Health & Physical Education
3041 West Avenue K                                     415-561-1912
Lancaster, California 93536                            ljohnsonsf@att.net
661-722-6402
kcowell@avc.edu                                        Contra Costa Community College
                                                       Debra Barnes
Bakersfield College                                    Sandra Castillo
Cindy Collier                                          Director of Nursing
Director of Nursing                                    2600 Mission Bell Drive
1801 Panorama Drive                                    San Pablo, CA
Bakersfield, CA 93305                                  510-235-7800 Ext. 4268
661-395-4282                                           Dbarnes@contracosta.edu
ccollier@bakersfieldcollege.edu                        Scastillo@contracosta.edu

Cabrillo Community College                             Crafton Hills College
Tom McKay                                              Ken Bryson
Director of Allied Health & Nursing                    Program Director
831-479-6455                                           Respiratory Care Program
tomckay@cabrillo.edu                                   11711 Sand Canyon Road
                                                       Yucaipa, CA, 92399
Chabot College                                         909-389-3284
Joanne Galliano                                        kbryson@crafton.sbccd.cc.ca.us
Program Director of Dental Hygiene, Health,
Physical Education & Athletics                         Cuesta Community College
25555 Hesperian Boulevard                              Susan Jones
Building 2200, Room 2204                               Director of Psychiatric Technology
Hayward, CA 94545                                      Ataascadero State Hospital
510-723-6866                                           805-468-3175
jgalliano@chabotcollege.edu
                                                       Foothill College
Chaffey College                                        Eloise J. Orrell
Andrea Dutton                                          Director, Radiologic Technology Program
Radiologic Technology Coordinator                      12345 El Monte Road
5885 Haven Avenue                                      Los Altos Hills, CA 94022
Rancho Cucamonga, CA 91737                             650-949-7469
909-477-8979                                           orrelleloise@foothill.edu
Andrea.Dutton@chaffey.edu
                                                       Phyllis Spragge
City College of San Francisco                          Director, Dental Hygiene Program
Peggy Guichard                                         12345 El Monte Road
Department Chair, Health Care Technology               Los Altos Hills, CA 94022
415-561-1967                                           650-949-7335
mguichar@ccsf.edu                                      spraggephyllis@foothill.edu



                                                                                                 110
Fresno City College                       Porterville College
Paul N. Gonzales                          Valerie Lombardi, Director
Director, Radiologic Technology Program   Health Careers Division
559-244-2652                              100 East College Avenue
paul.Gonzales@scccd.com                   Porterville, Ca 93257
                                          (559) 791-2321
Los Angeles Harbor College                vlombard@portervillecollege.edu
Wendy Hollis
Director, Health Science Division         Riverside Community College
310-233-4360 or 310-522-8341              Susan L. Robson
Wendy_Hollis@laccd.cc.ca.us               Assistant Professor, Nursing
                                          Nursing Education Resource Specialist
Long Beach City College                   909-222-8817
Mary Cavalier                             susan.robson@rcc.edu
Vocational Nursing Program Director
562-938-4160-mcavalier@lbcc.edu           Phyllis L. Rowe
                                          Associate Professor, Nursing
Modesto Junior College                    Assistant Director, Vocational Nursing Program
Shirley Buzbee                            909-222-8336
Director of Medical Assisting Program     phyllis.rowe@rcc.edu
Modesto, CA 95350
209-575-6377                              San Joaquin Delta College
Buzbees@Yosemite.cc.ca.ua                 Mary Neville
                                          Interim Director of Nursing and Health Sciences
Moorpark Community College                5151 Pacific Avenue
Karen Jensen                              Stockton, CA 95207
Coordinator of Health Sciences            209-954-5441
805-378-1400 (1830)                       mneville@deltacollege.edu
kjensen@vcccd.net
                                          Santa Barbara City College
Mount San Antonio College                 Kelly Graves
John Gardner                              CNA Program Director
Program Director                          805. 965-0581 Ext. 2738
909-594-5611 Ext. 4916                    Graves@sbcc.edu
jgardner@mtsac.edu
                                          Sequoias Community College
Palomar College                           Cindy DeLain
Judy Eckhart                              Director, Nursing and Allied Health
Chair, Health Science                     559-730-3732
760-744-1150, Ext. 2583                   cindyd@cos.edu
jeckhart@Palomar.edu
                                          Siskiyous Community College
Cathy Hawkins                             Dennis DeRoss
Health Programs Specialist                Dean of Technical and Career Education
760-744-1150, Ext. 2279                   530-938-5511
                                          derossd@siskiyous.edu
Pasadena City College
Tom Neiderer
Director, Dental Hygiene
626-585-7545
tpneidere@Pasadena.edu


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Skyline College
Raymond Hernandez
Director, Respiratory Therapy Program
3300 College Dr.
Building 7, Room 7311
San Bruno CA 94066-1698
650-738-4457
hernandezr@smccd.net

West Hills College
Dave Bolt
Dean of Educational Services
559-925-3222
davebolt@westhills.com




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