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Investing in a Student Training Program: Strengthening your Pipeline and Stabilizing your Workforce

Tuesday, June 20, 2017   (0 Comments)
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Kristine Gonnella, Director, Training and Technical Assistance, Community Health Partners for Sustainability


In April 2015, the National Association of Community Health Centers published “Recruitment, Onboarding and Retention: A Toolkit for Health Centers.”  In this resource, health centers are encouraged to consider, plan, develop, and implement a recruitment, onboarding, and retention cycle.  Often missing from these discussions is the recruitment, onboarding, and training of health professions students to help set the stage for a more robust health center workforce.  Recruiting and retaining providers is challenging, but there is a method to find talented young primary care providers who want to work in your health center. Health professions student training programs that are woven into the fabric of the health center infrastructure can provide a high quality training experience for students, including but not limited to medical assistants, medical students, nurses, physician assistants (PAs), and social workers.  A focused effort in building out a coordinated, collaborative training environment can result in a pipeline of professionals passionate and committed to service in health centers.


Last year, the U.S. Department of Health and Human Services Health Resources and Services Administration Bureau of Health Workforce National Center for Health Workforce Analysis published The National and Regional Projections of Supply and Demand for Primary Care Practitioners: 2013-2025.  In this publication, the national demand for primary care physicians is projected to increase by 38,320 full time equivalents (FTE) – from 224,780 FTEs in 2013 to 263,100 FTEs in 2025 - approximately a 17 percent increase. While differences in projected shortages differ by region, all regions project deficits. However, with delivery system changes and full utilization of nurse practitioner (NP) and PA services, the projected shortage of 23,640 FTEs can be effectively mitigated.  Some barriers exist to full utilization of NP services. For example, some managed care organizations (MCO) do not contract directly with NPs as primary care providers, and some states have restrictions to NP licensure and scope of practice.


The National Nurse-Led Care Consortium, in collaboration with the Hospital of the University of Pennsylvania and nine local Philadelphia Schools of Nursing, partnered on the CMS Graduate Nurse Education Demonstration (GNE) Project in August of 2012.  The primary goal of the demonstration was to increase the number of advanced practice nurse (APRN) students. The clinical training included in this demonstration provided APRNs with the clinical skills necessary to provide primary, preventive, and transitional, as well as chronic care management and other services appropriate for Medicare beneficiaries. Under the GNE Demonstration, CMS provided reimbursement for the reasonable cost of providing clinical training to APRN students enrolled in the demonstration.


Throughout the GNE Demonstration Project, NNCC worked to facilitate training opportunities for APRN students in health centers across Philadelphia.  In this capacity, NNCC partnered with the Philadelphia GNE Consortium and local health centers to develop strategies to overcome challenges in supporting NP student training.  These strategies, such as identifying a point person to facilitate training opportunities and streamlining the administrative and programmatic onboarding of students to the health center, were applicable to students irrespective of their discipline.


Universally health centers recognize that a robust, integrated student training program can lead to a pipeline of recruitment and retention opportunities.  However, an integrated program requires commitment from the health center administration, staff, and providers to uphold clear and intentional rules of engagement.  A universal understanding of the procedures and protocol for student training engagement include but are not limited to the following topics: 1) student training requests, 2) student eligibility, 3) HR onboarding, 4) health center onboarding, 5) preceptor expectations, 6) student evaluation, 7) preceptor evaluation, and 8) student recruitment status.


In order to maximize the student training opportunity as a pipeline to recruitment and retention, a health center must fully commit to develop and maintain a robust student training infrastructure supported by clear policies and procedures. Whether this infrastructure involves one person administratively overseeing student training or involves human resources coordinating student training policies and procedures, a health center must uphold clear and transparent rules of engagement, processes, and expectations with health center staff in order to support this programming. 


Future steps for NNCC include conducting time studies and cost benefit analyses to demonstrate the value of robust student training programming. NNCC is committed to supporting our national partners Community Health Center, Inc. as well as Associations for the Clinicians of the Underserved as they provide training and technical assistance to support the workforce of health centers across the country.  For more information on how the National Nurse-Led Care Consortium supports integrating student training into care team formation, contact Kristine Gonnella at kgonnella@nncc.us.



NWRPCA welcomes and regularly publishes white papers and articles submitted by members, partners and associates with subject matter expertise. The appearance of any guest publication in our Health Center News database represents the views of the author and does not constitute endorsement by NWRPCA of the stated opinions or perspectives, nor does it suggest endorsement of the contributor's products or services.

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