AHEC Moving Forward: On the Path to Health Careers
Editorial Overview: The Health Careers Pipeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Andrea Novak, PhD, RN-BC, FAEN; Kenneth L. Oakley, PhD, FACHE
Featured Articles
Cooperative Spirit: Montana WWAMI and Montana AHEC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-5
Jay Erickson, MD; and Jane Shelby, PhD
South Carolina Diversity Coalitions: A Statewide Approach for Extending the Outreach to
Under-Represented and Minority Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7
David R. Garr, MD; and Angelica Christie, MA
CT AHEC and Service-Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Tricia Harrity, MS
Innovative Pipelining Targeting the Under-Represented
How AHECs Can Help Refugee and Immigrant Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-12
Linda Rabben, PhD
USF’s Pre-Medical Summer Enrichment Program: Collaborating to Recruit a Diverse Physician Workforce . . . . . . 13-15
Cynthia S. Selleck, ARNP, DSN; Suzanne Jackson, MPH; and Nazach Rodriguez Snapp, MPH, MSW
The South Carolina AHEC Health Careers Program Creates Innovative Experiences for
Pipeline Students and Their Parents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-17
Angelica Christie, MEd; and Ragan DuBose-Morris, MA
Developing a Robust Health Career Academy on a Modest Budget . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Barb Dodge, PhD, RN; and Marty Schaller, MS
MassAHEC HOSA: Branding a Partnership with the AHEC Identity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19, 22
Sharon A. Grundel, MEd
Centerfold: Health Career Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-21
Pipeline Partnerships
Rural Medical Scholars: A Pipeline Program for Mississippi’s Future Physicians . . . . . . . . . . . . . . . . . . . . . . . 23-24
Bonnie Carew, PhD; Jeralynn Cossman, PhD; and Ann Sansing, MS
Promoting the Fields of Nursing and Nurse Education through Simulation . . . . . . . . . . . . . . . . . . . . . . . . . . 25-26
Amy D. Nelson, BS
Southern NC Allied Health Regional Skills Partnership’s Creative Career Ladder Links Allied
Health Students with Employers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27-28
Amy Glenn Vega, MBA, MHA, RHEd
Meeting the Need for Dental Hygiene Practitioners in Rural Arkansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29-30
Susan Long, EdD, RDH; Nancy Smith, RDH, MEd; and Rhonda Sledge, RDH, MHSA
Keeping Kids Smiling in Bridgeport, CT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31-33
Joan Lane, MPH; Vani Anand; and Meredith Ferraro
Pipeline Reponses to Unique Community Need
The Aurora LIGHTS Shine Bright in the Heart of Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34-35
Allegra Melillo, MD; Deidre Houston, PhD; and Carol McBride
Army Strong, AHEC Healthy: Northern AHEC’s Role in Support of Fort Drum . . . . . . . . . . . . . . . . . . . . . . . 36-37
Richard Merchant, MA
Volume XXVII, Number 1
Spring/Summer 2011
Journal of the National AHEC Organization
Editorial Overview
The Health Careers
Pipeline
Andrea Novak, PhD, RN-BC,FAEN;
Kenneth L. Oakley, PhD, FACHE
For several years now, the National AHEC Organization (NAO)
has embraced the slogan “connecting students to careers, professionals to communities, and communities to better health.” In this
issue of the Journal of the National AHEC Organization, the Editorial
Board elected to focus specifically upon articles pertaining to the first
component of our slogan, connecting students to careers. The Board’s
most recent Call for Articles, “AHEC Moving Forward: On the Path
to Health Careers,” elicited an almost overwhelming response in the
number of quality articles that were submitted. While it is an enjoyable circumstance to find ourselves in, it has been a true challenge to
select that finite number of articles best suited for publication at this
time. In making this difficult determination, we as co-editors sought
to select a balance of articles that best showcased the following
considerations:
• Strong, innovative, and well-established health education and
training strategies;
• A solid commitment to developing a truly diversified health
workforce for the future;
• Programming focused upon specialty career paths such as dental
health, medicine, nursing, and allied health;
• And finally, pipeline programs developed to address unique
challenges/needs at the community level
We wish to thank not only those authors whose articles are published
herein, but also all of those authors who chose to submit. The Board
sincerely hopes to see many more of these articles published in subsequent issues of the Journal.
As we begin to move along our path to health careers within this
issue, we start by featuring several articles that provide us with
information and evaluative data on statewide initiatives that have
received national attention over a number of years. Jay Erickson, MD
Andrea Novak, PhD, RNBC, FAEN, is Administrator
and Nursing and
Interdisciplinary Continuing
Education Training Center
Coordinator at Southern
Regional AHEC.
Kenneth L. Oakley, PhD,
FACHE, is Chief Executive
Officer of the Western New
York Rural AHEC.
and Jane Shelby, PhD, lead by sharing an overview of the history of
WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho),
an innovative five-state partnership first created by the University
of Washington School of Medicine in 1971. David R. Garr, MD
and Angelica Christie, MA, briefly discuss their past 17 years of
success in utilizing annual “building diversity summits” to inform and
energize a statewide Building Coalitions initiative sponsored in part
through the South Carolina State AHEC Program. Tricia Harrity, MS, also shares a short article on how the Connecticut AHEC
Program chooses to promote service-learning as a preferred teaching
method throughout their health careers pipeline beginning in middle
school through college preparation.
The next series of articles authored by Linda Rabben, PhD; Cynthia
S. Selleck, ARNP, DSN (et al.); Angelica Christie, MEd (et al.);
Barb Dodge, PhD, RN (et al.); and Sharon Grundel, MEd, all provide interesting information and insight regarding well-established
pipeline programming that focuses heavily upon essential support to
under-represented minorities or rural/urban disadvantaged health
career students across various levels of the pipeline continuum.
Additional pipeline partnerships include a submission from Bonnie Carew, PhD (et al.), who overviews a Rural Medical Scholars
partnership between the Mississippi State University Extension
Service and the Northern Mississippi AHEC; an article from Amy
D. Nelson, BS, highlighting a partnership between the Oregon
Health Sciences University’s School of Nursing, and the AHEC of
Southwest Oregon promoting nursing through the use of simulation instruction to develop nurse educators; and Amy Glenn Vega,
MBA, MHA, RHEd describing a partnership among the Lumber
River Workforce Development Board of Pembroke, North Carolina,
Southern Regional AHEC, a local community college, as well as
regional employers creatively addressing the need to increase the
number of licensed Physical Therapy Assistants and other allied
health personnel throughout their region.
continued on pg. 17
The National AHEC Organization supports and advances the Area Health Education Centers (AHEC) network
in improving the health of individuals and communities by transforming health care through education.
Tbe Journal of the National AHEC Organization is published by NAO.
Cooperative Spirit: Montana
WWAMI and Montana AHEC
Jay S. Erickson, MD; and Jane Shelby, PhD
WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) is a unique five-state partnership
created in 1971 by the University of Washington
School of Medicine (UWSOM) to address physician workforce shortages. The WWAMI region is
large, encompassing 27% of the U.S. land mass, yet
it contains only 3% of the U.S. population. The large
distances and low population densities create significant rural and underserved populations. In four of the
WWAMI states more than 59% of the population
live in rural areas (Ramsey, Coombs, Hunt, Marshall,
and Weinrich, 2001).
The WWAMI states all have significant physician
shortages. For example, in Montana all 56 counties
carry a full or partial HPSA (Health Professional
Shortage Area) designation (U.S. Department of
Health and Human Services, Health Resources
Services Administration). Eight of these 56 counties
are without physicians. The National Health Service
Corps lists a total of 53 primary care physician openings within the state of Montana (U.S. Department
of Health and Human Services, Health Resources
Services Administration), with similar shortages
throughout the other WWAMI states and highlights
the continuing need for physicians in the rural and
underserved areas of WWAMI. These challenges
require a strategic effort to enhance the delivery of
undergraduate and graduate medical education in the
WWAMI states to address the area’s critical needs for
physician workforce.
Medical educators have gained an understanding that
medical students need to learn medicine where it is
practiced—in the community rather than only in an
urban, academic hospital setting. The philosophy of
WWAMI is to put emphasis on a decentralized form
of medical education. A significant part of any given
student’s education occurs within the WWAMI region in communities utilizing a combination of both
full-time and volunteer teachers.
The WWAMI program had five main goals:
1.Admit more students to medical school from all
participant states
2.Train more primary care physicians
3.Bring the resources of the UWSOM to the
citizens and communities of each state
4.Avoid the capital costs of building a new medical
school
5.Redress the maldistribution of physicians by
placing more physicians in the rural areas of each
state.
All of these goals have been met over the years, with
the exception of the maldistribution of physicians in
rural and underserved practices within the WWAMI
region. Some of the positive results of the programs
at the UWSOM and WWAMI include:
1.Over 30 years, 61% of graduating students stay
within the five-state area to practice.
2.Over the past 20 years, close to 50% of graduating
students have chosen to pursue careers in primary
care.
3.An estimated 20% of WWAMI graduates will
practice in HPSAs following graduate medical
education.
4.UWSOM has been identified as the top primary
care school in each of the last 16 years by U.S. News
& World Report.
5. In addition to education for medical school
students, the WWAMI program focuses on the
identification and preparation of qualified students
in the K-12 and college years.
Jay S. Erickson, MD, is
Assistant Dean Regional
Affairs and Rural Health,
WWAMI Clinical
Coordinator/Montana, and
WRITE Co-chair at the
University of Washington
School of Medicine.
2
Jane Shelby, PhD, serves as
the Execuive Director Health
Sciences at Montana State
University.
6.UWSOM supports residency opportunities in
the five-state WWAMI region, including the 17
participating residencies in family practice, and also
provides innovative programs to support those in
community practice throughout the region.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Cooperative Spirit: Montana WWAMI and Montana AHEC
of WWAMI students to Montana as practicing
Montana AHEC Program
physicians, and especially target student interest and
The Montana AHEC program is one of the key
commitment to service in rural and underserved areas
partners in making the WWAMI program so sucin the state. Starting in 2008, five of the 20 Montana
cessful in this state. The Montana AHEC began in
1985 in partnership with the UWSOM. With federal WWAMI medical students, annually, matriculated
into a special four-year rural longitudinal medical
language changes allowing nursing colleges to apply
education curriculum. This longitudinal medical
for AHEC grants, the Montana State University
education program is called TRUST (Targeted Rural
(MSU) College of Nursing applied for and received
Underserved Track) and features a targeted admisan AHEC grant in 2007. This allowed the establishsions process that admits students with a background
ment of a state program office in Bozeman at MSU
and four regional AHEC
offices within the state.
Two of the four regional
AHEC offices in Montana
are located in communities with fewer than 4,000
residents. The Montana
AHEC program office is
located near the offices for
the Montana WWAMI
medical education program. The co-location
of both the WWAMI
and state AHEC offices
at MSU has allowed the
development of a close
working relationship
between the two programs. Fig. 1. The TRUST program training path
With the addition of the
Montana regional offices in
2008, this relationship has grown even closer. Togeth- and predispostion to return to rural and underserved
practices within the state.
er, Montana AHEC and WWAMI cooperate on a
number of health career pipeline programs that focus
on addressing physician and other health professional The TRUST program begins with a two-week prematriculation experience in a rural or underserved
shortages.
practice for entering medical students the summer
before beginning medical school. The continuum of
WWAMI Medical Education Program
training for the TRUST students is shown in Figure 1.
Twenty Montana residents enter the Montana
WWAMI program yearly and spend their first year
TRUST students are linked to a rural or underserved
at MSU in Bozeman. During the second year of
mentor in these communities. The Montana AHEC
medical school, Montana WWAMI students move
program assists with placement of these TRUST
to Seattle to join with 196 WWAMI students from
students and assists with travel to these communithe other WWAMI states to continue their medical
ties, some of which are over seven hours by car from
student education at the UWSOM. For the third
Bozeman. TRUST students return to their TRUST
and fourth years of medical school, during the phase
communities for both a fall and spring weekend exof clinical training called “clerkships” or “tracks,” the
perience to continue the mentoring connection. The
students have the opportunity to return to Montana,
or receive clinical training at any WWAMI site in the state AHEC office helped with a successful grant
application to the Montana Blue Cross Blue Shield
region.
Foundation to assist with initial start-up costs for the
TRUST program.
The Montana WWAMI Medical Education program has initiated several novel components targeted
During the first year of medical school at MSU, a
at increasing the number of students interested
member of the state AHEC office teaches a course
in primary care rural service, and returning these
to the TRUST students entitled “Rural Health Care
Montana WWAMI students to Montana to meet
Delivery Systems” and helps host a journal club in
its physician workforce needs. These programs are
conjunction with the Montana WWAMI Clinidesigned to increase the already good return rate
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
3
Cooperative Spirit: Montana WWAMI and Montana AHEC
cal Dean. The state and regional AHECs also help
with the organization and travel for a program called
SPARX (Students Providers Aspiring to Rural
Experiences), which sends students to present at rural
schools, including remote schools in Native American communities.
After the first year of medical school, most Montana
WWAMI students participate in a one-month rural/
underserved preceptorship. This program, the R/
UOP (Rural/Underserved Opportunities Program)
placed 32 WWAMI students in rural, Community
Health Center, and Indian Health Service sites
throughout Montana. Montana TRUST students
return to their pre-matriculation site. The Montana
WWAMI Clinical Dean oversees the placement of
these students with assistance and funding coming
from the Montana AHEC program and the efforts of
the regional offices.
During the second year of medical school, TRUST
students join the Underserved Pathway at the UWSOM, which helps prepare students to work with
a variety of underserved populations by providing a
foundational knowledge base and real-world experience.
During the third year of medical education, TRUST
students return to their TRUST mentor and community to complete a five-month continuity experience in rural or underserved medicine. This program,
called WRITE (WWAMI Rural Integrated Training
Experience), is currently located in seven Montana
Figure 2. WWAMI program training sites in Montana
4
TRUST communities. This is the culminating clinical experience for TRUST students, though they
may return to these communities for a fourth-year
elective. Thus, these Montana TRUST students have
the opportunity to do five separate clinical experiences in a single community over the first three years
of medical education, culminating in the five-month
WRITE experience. For the TRUST student, guidance is given toward career and residency choice,
engaging the student throughout the four years of
medical school with an emphasis on rural/underserved service in Montana.
For the traditional WWAMI student there are 25
required clerkships in eight communities across
Montana, as shown in Figure 2. There are over 275
WWAMI clinical faculty in Montana, almost oneeighth of Montana’s physicians.
Note: The “Fam” rectangle in the lower central area
of the map is half Req Clerkship Sites and half
Residency Programs. The remaining rectangles on
the map are Req Clerkship Sites.
Montana has only one residency, a 6-6-6 Family
Medicine Residency in Billings. Montana currently
ranks 50th in residency slots per capita. The Montana
AHEC had significant involvement in the development of the Family Medicine Residency. In 1993, the
AHEC prepared and received funding for a “Special
Project AHEC Grant” to study the feasibility for and
to start the process of establishing the residency. The
residency began in 1995, with a former WWAMI
student as the
first director.
The need for
another Family Medicine
Residency in
Montana was
recognized due
to the shortage of family
physicians and
the very limited number
of residency
graduates
per capita.
Therefore, in
2009, a study
to evaluate the
feasibility of
a new Family Medicine
Residency
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Cooperative Spirit: Montana WWAMI and Montana AHEC
in Missoula was initiated. The Western Montana
AHEC office, located at the University of Montana
(UM) in Missoula, has been instrumental in this
effort. The 3R NET (The National Rural Recruitment and Retention Network) is housed at the South
Central Montana AHEC in Dillon and is active in
recruiting and retaining physicians and other providers for Montana. The Montana WWAMI Clinical
Dean assists the director of the Southwest Montana
AHEC with this recruitment effort.
Other WWAMI and AHEC Partnerships
The WWAMI and Montana AHEC programs
are all about partnerships and relationships. The
WWAMI Clinical Dean and the Executive Director
for Health Sciences sit on the state AHEC Advisory
Committee and the Clinical Dean sits on the Western Montana AHEC Advisory Committee. The state
AHEC director is on the Montana WWAMI Advisory Committee. All three leaders sit on the Montana
Healthcare Workforce Advisory Committee, on the
recently created Montana WWAMI Graduate Medical Education Council, and other state groups.
The state AHEC office recently wrote a grant application with assistance from WWAMI, and was
awarded a Rural Health Workforce Development
Program grant from HRSA. This grant will fund
the Montana Rural Health Workforce Development
Network. The Network will address ways to improve
access to and the quality of health care in rural communities throughout Montana. The Network will use
the TRUST, R/UOP, and WRITE programs to help
accomplish the goals of this grant.
Every other year, the Montana WWAMI and Montana AHEC offices jointly host a one-day conference
to help Montana’s pre-medical students prepare a
robust medical school application. Many students in
Montana have limited access to adequate pre-medical
advising and this conference allows them access to
this information. Generally, over 100 students participate.
designed for high school students to explore
health careers
4.Health Occupations Students of America
(HOSA), support for HOSA advisors in rural
and underserved school districts
5.MED Start summer camp, a one-week health
careers camp for high school students
The Montana WWAMI program, which is “Montana’s Medical School,” and the Montana AHEC
program are all about partnering to solve the physician workforce shortage in Montana. Working together, the two programs are intertwined at many levels. This cooperative spirit has allowed many unique
collaborative efforts aimed at solving the physician
workforce shortage. This joint AHEC and WWAMI
effort will surely continue to create new and innovative programs in Montana.
REFERENCES
Ramsey, P. G., Coombs, J. B., Hunt, D., Marshall, S.
G., & Weinrich, M. D. From concept to culture: The WWAMI program at the University
of Washington School of Medicine. Academic
Medicine 2001, 76, 765-75.
U.S. Department of Health and Human Services,
Health Resources Services Administration. Find
shortage areas: HSPA by state and county. Washington, DC: U.S. Department of Health and
Human Services, 2010. Retrieved Aug. 29, 2010
from http://hpsafind.hrsa.gov/HPSASearch.
U.S. Department of Health and Human Services,
Health Resources Services Administration,
National Health Service Corps. Washington, DC:
U.S. Department of Health and Human Services,
2010. Retrieved Aug. 29, 2010 from http://nhscjobs.hrsa.gov.
Other collaborations with Montana WWAMI also
occur in Montana AHEC’s K-12 pipeline programs,
including the following, which often receive assistance from Montana WWAMI students:
1.The Great Hospital Adventure, a kindergarten
through third grade curriculum designed to
expose students to healthcare careers
2.Curriculum in a Box, a health science curriculum
designed for middle school students
3.REACH camps (Research and Explore Awesome Careers in Healthcare), one-day camps
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
5
South Carolina Diversity
Coalitions: A Statewide Approach
for Extending the Outreach to
Under-Represented and Minority
Students
David R. Garr, MD; and Angelica Christie, MA
In 2004, the South Carolina AHEC recognized the
existence and convergence of four realities:
1.South Carolina has far fewer African American and
Hispanic healthcare professionals than are reflected
in the population.
2.The environments in which learning occurs is
expanding beyond traditional classrooms into those
supported by systems and relationships between
individuals and organizations.
3.Historically, numerous programs were independently addressing workforce diversity issues resulting in a fragmented system that failed to achieve
notable success.
4.Collaborations are essential for improving the effectiveness of student development within South
Carolina.
In response, the South Carolina AHEC hosted a summit in December 2004 titled, “Increasing Minorities in
Health Care: Building Partnerships for Success.” The
goals were to: a) open dialogue between organizations;
b) harness the energy and creativity necessary to forge
collaborative efforts; and c) lay the groundwork for the
establishment of regional coalitions that would support and advance the mission of increasing workforce
diversity. The result of the Summit was the decision to
create regional, community-based coalitions to improve
David R. Garr, MD, is
Executive Director, South
Carolina AHEC.
6
Angelica Christie, MA, works
as Director, Health Careers
Program, South Carolina
AHEC.
communication and strengthen collaborative efforts. In
2005, the South Carolina AHEC convened the “South
Carolina Coalitions for Health Careers” with support
of The Duke Endowment, a foundation that seeks to
strengthen communities in North Carolina and South
Carolina by nurturing children, promoting health,
educating minds, and enriching spirits. Funding was
awarded in two phases: Phase I (2005) supported development of the coalition concept and Phase II (20062010) supported the implementation of coalition-driven
initiatives.
The four South Carolina AHEC Regional Centers,
with Program Office support, worked together to convene the coalitions. Phase I of the “Building Coalitions”
initiative began with regional centers inviting influential
partners to become members. Representatives from local
business/industry, schools, school districts, colleges/
universities, practicing health professionals, grassroots
and governmental agencies, faith-based groups, and
hospital representatives were invited. Once convened,
the group focused on barriers associated with the low
rates of minority and underrepresented students entering the health professions pipeline. Although discussed
regionally, several recurring barriers were identified by
each of the four groups leading to the development of
the following statewide initiatives:
1.Increasing Public Awareness—The Health Career
Education Resources (HCER) in South Carolina
website, an electronic database, was developed.
The HCER contains information about organizations that support the preparation of minorities
and under-served residents who have an interest in
exploring or pursuing healthcare professions. (Access the HCER website at http://ahec.library.musc.
edu/hcer/)
2.Health Careers Preparatory Program—The South
Carolina AHEC “Health Careers Academy” is a
four-year, longitudinal, curriculum-based health
career exploration experience for high school
students. Activities demonstrating the use of
knowledge and skills in math, science, and communication comprise the curriculum specifically
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
South Carolina Diversity Coalitions: A Statewide Approach for Extending the Outreach to UnderRepresented and Minority Students
designed for future health professions students in
South Carolina.
3.Mentorship—A best practices guide for mentors regarding mentor/child relations, study skills,
motivation, professional behavior, and academic
coaching was designed and made available to organizations and schools. A mentoring module was
developed as an important component of the South
Carolina AHEC “Health Careers Academy.”
4.Increased Parental Involvement—A module that
was created as a component of the South Carolina
AHEC “Health Careers Academy” provides tools,
resources, and concepts to promote parental engagement in the health careers exploration process
for their children.
5.Teacher Advocacy—The “Teach-the-Teacher
Academy” is an instructional program for middle
and high school educators designed to promote
health career advocacy. This program provides instructional tools and information that educators can
utilize when working with students to encourage
their interest in healthcare careers. Recertification
hours are provided for program completers through
the South Carolina Department of Education.
Phase II of the “Building Coalitions” initiative focused
on the design and implementation of strategies to be
used by the coalitions. The overarching goal was to
positively impact those issues that impair the entrance
of the minority and under-represented students into the
health professions pipeline. A wide variety of projects
and programs were implemented by the Coalitions
to promote student achievement, increase awareness,
advocate career exploration, and engage parents. Each
Coalition prepared a blue paper on one of the projects
they implemented in their region which describes the
objectives, processes, outcomes, and lessons learned.
The South Carolina Coalitions for Health Careers Blue
Papers may be found online at http://www.scahec.net/
hcp/blue.html.
The South Carolina AHEC has continued to sponsor an annual “Building Diversity Summit” since 2004.
Coalition members, partnering agencies, students, and
other interested individuals have been invited to attend,
with the goals of:
1.Highlighting the best practices of initiatives designed and/or facilitated by the four regional South
Carolina Coalitions for Health Careers
2.Providing networking opportunities for those
who support increased representation of minority
students in the health professions
3.Featuring resources to promote the entry of minority students into South Carolina’s health professions pipeline
4.Presenting a forum to discuss future options and
opportunities for continued coalition growth and
development
Regional feedback confirmed that advocacy and support increased during that five-year period for both
the development and implementation of health career
exploration.
Of the 165 organizations that participated as coalition
members:
1.15% (N= 25) were not engaged in health career exploration and advocacy activities prior to becoming
coalition members.
2.33% (N= 54) increased their involvement with
health career exploration as a result of their coalition membership.
3.26% (N= 43) became new, collaborating partners
with the AHEC system on some additional, noncoalition-related activities as a result of learning
about the AHEC system through their work on the
coalition.
4.8% (N= 14) increased or re-instituted a collaborative connection with their regional AHEC.
At the start of the 2011 fiscal year, the Coalitions
plan to sustain initiatives through members’ in-kind
contributions, partnership support, and sponsorship. Now that the administrative responsibilities of
each Coalition have been assumed by the Coalition’s members, the AHEC Regional Centers are
actively involved, but involved as members of the
Coalitions rather than as the convening, coordinating entities.
REFERENCES
Clark, R. (2009). Close the gap: Community leaders
work to get more minority students in AP, honors
classes. The Star, Cleveland County, NC. Retrieved Oct. 6, 2009 from www.shelbystar.com/
articles/leaders-41586-classes-minority.html
Jackson, A. (2009). Six strategies to help young
adolescents at the tipping point in urban middle
schools, Middle School Journal, 40(5), 18-21.
Winik, L. W. (2006). Good schools can happen.
Parade Magazine. Retrieved Oct. 6, 2009 from
http://www.parade.com/articles/editions/2006/
edition_08-27-2006/Better_Schools.
Zeldin, S., & Petrokubi, J. (2008). Youth-adult partnerships: Impacting individuals and communities.
The Prevention Researcher, 15(2), 16-20.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
7
CT AHEC and Service-Learning
Tricia Harrity, MS
When the Connecticut (CT) AHEC Program was
established at the University of Connecticut School
of Medicine, Dr. Bruce Gould, CT AHEC Program
Director, envisioned using service as the “hook” to
cultivate the next generation of caring health professionals. CT AHEC has made that vision become a
reality through a pipeline of health careers recruitment service-learning programs implemented across
the state. These programs stretch from middle school
to college. The Earth Service Corps, Youth Health
Service Corps, and Collegiate Health Service Corps
(CHSC) encourage students to pursue health careers
and ultimately to serve underserved populations. CT
AHEC has focused on student learning and growth
through hands-on experiences that have a positive
impact on the community through service learning.
Service learning capitalizes on the student’s desire to
make
a difference in his/her community—channeling
CT AHEC and Service Learning
Harrity, MS
thisTricia
desire
into projects that address pressing comTricia Harrity, MS, is the Executive Director at Northwestern CT AHEC.
munity
health issues. This in turn helps cement their
When the Connecticut AHEC Program was established at the University of Connecticut School
desire
to pursue
postsecondary
professions
of Medicine,
Dr. Bruce Gould,
Connecticut (CT) AHEChealth
Program Director,
envisioned using
service as the “hook” to cultivate the next generation of caring health professionals. CT AHEC
training.
The
therecruitment
servicehas made that
vision student
become a realitywho
through acompletes
pipeline of health careers
service
learning programs implemented across the state. These programs stretch from middle school to
learning
experience
matriculates
into the
college. The
Earth Service Corps,and
Youth Health
Service Corps, and Collegiate
HealthUniService
Corps (CHSC) encourage students to pursue health careers and ultimately to serve underserved
populations.
CT AHEC has focused on student
learning and
through hands-on
versity
of Connecticut’s
School
ofgrowth
Medicine,
Dental
experiences that have a positive impact on the community through service learning. Service
learning capitalizes
on the student’s or
desireNursing,
to make a difference
inable
his/her community—
Medicine,
Pharmacy
is
to
train
to
channeling this desire into projects that address pressing community health issues. This in turn
helpsin
cement
their desire
to pursue postsecondaryareas
health professions
training. The student who
work
urban
underserved
by participating
in
completes the service learning experience and matriculates into the University of Connecticut’s
ofAHEC’s
Medicine, Dental Medicine,
Pharmacy
or Nursing,
is able to train to work in urban
the School
CT
Urban
Service
Track.
underserved areas through participating in the CT AHEC’s Urban Service Track.
CT AHEC Program Health Careers Service Learning Pipeline
Middle
School
High
School
College
Earth
Service
Corps
YHSC
CHSC
Schools of Medicine, Dental
Medicine, Pharmacy, and Nursing
Urban Service Track
CT AHEC program health careers service learning pipeline
Middle School Component—Summer of Service
Connecticut AHEC and Northwestern AHEC, in collaboration with Eastern AHEC, successfully
competed for 1 of 17 national Summer of Service grants awarded by the Corporation for
Middle
School Component—Summer of Service
National and Community Service (CNCS). Summer of Service is a new initiative of CNCS and
was established as part of the Edward M. Kennedy Serve America Act. CT AHEC’s Summer of
Connecticut
AHEC
andengages
Northwestern
Service program, the
Earth Service Corps,
middle school studentsAHEC,
in 100 hours of in
community service during the summer months. Middle school students also learn about the
collaboration with Eastern
AHEC, successfully
competed for 1 of 17 national Summer of Service
grants awarded by the
Corporation for National
and Community Service
(CNCS). Summer of Service is a new initiative of
CNCS and was established
as part of the Edward M.
Tricia Harrity, MS, is
Kennedy Serve America
the Executive Director at
Northwestern CT AHEC.
Act. CT AHEC’s Summer
8
of Service program, the Earth Service Corps, engages
middle school students in 100 hours of community
service during the summer months. Middle school
students also learn about the impact environment has
on health and about public health careers. Through
the Summer of Service program, AHEC has built
strong collaborative relationships with the Greater
Waterbury YMCA and Willimantic Public Schools’
21st Century Learning Community program.
A YHSC member in a YHSC class reads to young children as part of
his service-learning project.
High School Component—Youth Health Service
Corps
Under the leadership of Northwestern AHEC,
the YHSC engages under-represented high school
students in meaningful service-learning projects that
address pressing community health issues such as
childhood obesity prevention, oral hygiene, elderly
and aging, and health disparities. Program completers
are awarded the YHSC national certificate signed by
the National Health Service Corps.
Due to the success of the YHSC program in
Connecticut, Northwestern AHEC was awarded
funding from CNCS to replicate the YHSC Program throughout the national network of AHECs.
Over the course of the program that spanned from
September 2006 to June 2010, Northwestern AHEC
worked with over 60 AHECs from 20 states to
replicate the YHSC service learning program. During that time, over 3,000 AHEC students completed
83,000 hours of community service. Post-assessments
revealed that 60% of YHSC members report they are
doing better in school because of their participation
in the YHSC and 85% report they plan to volunteer
in the future.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
CT AHEC and Service-Learning
AmeriCorps is our nation’s domestic service program.
In 2010, the Serve America Act increased the number of AmeriCorps program volunteer slots by over
200%—from 75,000 members to 250,000 members.
Northwestern AHEC was awarded funding from the
State of Connecticut Commission on Community
Service to engage 20 full-time AmeriCorps volunteers who will implement the YHSC program with
local high school students who have been identified
as at-risk for dropping out of school and involve
them in service-learning projects. The AmeriCorps
members will also provide additional support to the
YHSC members to include mentoring, educational
assistance, and home visits. Aligning the YHSC
program with AmeriCorps is a win-win proposition
creating volunteer opportunities for AmeriCorps
members at established AHEC centers while increasing the capacity of the YHSC program to work with
our state’s neediest students.
College Component
In 2008, a grant from the State of Connecticut
Department of Higher Education and Department
of Public Health supported the implementation of
the Collegiate Health Service Corps (CHSC) at five
Connecticut university campuses. Under the leadership of Eastern AHEC, the CT AHEC Program
developed the CHSC to extend the service-learning
health careers pipeline to include college students
who are interested in impacting the health needs
of their communities. Students perform service at a
wide range of community sites, including migrant
farm work clinics, a federal correctional facility, and
homeless shelters. CHSC students also participate
in extensive trainings, including the Medical Reserve
Corps Training and Medical Interpreter Training. The CHSC has partnered with the Federal
Work Study Program to ensure that a percentage of
recipients of federal work study awards are providing
service off-campus in the local community. Due to its
success, CHSC is poised to begin working with the
national network of AHECs to replicate the program
on local college campuses across the country.
The CT AHEC Program developed the Urban
Service Track (UST) program at the University of
Connecticut schools of Medicine, Dental Medicine,
Nursing, and Pharmacy. The UST nurtures and trains
a cadre of students from these four health professions
schools to work in urban underserved communities. Students receive clinical training and enhanced
learning opportunities maximizing inter-professional
training and exposure. Annually, four to six slots
within the entering classes of each participating
health professions school are reserved for students
specifically selected for the UST. Urban Health
Scholars receive targeted training in cultural and linguistic competency, population health, health policy,
advocacy, healthcare financing and management,
leadership, community resources, healthcare teams,
and quality improvement. Interdisciplinary clinical
training for UST students takes place in federally
qualified health centers and other primary care facilities in urban underserved communities. As successive
cohorts of Urban Health Scholars graduate, the UST
will contribute to a statewide integrated network of
quality health care for underserved communities.
Tracking Outcomes
CT AHEC is working with a national vendor to
refine its web-based data collection system to track its
health careers service-learning participants. The database allows volunteers to register for a health careers
program, sign up for volunteer opportunities, log
volunteer hours, complete pre- and post-assessments,
and communicate with program coordinators, as
well as enable AHEC to track participants in health
professions training programs and ultimately in the
healthcare workforce.
The Future of Service-Learning
CT AHEC has harnessed service-learning as an
innovative method to engage and inspire future
healthcare providers. Service-learning is the common component throughout CT AHEC’s health
careers recruitment programs providing continuity for
students as they travel through the pipeline towards a
health career. This focus and continuity has enabled
CT AHEC to secure outside funding from federal, state, and local sources. It has also enabled CT
AHEC to work across state lines with other AHECs
who are interested in engaging students through
service-learning.
CHSC member volunteers at the Mission of Mercy free dental clinic.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
9
Innovative Pipelining Targeting the Under-Represented
How AHECs Can Help
Refugee and Immigrant Health
Professionals
Linda Rabben, PhD
Immigrant Healthcare Workers Are a Significant Part of the Workforce
Refugee and immigrant
health professionals
already in this country can
play an important role in
addressing the looming
shortages of healthcare
providers in the United
States. AHECs can assist,
prepare, and recruit them
for service in community
health centers, hospitals,
clinics, and other medical
institutions. Then these
new Americans can help
to increase the diversity
of their profession, reduce
disparities, and improve
treatment outcomes for
millions of underserved
people.
19.2
81
10.4
Health-care technologists and
technicians
90
12.3
Health diagnosing and treating
practitioners
88
13.2
Registered nurses
87
26.3
Physicians and surgeons
74
11.6
Other
88
14.5
Total
86
0
10
20
30
40
% Native
50
60
70
80
90
100
% Foreign Born
Immigrant healthcare workers are a significant
of the Policy
workforce.
Source:
Source:part
Migration
Institute,
2007 Migration Policy Institute, 2007.
In collaboration with the Louisiana Hospital Association and the Louisiana Primary Care Association,
the Central Louisiana AHEC’s recruitment program
helps International Medical Graduates (IMGs) with
recertification. The Central AHEC of Hartford,
Connecticut has set up an International Health
Professionals Bridge Program that includes services
to refugees and immigrants. The Baltimore AHEC,
located in Baltimore City, MD, is investigating the
possibility of developing a model for local provision of recruiting services for refugee and immigrant
health professionals (personal communication, Susan
Sweitzer, Baltimore City AHEC, 2010).
Linda Rabben, PhD, is a
Recertification Specialist
with RegugeeWorks.
10
Nursing, psychiatric, home
health aides
Who are the refugees and
immigrants that AHECs
may encounter? Omar, 32,
is an Iraqi surgeon and
his wife, Nour, 30, is an
obstetrician-gynecologist.
Because he worked for a
U.S. contractor in Iraq,
he received written death
threats and a bullet in
the mail. It took more
than three years for the
UN High Commissioner for Refugees and the U.S.
State Department to arrange for them to come to the
United States as refugees.
Omar’s English is excellent because he lived in the
UK as a child, while his father was studying there.
After arrival in the United States both Omar and
Nour started looking for work but could find nothing. Nour stopped searching for jobs to care for their
daughter and her mother, who is with them. When
he applies for jobs Omar is told there are no vacancies
or he cannot be considered because he has no U.S.
work experience. He plans to continue studying six to
eight hours per day for qualifying exams once he gets
work.
Dr. X was the first physician to practice as an Ear,
Nose, and Throat (ENT) surgeon in his African
country after studying and qualifying in Europe. He
founded a program in ENT surgery at his medical
school, where he taught for many years. After accepting an invitation to take up a one-year fellowship
at an American medical faculty, he applied for and
received asylum with his wife and child. Later he
began looking for work in the healthcare field. He
soon discovered that at age 48 it would take him five
to eight years to obtain licensure as a physician in
the United States. He finally found a “survival job”
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
How AHECs Can Help Refugee and Immigrant Health Professionals
Steps to receive license to practice medicine
as a parking lot attendant and began training to be a
Certified Nursing Assistant at a community college.
At the same time he was trying to study several hours
a day for Step 1 of the U.S. Medical Licensure Examination (USMLE), which he had to pass before he
could apply for a residency. But this was only just the
beginning of his medical recertification process after
two years in this country.
Omar, Nour, and Dr. X are three among thousands
of recently arrived refugee professionals. In 2009 the
federal government admitted almost 75,000 refugees
to the United States. Most came from refugee camps
or slums in developing countries, and many had
waited years for the chance to escape intolerable situations. Once here, refugees receive limited financial
and logistical help from private and state agencies to
find jobs, housing, schooling, and medical care for a
maximum of eight months.
Under the Refugee Act of 1980, refugees are authorized to work immediately after arrival and they
receive social security numbers within one or two
months. They are required to apply for Legal Permanent Residence (LPR—green card) a year after they
arrive. When they become legal permanent residents
they are eligible for in-state college tuition, federal
scholarship aid, and Medicaid, among other benefits.
Some 168,000 refugees and asylees obtained LPR in
2008.
Refugee health professionals face many obstacles
in the United States. Recertification is a timeconsuming and complicated process for physicians,
nurses, dentists, and other health professionals. It is
Many refugee professionals need special assistance
to find mentors, retraining courses, vocational
ESOL instruction, clinical
experience, observerships,
financial aid, medical
treatment, and other kinds of help. Some suffer from
post-traumatic stress, consequences of torture, or
chronic illness. But almost all are highly motivated to
practice their profession in this country.
The healthcare field in the U.S. already includes
hundreds of thousands of immigrants. According
to a 2007 study by the Migration Policy Institute,
international medical graduates (IMGs) comprise
26.3% of physicians and surgeons in the United
States. Foreign nursing, psychiatric, and home health
aides make up 19.2 % of those occupations. Foreign
nurses comprise 13.2 % of registered nurses. Most
are not refugees or asylees. Some came to the United
States to study; others entered with special work visas
obtained by U.S. employers. Ideally it would be more
cost-effective to recruit immigrants and refugees who
are already here, unlikely to return home, and ready
and eager to work at whatever healthcare job they can
find.
Innovative Pipelining Targeting the Under-Represented
also expensive. Credential
evaluation, continuing
education or retraining,
residency applications,
interview travel, and
licensure exams cost tens
of thousands of dollars.
Legal immigrant professionals who are not
refugees may also be in a
difficult position, as they
struggle to support their
families by working at
low-paying jobs for which
they are overqualified.
Numerous studies have found that culturally competent immigrant health professionals can improve
treatment outcomes and reduce disparities of care
among immigrant, minority and underserved
populations. (See, for example, National Academy
of Sciences, 2004: In the Nation’s Interest: Ensuring
Diversity in the Health Care Workforce; and Beach,
Mary Catherine, et al., 2004: "Strategies for Improving Minority Healthcare Quality," Rockville, MD:
Agency for Healthcare Research and Quality, Pub.
# 04-E008-02.) For more than 20 years, significant
numbers of IMGs have provided primary care to
these populations. Likewise, recertified refugee health
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
11
Innovative Pipelining Targeting the Under-Represented
How AHECs Can Help Refugee and Immigrant Health Professionals
12
workers could help to address looming personnel
shortages in many health occupations. Programs that
are targeted to retraining, English language acquisition, licensure-examination preparation, mentoring,
continuing education, clinical experience, and other
aspects of recertification by providing fast-track programs that would take account of their needs, skills,
and experience are needed.
A few such programs already exist around the country. The best known is the Welcome Back Initiative,
which has provided a model for Welcome Back
Centers in San Francisco; San Diego; Denver; San
Antonio; Washington state; Boston; Providence, RI;
and suburban Maryland. In conjunction with community colleges, local social-service organizations
and public agencies, these nonprofit centers help
immigrant and refugee health professionals retrain,
obtain certification, prepare for qualifying examinations, seek employment, improve their English, and
obtain licensure. There are several other programs
which focus on retraining foreign nurses, pharmacist
assistants, and allied health professionals across the
country.
As part of comprehensive healthcare reform, the
federal government is providing hundreds of millions
of dollars to fund pilot projects for health workforce
development. In June 2010, the U.S. Department of
Health and Human Services requested proposals for
“demonstration projects that support the establishment and maintenance of training, education, and
career advancement programs to address health care
professions workforce needs.” These projects would
“assist TANF [Temporary Assistance for Needy
Families], RCA [Refugee Cash Assistance] and
low-income clients enter or reenter the medical field”
(personal communication, U.S. Office of Refugee
Resettlement, 2010). Refugee and immigrant health
professionals could be eligible for such assistance.
AHECs could apply for funds to provide workforce
development services for refugee and immigrant
health professionals in partnership with resettlement
agencies, social service providers, community colleges,
universities, hospitals, community health centers,
clinics, ethnically based community organizations,
and other groups. In the midst of the healthcare
crisis, opportunity beckons from many directions.
REFERENCES
Personal communication, Susan Sweitzer, Baltimore
City AHEC, August 11, 2010.
Personal communication, U.S. Office of Refugee
Resettlement, June 30, 2010.
SUGGESTED READING
National Academy of Sciences. 2004. In the Nation’s Interest: Ensuring Diversity in the Health Care
Workforce, and Beach, Mary Catherine, et al. 2004.
"Strategies for Improving Minority Healthcare Quality," Rockville, MD: Agency for Healthcare Research
and Quality, Pub. # 04-E008-02.
AUTHOR’S NOTES:
Linda Rabben coordinated the Refugee Professional
Recertification Project for RefugeeWorks, a program
of Lutheran Immigration and Refugee Service, from
September 2008 to October 2010.
The author wishes to thank NAO Board Member
Kelley Withy for her comments and suggestions on a
draft of this article.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Cynthia S. Selleck, ARNP, DSN; Suzanne Jackson, MPH; and Nazach Rodriguez Snapp, MPH, MSW
Enhancing the diversity of the physician workforce
is one of the most important healthcare challenges
today. It is well documented that physician diversity
leads to improved access, increased patient satisfaction, and ensures more culturally appropriate health
care, all of which lead to a reduction in the health
disparities that are prevalent among minority and disadvantaged populations in this country (Betancourt,
2006; Freeman, Ferrer, & Greiner, 2007; Institute
of Medicine, 2002; Smith, Nsiah-Kumi, Jones, &
Pamies, 2009).
Despite the growing population of racial and ethnic
minorities in the United States, the gap between our
increasingly diverse population and the diversity of
our health professions students and health professionals remains wide (Betancourt, 2006; Freeman, et
al., 2007; Olson, 2010; Smith, Nsiah-Kumi, et al.,
2009; Sullivan & Mittman, 2010). While African
Americans and Hispanics are among the fastest
growing segments of the population, recent data
from the Association of American Medical Colleges
(AAMC) shows that only 7% of medical students
are African American and only 8% are Hispanic and
these percentages have remained relatively unchanged
Cynthia S. Selleck, ARNP,
DSN, is Professor and
Associate Dean, Clinical
Affairs and Partnerships, at
the University of Alabama
at Birmingham School of
Nursing. Formerly she was
AHEC Program Director,
University of South
Florida,College of Medicine.
Suzanne Jackson, MPH,
is Former Director, Office
of Student Diversity and
Enrichment, with the
University of South Florida
College of Medicine.
for the last 25 years (AAMC, 2008; Olson, 2010;
Sullivan & Mittman, 2010).
Overview of the Pre-Medical Summer Enrichment
Program
The University of South Florida (USF) Pre-Medical
Summer Enrichment Program (PSEP) has been a
collaborative effort of the College of Medicine’s Office of Student Diversity and Enrichment (OSDE)
and the Florida AHEC Program since 2003. PSEP
is a six-week, full-time enrichment program for students planning to pursue medicine. The program targets under-represented minority and disadvantaged
college juniors and seniors at USF and elsewhere.
The PSEP curriculum consists of academic enrichment in biology, chemistry and physics, critical writing skills, reading and test-taking strategies, MCAT
preparation, and weekly clinical shadowing experiences with a minority physician. Students participate
in workshops on admission to medical school, a mock
medical school interview and selection committee
meeting, and weekly clinical seminars. They learn
about AHEC, the National Health Service Corps
(NHSC), and visit a local federally qualified health
center. A book club requires them to read for pleasure
and reflect on what they learned. The program culminates in small group scholarly
presentations on assigned
clinical topics.
Nazach Rodriguez Snapp,
MPH, MSW, is Director
of Admissions, University
of South Florida School of
Pharmacy. Formerly she
was Coordinator, Office
of Student Diversity and
Enrichment, College of
Medicine.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Innovative Pipelining Targeting the Under-Represented
USF’s Pre-Medical Summer
Enrichment Program:
Collaborating to Recruit a Diverse
Physician Workforce
Management of PSEP is
done jointly with AHEC
responsible for clinical seminars, shadowing experiences,
the field trip to the federally
qualified health center, and
NHSC information. OSDE
coordinates all other aspects
of the program, including
developing the schedule and
communicating with faculty
and with students during the
acceptance process. Once the
program starts, OSDE does
the day-to-day oversight.
13
Innovative Pipelining Targeting the Under-Represented
USF’s Pre-Medical Summer Enrichment Program: Collaborating to Recruit a Diverse Physician Workforce
OSDE also conducts the program evaluation, provides a summary report, and facilitates a debriefing
meeting following program completion.
PSEP Outcomes
Between 2003 and 2009, a total of 119 students
completed PSEP. Demographics of the students are
shown in the table below.
Demographics of PSEP participants, 2003-2009
Gender
Female
n=90
76%
Male
n=29
24%
African American/Black
n=69
58%
Hispanic
n=29
24%
White
n=10
8%
Asian Pacific Islander
n=3
3%
Other
n=6
5%
Missing Data
n=2
2%
Yes
n=52
44%
No
n=63
53%
Missing Data
n=4
3%
English
n=81
68%
Spanish
n=18
15%
Creole
n=15
13%
Other (Vietnamese and Farsi)
n=2
2%
Missing Data
n=3
3%
Race/Ethnicity
First Generation College
Primary Language
Three follow-up surveys have been conducted—a
mailed survey in 2006 followed by online surveys in
2008 and 2010. Phone, e-mail, and Facebook have
also been used to connect with students. No followup information is available on 23 students (19%).
Because others responded to some but not all of the
surveys, the statistics below are likely underestimates
of the true numbers of students who have successfully
matriculated into medical as well as other health professions schools. Many others remain in the pipeline.
including nursing, pharmacy, physician assistant,
physical therapy, and podiatry.
Cost of PSEP
Up to 20 students are accepted into PSEP each
year and the annual budget to support that number
of students is $55,000, not inclusive of staff time.
OSDE and AHEC each provide staff to plan and
implement the program and AHEC supports the
additional budget items that include payment for faculty to teach the sciences, writing skills, reading, and
test-taking strategies, a contract with The Princeton
Review to teach a customized MCAT prep course,
books and supplies, and student educational stipends
of $1,500 each.
Summary
PSEP was developed with the goal of enhancing the
competitiveness of talented minority and disadvantaged students for admission into medical school
while also providing them with needed role models
and mentors. It was anticipated that PSEP would
serve as a recruitment tool to the USF College of
Medicine and to retain more of these students in
Florida where they can impact positively on the
health disparities that are so prevalent in this state.
Outcome data from the first seven years of PSEP
are impressive. Despite some students being lost to
follow-up and others still in the pipeline, a total of
50 PSEP alumni (42%) have entered medical school
(n=39) or another health professions program (n=11).
From a targeted pool of under-represented minority
and disadvantaged students who frequently encounter a number of obstacles to their success, this is a
tremendous accomplishment.
The collaboration between the College of Medicine’s OSDE and the FL AHEC Program has been
paramount to PSEP’s success since both offices
understand the importance of training a more diverse
and culturally competent healthcare workforce. At a
Responses from 119 alumni revealed that 39 (33%)
matriculated into medical school (37 into MD programs and 2 into DO programs). Of these, 4 (10%)
completed additional post-baccalaureate coursework
and 13 (33%) completed a master’s degree prior to
medical school acceptance. In addition to those who
entered medical school, another 11 students (9%)
matriculated into other health professions schools,
Pre-Medical Summer Enrichment Program (PSEP) Class of 2009
14
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
USF’s Pre-Medical Summer Enrichment Program: Collaborating to Recruit a Diverse Physician Workforce
REFERENCES
Association of American Medical Colleges. (2008).
Diversity in medical education: Facts and figures
2008.
Betancourt, J. R. (2006). Eliminating racial and
ethnic disparities in health care: What is the role
of academic medicine? Academic Medicine, 81(9),
788-792.
Institute of Medicine. (2002). Unequal treatment:
Confronting racial and ethnic disparities in health
care. National Academies Press, Washington, DC.
Olson, E. (2008). Medical schools use outreach programs to make student bodies more diverse. The
Washington Post, June 8, 2010.
Smith, S .G., Nsiah-Kumi, P. A., Jones, P. R., &
Pamies, R. J. (2009). Pipeline programs in the
health professions, Part 1: Preserving diversity and
reducing health disparities. Journal of the National
Medical Association, 101(9), 836-847.
Sullivan, L. W., & Mittman, I. S. (2010). The state of
diversity in the health professions a century after
Flexner. Academic Medicine, 85(2), 246-253.
Freeman, J., Ferrer, R. L., & Greiner, K. A. (2007).
Developing a physician workforce for America’s
disadvantaged. Academic Medicine, 82(2), 133-138.
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Innovative Pipelining Targeting the Under-Represented
time when medical schools are evaluating applicants
holistically and struggling with how to identify more
qualified under-represented minority and disadvantaged students, USF’s PSEP has shown to be a
“promising practice” that is successful, cost-effective,
and easily replicable.
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Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
15
Innovative Pipelining Targeting the Under-Represented
The South Carolina AHEC
Health Careers Program Creates
Innovative Experiences for Pipeline
Students and Their Parents
Angelica Christie, MEd; and Ragan DuBose-Morris, MA
Throughout its history, the South Carolina AHEC
Health Careers Program (HCP) has worked to
increase the number of students entering the health
professions in South Carolina. Emphasis is placed
on under-represented minority and disadvantaged
students in order to address health workforce disparities. HCP educational programs and activities strive
to cultivate academically proficient and self-confident
healthcare professionals.
In 2006, the South Carolina AHEC revised its
delivery of HCP programming. The Health Careers
Academy (HCA) for students in grades 9–12 was
implemented to provide a four-year, professionally
relevant curriculum design to promote academic success, career development, personal growth, and parental engagement. The redesign complemented the
Personal Pathways to Success Health Careers Cluster
implemented by the South Carolina Department
of Education in 2005. This program helps students
choose a career path from among 16 options. The
choices students make guide their courses and educational experiences during their high school years.
While the HCA is offered as a weekday evening
or Saturday community-based program, two of the
state’s four AHEC centers have successfully collaborated with the health science technology programs
within two schools to successfully integrate the HCA
curriculum with that of the school district. Regional
AHEC Coordinators assist classroom teachers with
Angelica Christie, MEd,
is Director, Health Careers
Program, at South Carolina
AHEC.
16
Ragan DuBose-Morris, MA,
works as Program Services
Manager at South Carolina
AHEC.
the delivery of health career information and serve as
instructors for the HCA Modules.
The HCA provides exploration into health careers
and prepares students for the rigors of healthcare
training programs through activities focused on communication, math, and science. Curricular modules
offer basic knowledge and skills, service-learning
activities that incorporate community projects to
enhance the health careers experience while fostering
civic responsibility, student advising, mentoring and
parent information sessions that support the successful entry into the health career educational pipeline,
and student placement opportunities with community healthcare professionals.
“Lowcountry AHEC played a vital role in helping
to identify my area of interest in healthcare,” shared
Levi Blue, a freshman at Clemson University. “Because of AHEC’s internship program, I was able to
get a glimpse of my future career.”
The HCA continues to evolve as it aligns with the
educational initiatives of the South Carolina Department of Education. Plans for further development
of the HCA include packaging modules for distance learning and making the educational content
available so teachers can use it in their school-based
curriculum.
The South Carolina AHEC HCP also offers summer programs that provide an array of educational
experiences. The Health Careers Summer Institute
for high school and undergraduate students is a
four-day residential leadership experience held on a
college campus. Five-week regional AHEC programs
that are varied in their delivery follow this Institute.
An annual Summer Health Careers Academy held
on the Medical University of South Carolina campus
is designed to increase the acceptance, retention,
and graduation rates of minority and disadvantaged
students who have identified specified career paths in
dentistry, medicine, and nursing.
Approximately $330,000 is allocated annually for regional HCP activities. Of this amount, 69% are state
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
The South Carolina AHEC Health Careers Program Creates Innovative Experiences for Pipeline Students
and Their Parents
Incentives to enhance academic advancement are
offered to students who actively become engaged in
health careers programs. Students who successfully
document 60 hours of HCA activity are designated as
HCA Scholars, while those documenting more than
110 hours of HCP-sponsored activities are recognized as HCP Achievers. Hours can be earned for
active participation in the HCA, the Health Careers
Summer Institute, and the Summer Careers Academy. These high achievers are closely tracked after
graduation through a variety of means, including
national and state databases, and social networking
sites.
Outcome data from the past four years indicate
that 247 Scholar- and Achiever-level students have
been fully engaged in AHEC activities. The first
class of 100 graduating seniors recently took part in
“white-coat” recognition ceremonies and 70 began
their undergraduate studies in the fall of 2010. The
South Carolina AHEC system has put in place a
comprehensive data tracking system to document the
long-term outcomes of these initiatives.
Overall, the South Carolina AHEC system is
confident that by providing an intensive academic
experience for under-represented minority and disadvantaged students, the future healthcare workforce
in the state will be more reflective of South Carolina’s
population and better able to meet the healthcare
needs of its residents.
REFERENCES
ACT, Inc. (2009). The path to career success:
High school achievement, certainty of career
choice, and college readiness make a difference. ACT Issues in College Success, Retrieved
October 6, 2008 from http://www.eric.ed.gov/
ERICDocs/data/ericdocs2sql/content_
storage_01/0000019b/80/45/0b/66.pdf
Glenn, D. (2008). Institutional researchers delve into
student data at annual meeting. The Chronicle of
Higher Education, 54(39), A24.
Mangan, K. S. (2005). Fate of the castaways: Group
tallies where 18,000 students displaced by Katrina
ended up. The Chronicle of Higher Education, Daily
News, November 16, 2005.
continued from pg. 1
Editorial Overview
The Health Careers Pipeline
Two additional articles specifically relate to dental health
and exemplify how AHECs in partnership with others can
help develop the dental health workforce as well as increase
access to dental services, particularly for disadvantaged
children. Susan Long, EdD, RDH (et al.), first shares a
story of how the University of Arkansas for Medical Sciences, the North Central AHEC and others have come
together to enhance and expand dental hygiene programming through interactive video-based distance education.
Joan Lane, MPH (et al.), describes an association between
the ADA’s annual volunteer initiative Give Kids A Smile® and
the Southwest AHEC that coordinates and provides free
educational, preventive, and restorative dental services to
children otherwise without access to such care.
The final articles in this issue highlight AHECs’ ability to
serve as focused problem-solving partners at the local community level. Interestingly, both articles relate to community
need prompted by the changing demands of our United
States military. Allegra Melillo, MD (et al.) from the Colorado AHEC Program Office highlights their targeted pipeline development efforts in Aurora, Colorado, once home
to Lowry Air Force Base and Fitzsimons Army Medical
Center (both of which closed in the 1990s). The Aurora
community now faces extreme levels of poverty and a growing minority student population greatly in need of academic
and career pipeline support, both of which the AHEC’s
Aurora LIGHTS program is attempting to provide. Rich-
ard Merchant, MA, also offers a story of military-connected
communities in transition. For rural Jefferson County, New
York, home to Fort Drum, the challenge is quite different—
to build a coordinated health delivery system with a variety
of partners, while at the same time beginning the development of a robust healthcare workforce.
As a bonus, this issue’s centerfold features a variety of
regional and national pipeline resources, showcasing webbased tools for recruiting students into healthcare from five
different AHEC programs across the country. This is of
course just a snippet of what is actually going on for growing our healthcare workforce, but it will give you a starting
point if you are looking for additional resources and/or ideas
to move your own projects forward. In this age of budget
cuts and tightening belts, having this information at your
fingertips may help you avoid “reinventing the wheel” with
starting up a new health careers project.
Innovative Pipelining Targeting the Under-Represented
funds, 17% are local, and 14% are federal AHEC
funds. The Program Office provides additional funding for certain statewide HCP activities.
We may be preaching to the choir, but AHEC has a vital
role in recruiting for healthcare careers, especially in the
numerous medically underserved regions of this country.
There is no “magic bullet” to solve the healthcare workforce
shortage we are facing today and predicted in the future, yet
it is indeed refreshing to see so many innovative and creative
pipeline solutions that may be replicated and implemented.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
17
Innovative Pipelining Targeting the Under-Represented
Developing a Robust Health Career
Academy on a Modest Budget
Barb Dodge, PhD, RN; and Marty Schaller, MS
The Lakeshore Healthcare Alliance (LSHCA) serves
Manitowoc and Sheboygan Counties, two predominantly rural counties located in northeastern Wisconsin. LSHCA is a collaboration of hospitals, medical
groups, long-term care facilities, higher education,
and the Northeastern AHEC (NEWAHEC). Its
purpose is to strengthen the healthcare workforce of
the two counties.
The LSHCA’s Lakeshore Health Career Academy
(Academy) had its beginnings in fall 2006 when
administration from Lakeshore Technical College
(LTC) approached NEWAHEC with the vision of
a partnership to benefit the Sheboygan Area School
District’s high schools and alternative programs.
NEWAHEC funded medical terminology and nursing assistant courses, taught onsite at the high schools,
which provided valuable career exploration opportunities. In addition, the program reached out to underserved populations who needed a stronger presence in
healthcare employment situations in the community.
The first two years demonstrated more than 50% of
course participants coming from underserved populations.
Building on the success of these pilot classes, LTC
sought grant funding to develop a health careers
academy for the two counties. A large Department
of Public Instruction grant was written in successive years, but neither grant was funded. The primary reason for not getting funded was the lack of a
critical mass of population. The largest cities in each
county are Sheboygan and Manitowoc, with populations of 50,000 and 35,000 respectively. LTC and
NEWAHEC continued to develop the program.
Classes were offered onsite at the public high school
in Manitowoc and eventually to students in rural
Barb Dodge, PhD, RN, is
Dean, Health and Human
Services, at Lakeshore
Technical College and
a Board Member of
Northeastern Wisconsin
AHEC.
18
Marty Schaller, MS, is
Executive Director of
Northeastern Wisconsin
AHEC.
school districts in the two counties through online
classes.
To complete the development of the Academy, additional courses were developed and combined with
existing health careers exploration programs that had
already been developed by LSHCA: a highly integrated job shadow program, an AHEC-coordinated
health careers summer camp, and health careers
counseling. Student recruitment for the Academy was
launched in late spring of 2009 and implemented for
enrollment beginning in the 2009-2010 academic
year. The Academy primarily serves the small, rural
school districts in the two counties that do not have
the resources or student volume for health career
exploration experiences typically found in larger high
schools.
The three-year academy model is flexible for students
to enter and exit at any point. Sophomores are encouraged to begin with cardiopulmonary resuscitation
(CPR) training, job shadowing, and volunteering. A
series of highly interactive online courses packed with
animated learning activities, YouTube videos, and
medically oriented games keep sophomores through
seniors engaged in such courses as Health Care and
Health Behavior, Medical Terminology, and Health
Care Customer Service. Learning is facilitated using
specially selected college faculty.
Students are provided career and academy advisement
by Jill Niemczyk, NEWAHEC’s Program Manager.
The Health Care Internship, a 40-hour work-based
learning component, completes the Academy experience. The first three interns have completed their onecredit course working in aide roles in area healthcare
organizations. July 1, 2010 marked the end of the first
official year of the Lakeshore Health Career Academy, boasting 60 high school juniors and seniors who
completed credit-based healthcare college courses.
The Academy budget is modest. NEWAHEC funds
the cost of instruction. Using adjunct faculty and
making sure class size is maximized, a little goes a
long way. Textbooks and instruction for 60 students
cost about $12,000 last year, or about $200 per
student per three-credit college course. For students
completing all Academy courses, the development
of an advance track is underway. AHEC also funded
the first year of the Health Care Internship. Over
time, the goal is to have the cost for this component
absorbed by the healthcare providers.
For more information about the Lakeshore Health
Career Academy, please visit the LSHCA web site at
http://www.lshca.org.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Sharon A. Grundel, MEd
At its 30th anniversary celebration, the MassAHEC
Network at the University of Massachusetts Medical School (UMMS) affirmed that “accomplishment
through collaboration” is a strategic and sustainable method of achieving the AHEC mission. An
illustration is the recent expansion of MassAHEC’s
statewide youth-to-health careers programs through
a partnership with a national organization—Health
Occupations Students of America (HOSA). Until
2009, HOSA was not available in Massachusetts.
While many AHECs nationally sponsor HOSA
activities and/or partner on workforce initiatives,
MassAHEC had a unique opportunity to shape the
direction of HOSA in Massachusetts and set a goal
of promoting the AHEC identity while broadening
youth pipeline efforts, creating MassAHEC HOSA.
MassAHEC HOSA was launched in 2009 with
78 students and 8 adult advisors in 6 high school
chapters. Over 60% of the members are underrepresented minority or educationally disadvantaged
students. In the pilot year, a planned growth strategy
(chapter-in-training) was established for schools, colleges, and AHEC centers that expressed interest in
joining after the membership deadline. In preparation
for full membership, 8 chapters-in-training received
technical assistance and resources throughout the year
and their students were invited to participate in the
first annual State Leadership Conference at UMMS.
This successful approach will be replicated annually
as MassAHEC HOSA grows, utilizing experienced
advisors to mentor chapters-in-training.
Both AHEC and HOSA promote experiential activities that support academic success, build career and
leadership skills, and connect youth with their communities through service-learning projects. HOSA
supports state and national competitions, bringing
youth together in ways not typically found within the
AHEC system. What makes the partnership between
MassAHEC and HOSA unique is the flexibility to
shape program direction and customize resources
that address cultural competence in health care and
the importance of practicing (especially primary
care) in communities where the need is greatest. As
a branded, collective identity, MassAHEC HOSA
is familiar to healthcare systems that understand
AHEC and HOSA is a well-known model to high
schools supporting similar student organizations (i.e.
SkillsUSA, DECA). Mass-AHEC HOSA is adaptable because high schools without a formal Career
Vocational Technical Education (CVTE) track are
welcome to apply, given there is a structured health
career exploratory for students. This is a key point
because it creates an access point for students to learn
about health occupations in small learning communities that otherwise may not exist. At the college
level, HOSA provides a strong, nationally recognized
platform to introduce a health careers exploratory for
undeclared majors, or create a structured forum for
specific healthcare majors (nursing, dental, veterinary,
etc.). Many college students satisfy service-learning
requirements utilizing HOSA activities. HOSA’s
Miguel Olmedo, DNP, FNP-c, a Nurse Practitioner at the Family
Health Center, Worcester (pictured in middle) is interviewed by
high school students during the Speed Dating for Health Careers
event.
Innovative Pipelining Targeting the Under-Represented
MassAHEC HOSA: Branding
a Partnership with the AHEC
Identity
structured Competitive Events program (http://www.
hosa.org/competitive_events.html) provides opportunities for students to showcase their skills, knowledge,
and creativity as individuals and in small teams and
receive recognition in an awards ceremony.
The first MassAHEC HOSA State Leadership
Conference included competitive events, hands-on
clinical activities, a Haiti Relief mission debriefing
by the commander of the UMMS Disaster Medical
Assistance Team, “Speed Dating for Health Careers,”
and Emergency Department tours including the
LifeFlight helicopter. Over 40 volunteers, primarily
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
continued on pg. 22
19
Health Careers Tools
nchealthcareers.com/
These two pages showcase screenshots of
websites and other tools from various AHECs
a Area Health Education Centers Program
used to recruit students into health careers. While
y of North Carolina at Chapel Hill
this centerfold is nowhere near comprehensive, it
5 N. Medical Drive
calls attention to the many ways that AHECs can
NC 27599-7165
trumpet their health career recruitment efforts.
809 F: 919-966-5830
ncahec.net
www.myhealthcareer.org
Northern AHEC
Richard K. Merchant, CEO
105 Main Street
Canton, New York 13617
(315) 379-7701
[email protected]
Medical student David Holland, preceptor Dr. Narayan Veligati, and baby Kobe Koehler.
www.nchealthcareers.com
North Carolina AHEC Program
The University of North
Carolina at Chapel Hill
CB 7165 , 145 N. Medical Drive
Chapel Hill, NC 27599-7165
919-966-0809
www.ncahec.net
others
• Becoming a Pharmacist
www.healthtecdl.org/events/details/Becoming-a-Pharmacist.cfm
Lori Larson
Regional Specialist
Central MN Area Health Education Center
1414 College Way • Fergus Falls, MN 56537
218-736-1690 • www.cmahec.com • www.mnahec.umn.edu
www.cmahec.com
Central MN AHEC
Lori Larson, Regional Specialist
1414 College Way
Fergus Falls, MN 56537
218-736-1690
www.mnahec.umn.edu
HEC has launched a versatile social hub at http://cmnahec.com/. The site
s, health care professionals, and other stakeholders to the latest events,
ormation pertaining to Central MN AHEC and their mission.
20
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
• Becoming a Dentist
www.healthtecdl.org/events/details/Becoming-a-Dentist.cfm
• State of the Behavioral Health Workforce
www.healthtecdl.org/events/details/State-of-the-Behavioral-Health-Workforce.cfm
Foothills Area Health Education Center
Sheila Griffin Harrison, PT, MLIS, Director
700 South Enota Dr., Suite 102
Gainesville, GA 30501
770-219-8130
[email protected]
USI Nursing student Brandi Johnson teaches a Bosse High
School student how to take blood pressure at a PROMiSE
Health Careers Boot Camp.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
21
Innovative Pipelining Targeting the Under-Represented
MassAHEC HOSA: Branding a Partnership with the AHEC Identity
22
cation requirements. New advisors participate in
a full-day orientation led by experienced advisors
where they receive comprehensive start-up resources,
ideas for service-learning projects, and partnershipbuilding strategies. Advisors also earn credits through
a MassAHEC-sponsored annual conference, where
educators and workforce development professionals receive practical tools and resources that bridge
education and health careers.
Students presenting at the Career Health Display competitive
event for judges during the inaugural MassAHEC HOSA State
Leadership Conference.
health, dental, and veterinary professionals, staffed
the activities, and judged the competition’s (heath
careers posters, photography, and knowledge tests).
Student comments illustrate the impact of the day:
Utilizing the regional relationships established by
MassAHEC's centers, state, and workforce development entities, and the resources of UMMS, the partnership between MassAHEC and HOSA promises
to expand and enrich tomorrow’s healthcare workforce by forging links with the broader healthcare
community, secondary and post-secondary institutions, and Workforce Investment Boards. The collaboration with HOSA raises the statewide visibility
of MassAHEC and expands academic-community
partnerships more rapidly.
• "I met the person I want to become.” (referring
to a Nurse Practitioner in the Speed Dating
event).
• "I never knew that my love of animals could
be part of my career.” (following the veterinary
skills clinical stations).
• "I worked so hard and learned so much; and it
was fun!" (Health Career Display competitive
event).
• “This was so cool, I never thought I would be
able to do it—but I did!" (suturing activity).
Teachers serving as MassAHEC HOSA advisors
reap tangible benefits, too. Professional development
offered through an “Advisor Leadership Academy”
provides credit applicable toward ongoing certifi-
(from l-r) Warren J. Ferguson, MD, MassAHEC Medical Director,
helps a high school student practice suturing techniques during
the inaugural MassAHEC HOSA State Leadership Conference.
Looking on is Corinne Snyder, RN, Health Sciences teacher and
chapter advisor at Brighton High School, Boston.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Bonnie Carew, PhD; Jeralynn S. Cossman, PhD; and Ann Sansing, MS
rural affinity and intent to choose family medicine
or primary care are also a necessary component in a
budding rural physician’s education and residency”
(p. 280).
In 1998 the Mississippi State University Extension
Service (MSU-ES) developed and directed the Rural
Medical Scholars (RMS) program. After a two-year
lapse, it was reinstated in 2010 in partnership with
the Northeast Mississippi AHEC (NE MS AHEC)
in response to a statewide physician shortage.
This is not a skills-building program. Students are
screened for their potential to meet the academic
rigor associated with acceptance to and completion of
a medical school education. The scholars are all between their junior and senior year of high school and
must have a minimum ACT score of 25. Over time,
the application process has become more competitive
and a smaller proportion of applicants have been able
to be accepted.
The objective of the program is to “grow local docs”
for the state by identifying talented and interested
high school students and exposing them to academics and experiences relevant to the life of a family
medicine physician. During the program, the scholars
enroll in two pre-medicine courses, “shadow” local
physicians, and participate in a variety of activities
related to rural physicians. Previous scholars have recently started to arrive at the point in their academic
careers when medical school is becoming a reality.
Many locations with physician shortages attempt to
inspire interest in high school students with shadowing programs and evidence indicates that these efforts
are successful (Bly, 2006). Though we frequently
think that students from rural areas will be most
likely to return to rural areas, two-thirds of new
rural physicians in one study were originally from
urban areas (Chan, Degani, Crichton, Pong, Rourke,
Goertzen, and McCready, 2005). Ballance, Kornegay,
and Evans (2009) summarize the issues associated
with recruiting to rural areas nicely when they state:
“While ‘nature’ or rural background is a common
factor in many physicians who choose rural practices,
‘nurture’ or programs that encourage and maintain
Bonnie Carew, PhD, is
Rural Health Program
Leader at the Mississippi
State University Extension
Service.
Jeralynn S. Cossman, PhD,
is Professor of Sociology
with the Mississippi State
University and Northeast
Mississippi AHEC.
Pipeline Partnerships
Rural Medical Scholars: A Pipeline
Program for Mississippi’s Future
Physicians
From 1998-2007, MSU-ES directed the program in
partnership with the state’s 15 public community and
junior colleges. These institutions, spread across the
state, were able to assist in recruiting a geographically
diverse group of Scholars. NE MS AHEC worked
with other regional AHECs around the state to
spread the word of the program and to attract students from around the state. Through 2010, students
have come from 59 of the state’s 82 counties and
included 63% females, 37% males; racial diversity has
also been notable with 21% of Scholars, over time,
having been racial or ethnic minorities.
In the spring of 2009, a new funding source, the Mississippi Institute for the Improvement of Geographic
and Minority Health (MIGMH), was identified. It
is funded by the U.S. Health and Human Services'
Office of Minority Health Research and is supplemented by the Mississippi
Department of Health Office
of Rural Health. Both of
these funding sources will run
through 2011. A new funding
source is being researched for
future years.
Ann Sansing, MS, works
as Community Health
Coordinator at Mississippi
State University.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
By the end of 2007, 217 students have participated in the
program, more than 75% of
them have gone on to pursue
a health-related career, 20
went to medical school, 3 were
accepted for Fall 2010, and 8
23
Pipeline Partnerships
Rural Medical Scholars: A Pipeline Program for Mississippi’s Future Physicians
Class Picture of 2010 Rural Medical Scholars (RMS)
are practicing physicians. Five of the eight practicing physicians are in Mississippi residency programs
and six of the eight are in primary care residency
programs. In addition to future physicians, many
others are going into nursing, and some are working
towards pharmacy, counseling, dentistry, and physical
or occupational therapy. Others are working toward
health-related research careers. For future tracking
purposes, the NE MS AHEC Director, Katherine
Harney, has entered the 2010 Rural Medical Scholars
into the state’s HCTracker program. These students
will be followed in their pursuit of other healthcare
professional development programs.
The program is certainly beginning to pay dividends for the state. For example, one of the first two
scholars to graduate from medical school is now in
a family medicine residency program—the same
location where he had his first shadowing experience
as a Rural Medical Scholar. Upon completion of the
program, and a gerontology fellowship at Harvard,
he plans to return to practice in his hometown where
the three family practice physicians in the county
are close to retirement age. This scholar is clearly
meeting the need that the program was designed to
accomplish—assuring the availability of primary care
physicians throughout rural Mississippi.
24
References
Ballanace, D., Kornegay, D., and Evans, P. (2009).
Factors that influence physicians to practice in
rural locations: A review and commentary. The
Journal of Rural Health, 25(3), 276-281.
Bly, J. (2006). What is medicine? Recruiting highschool students into family medicine. Canadian
Family Physician, 52(3), 329-334.
Chan, B. T., Degani, N., Chrichton, T., Pong, R.
W., Rourke, J. T., Goertzen, J., & McCready,
B.,(2005). Factors influencing family physicians to enter rural practice: does rural or urban
background make a difference? Canadian Family
Physician, 51, 1246-1247.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Amy D. Nelson, BS
Background
Oregon currently has four to five qualified applicants
for every available spot in a nursing program despite
the fact that efforts have been made over the last
several years to increase capacity of training programs
within the state (Oregon Center for Nursing-OCN,
2009). A shortage of nursing faculty is the key
contributor to this phenomenon and will contribute
greatly to the projected nursing shortage in Oregon.
In 2008, the student-to-faculty ratio was 6:8, compared with a ratio of 3:2 in 2001 (OCN, 2009). To
further compound the situation, it is predicted that
half of the nursing faculty in Oregon will retire by
2025 (OCN, 2009).
One possible strategy to address this
shortage is to introduce current nursing
students to the idea
of becoming a Nurse
Educator while still
in an undergraduate program. Many
nursing programs
around the state currently utilize highand medium-fidelity
Measuring the patient for postsimulation scenarios
surgical support hose
as an integral part of
the clinical education for nursing students (Oregon Consortium for
Nursing Education, n.d.). Placing current nursing
students in the role of an Educator during a controlled simulation allows
them to experience the difference between teaching
in a clinical setting and
teaching in an academic
setting to instruct students
in the performance of skill
set.
Amy D. Nelson, BS, is
Education Coordinator at
AHEC of Southwest Oregon.
In addition, the need to recruit young people into the
field of nursing remains
acute due to the retirement
of current nurses and the
increasing demands of an aging
population. Using
simulation, high
school students
have the opportunity to experience the role of a
nurse in a patient
care setting. This
Inserting the patient IV
enables them to
internalize what
nurses actually do, dispel myths they may have about
the profession, and to determine if this career is of
interest to them.
Pipeline Partnerships
Promoting the Fields of Nursing
and Nurse Education through
Simulation
Developing a Pilot Program to Benefit Nursing
and High School Students: Sowing the Seeds of
Simulation
In February of 2009, AHEC of Southwest Oregon
(AHEC-SW) partnered with the Oregon Health
& Sciences University (OHSU) School of Nursing
(Ashland Campus), and Grants Pass High School to
develop a pilot program that would allow students in
the Advanced Medical Skills Class at the high school
to participate in activities in the simulation lab as part
of a healthcare recruitment strategy. The program
consisted of both classroom and simulation lab components. Throughout the planning process, AHECSW facilitated communication and monitored details.
In addition, AHEC-SW provided funds to cover bus
costs to transport the high school students to the lab.
The classroom component involved OHSU School
of Nursing students visiting the Advanced Medical
Skills Class at Grants Pass High School on two separate occasions to serve as clinical instructors. During
the first visit, these nursing students taught the high
school students how to start an IV using simulation
arms. One week later, the nursing students returned
to test the high school students based on the speed
and proficiency with which they performed the skill.
Nine students with the fastest times were eligible to
participate in the simulation scenarios on the School
of Nursing campus the following week. The nursing students served as mentors to guide the high
school students through their nursing roles during
the simulation and assisted with the group debriefing
following each patient scenario.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
25
Pipeline Partnerships
Promoting the Fields of Nursing and Nurse Education through Simulation
Continued Growth of the Simulation Program
The 2009 pilot program was so well received by all
participants that it was repeated in 2010. The same
format was used, with a few additions to the simulation lab component. A medical student completing a
rural rotation in Grants Pass was recruited to play the
role of the physician during the scenarios. The high
school students were given a pre-surgical checklist,
as well as a patient case notes form to complete prior
to entering the patient room. These documents were
used as reference when providing patient care and
when calling the doctor to clarify orders.
High school students who participated in the 2010
program provided the following feedback:
• "I had the time of my life! This experience definitely showed me I have what it takes to become
a nurse. And without this program, I probably
wouldn’t have known.” -D’Arcy
• “Working in the simulation lab is an awesome
experience, and it really influenced me to want to
be in the medical field (more than I used to be).”
-Melissa
Goals for the future include establishing annual
dates for Grants Pass High School, improving the
experience to align
with the education and career
pursuits of both
nursing and high
school students,
and expanding the
program to offer an
additional simulation lab experience
for candidates from
the other nine high
schools within the
geographic area.
Reviewing the patient chart
Conclusion
AHEC-SW staff
facilitated a dialogue between faculty members at the
OHSU School of Nursing and at Grants Pass High
School, resulting in the creation of a program that
allows high school students to experience nursing
through hands-on simulation activities. This program
also provides current nursing students the opportunity to step into the role of a Nurse Educator while
serving as mentors to the younger students during the
simulated scenarios. One goal of the program is to
promote the fields of nursing and nursing education.
However, up to this point, data has not been collected
to determine if the participating nursing students are
pursuing a career in nursing education or if the high
school students involved in the program are enrolled
in nursing courses of study. In the future, AHECSW hopes to work with both OHSU and the high
school to track these students. As anecdotal evidence
of positive impact, two nursing students who served
as mentors for the pilot program in 2009 requested to
return to act in a similar capacity in 2010. In future
semesters, nursing faculty will try to identify nursing
students in their junior year who have an interest in
education, so that these students may be an integral
part of the program for two consecutive years.
Learning IV insertion under the direction of an OHSU nursing
student
References
Oregon Center for Nursing. (2009). Oregon’s Nurse Faculty Workforce: A Report from the Oregon Center for Nursing. Retrieved October 23, 2009 from: http://www.oregoncenterfornursing.org/documents/
OCN%20Nurse%20Faculty%20Workforce%20Report%202009.pdf.
Oregon Consortium of Nursing. (n.d.) OCNE Curriculum. Retrieved June 3, 2010 from http://www.ocne.
org/curriculum.html.
26
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Amy Glenn Vega, MBA, MHA, RHEd
The loss of thousands of textiles and manufacturing
jobs over the past decade has left North Carolina
in economic devastation, and has contributed to
the state’s historic high unemployment rate. At the
same time, the demand for healthcare professionals
is steadily rising, particularly in allied health. Nine of
the ten fastest growing jobs are allied health professions, with nearly one quarter of a million new jobs
anticipated over the coming decade.
approached Southern Regional AHEC in nearby
Fayetteville with an invitation to serve as the partnership intermediary. The aim of the project aligned
nicely with AHEC’s mission in strengthening the
healthcare workforce, and the solid reputation and
relationships that Southern Regional AHEC held
with healthcare employers and training institutions in
the region made it a logical fit to serve in a leadership
role for the RSP.
With this unique opportunity in mind, the North
Carolina Department of Commerce issued a request
for proposals for workforce planning grants in October 2007. Seven workforce development boards in the
state were awarded monies to fund the formation of
allied health regional skills partnerships (AHRSPs),
which are collaborative, industry-focused groups that
bridge the supply and demand sides of skilled labor.
The AHRSPs’ charge was to create a paradigm shift
from traditional employer competition for a limited
pool of qualified candidates for jobs, to collaborative
work in strengthening training pipelines that supply
workers to the local region. The AHRSPs were required to develop a region-specific sector initiative for
moving unemployed or low-wage workers into livable
wage allied health careers, and supporting their
continued progression into higher-paying roles via
defined career ladders and
lattices. Each workforce
development board had to
select an organization to
serve as a neutral, noncompetitive intermediary
to convene the partners
and provide leadership for
the planning process.
Over the next several months, Southern Regional
AHEC assembled and strengthened the partnership.
The partners came from all over the medically underserved seven-county region, and included hospitals
and healthcare systems, community colleges and
universities, K-12 school systems, workforce and economic development agencies, and other key partners.
The AHRSP adopted the name ‘Southern North
Carolina Allied Health Regional Skills Partnership,’
and began with a needs assessment of allied health
workforce shortages. A review of primary and secondary data showed that Physical Therapists (PTs)
and Physical Therapy Assistants (PTAs) comprised
more than half of all tracked allied health job vacancies in the region.
Amy Glenn Vega, MBA,
MHA, RHEd, is Executive
Director of Southern North
Carolina Allied Health
Regional Skills Partnership.
Upon being awarded one
of the regional planning
grants, the Lumber River
Workforce Development
Board in Pembroke, NC
Pipeline Partnerships
Southern NC Allied Health
Regional Skills Partnership’s
Creative Career Ladder Links
Allied Health Students with
Employers
The results of the needs assessment came as no shock
to the employers in the partnership, as there was no
Physical Therapy degree program in the area. “As a
largely rural region, it is extremely difficult to compete with metro areas of the state when recruiting
skilled therapists from outside of our local area,” said
Teresa Sessoms, Recruitment Director at FirstHealth
of the Carolinas in Pinehurst, and Chair of the
Southern NC AHRSP. “However, we do have one
PTA program in our region at Fayetteville Technical
Community College (FTCC), so we wanted to see
what we could do to strengthen the capacity program so that it could produce more graduates for our
region to employ.” Under the leadership of Southern
Regional AHEC, the partnership assembled a detailed workplan and submitted it to the Department
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
27
Pipeline Partnerships
Southern NC Allied Health Regional Skills Partnership’s Creative Career Ladder Links Allied Health
Students with Employers
of Commerce, which in turn extended funding with
an implementation grant to offset the financial costs
of the collaborative work focusing on the PTA degree
program.
“The program is the most rigorous degree program
on our campus,” said Heidi Shearin, Chair of the
PTA program at FTCC. “The first-year dropout rate
is approximately one third of the class.” Amy Glenn
Vega, Southern Regional AHEC’s representative
to the RSP, conducted interviews and focus groups
with the PTA program faculty and students in search
of the underlying causes of students leaving the
program, and shared them at a partnership. “We saw
that one of the biggest challenges that students face is
juggling the responsibilities of school with the obligations of home and family,” Vega shared. “Several of
the students are middle-age adults who own homes,
have spouses and children, and have to work a parttime job in order to pay the bills and support their
families. If it came down to making a choice between
school and work, the students typically chose the job
in order to survive, and school to go.”
Sessoms and Shearin discussed ways to remedy the
problem. Their brainstorming led to the creation of a
new position, Physical Therapy Aide, for which Sessoms drafted a job description to share with partners,
including representatives from the North Carolina
Physical Therapy Association. When it received
approval from the partnership, the position was pilottested at FirstHealth of the Carolinas.
The Physical Therapy Aide (PT Aide) position was
open only to students in the PTA program. Students
hired to the jobs received a salary higher than the
part-time restaurant and retail jobs that they previously held. Plus, they had greater flexibility with
an employer who was willing to work around their
school obligations. The duties of the job involved answering phones on rehab units, sanitizing equipment,
and other assistive tasks as needed, but students hired
into the PT Aide role found an added benefit of their
new jobs—the time that they spent observing and
shadowing their PTA colleagues at work helped them
to more easily assimilate the academic information
that they were learning in the classroom. Their colleagues became their informal mentors.
we can just promote the PT Aide to PTA when he or
she graduates. That person has already been oriented
to our organization, has learned our computer and
documentation systems, and has formed relationships
on the unit and with their coworkers. It’s a win-win
for both our organization, and the PTA.” Shearin
agreed, and spoke with the other hospitals in the
region about the success of the pilot test. Scotland
Memorial Hospital in Laurinburg has also adopted
the PT Aide to PTA career ladder model, and other
hospitals are discussing it with their administration.
In just one year, FTCC’s PTA program has decreased
by nearly 50%, suggesting that the new career ladder
made a positive impact for those students that it
engaged.
The Southern NC AHRSP has also developed a creative strategy to support employers’ efforts to recruit
Physical Therapists to the region. “Without a Physical Therapy degree program in our area, we have to
recruit from elsewhere in the state and nation,” says
Sessoms. “One of the biggest misconceptions that
employers face is that there’s nothing to do in smaller,
less urban areas like ours.” Southern Regional AHEC
rallied the employers of the partnership together to
produce a video showcasing the five “success stories”
of therapists who had moved to our region from
other states. Through their positive experiences, the
video highlights all that is great about living and
working in southeastern North Carolina. The video
is available for public viewing online at: http://www.
youtube.com/watch?v=qPUDxypbYxY
As regional skills partnerships and sector initiatives
become more widely adopted throughout the nation,
AHECs can expect to find new opportunities to
lead these types of collaborative efforts. AHECs are
uniquely positioned as neutral, non-partisan, nonprofit, and service-oriented agencies to unite partners
that have traditionally been competitors; to foster a
stronger spirit of collaboration among them; and to
facilitate the work that will lead to systems changes
that benefit all.
When the student PT Aides graduated from the
PTA program and passed their licensing board exam,
they were offered promotions to PTAs. “From the
employers’ perspective, this is a great way to grow
new talent within the organization,” said Sessoms,
who filled a long-term PTA vacancy through the
career ladder model. “Instead of having to devote resources to recruiting a new PTA to our organization,
28
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Susan Long, EdD, RDH; Nancy Smith, RDH, MEd; and Rhonda Sledge, RDH, MHSA
While the use of distance education technology in
dental hygiene programs has been steadily increasing, dental hygiene education remains behind many
other healthcare professions in distance learning
(Grimes, 2002). The 2008-2009 Survey of Allied
Dental Education reported that only 20 of the 301
accredited entry-level dental hygiene programs in the
United States (7%) provided didactic instruction to
a distant site. While the prevalence of distance education in degree completion and graduate education
is much higher, dental hygiene programs providing
their entire didactic curriculum using distance education are not nearly as common (American Dental
Association, 2009). Furthermore, the collaboration
required to make the distant dental hygiene site come
to fruition is rather unique.
In the fall of 2007, several local dentists expressed to
the leadership of Arkansas State University-Mountain Home (ASUMH) concerns about a perceived
unmet need for dental hygienists in the north central
area of the state. At that time, University of Arkansas for Medical Sciences (UAMS) was establishing
the AHEC North Central (AHEC-NC) to provide
education and other health-related programs for a
10-county region in that same part of the state. In a
state with no dental school and only two dental hygiene programs, the AHEC-NC saw the value in developing the dental hygiene workforce and providing
Susan Long, EdD, RDH, is
currently a Professor in and
Chairman of Dental Hygiene
at the University of Arkansas
for Medical Sciences.
Nancy Smith, RDH, MEd,
serves as Assistant Professor
in the AHEC-NC and
Site Coordinator of the
distance education site of
the Department of Dental
Hygiene at the University
of Arkansas for Medical
Sciences.
Pipeline Partnerships
Meeting the Need for Dental
Hygiene Practitioners in Rural
Arkansas
Dental hygiene student Hannah Johnston provides treatment to a
patient in the Mountain Home Christian Clinic.
dental hygiene career support in the North Central
area. One clinical education site was identified at the
Mountain Home Christian Clinic (MHCC), which
provides medical and dental care to the underserved.
A 2008 needs assessment was conducted of dental
hygienists and dentists practicing in one of the ten
counties serviced by the AHEC-NC. The survey
response indicated a perceived shortage of dental
hygienists in the region. In early 2009, a Memorandum of Understanding (MOU) between the UAMS
College of Health Related Professionals (CHRP),
UAMS AHEC-NC, and ASUMH was signed and
approval was received from
the Arkansas Department of
Higher Education. In August
2009, five students were
enrolled at the MHCC site.
With the goal of retaining
the graduates of this distant
site where they are needed,
first consideration for admission was and will continue to
be given to applicants from
Rhonda Sledge, RDH,
the AHEC-NC’s 10-county
MHSA, is Assistant Professor service area.
in the Department of Dental
Hygiene at the University
of Arkansas for Medical
Sciences.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
UAMS Department of
Dental Hygiene provides all
aspects of the educational
program to the distant site
via interactive video from
29
Pipeline Partnerships
Meeting the Need for Dental Hygiene Practitioners in Rural Arkansas
will participate with the local Head Start Centers
in a fluoride varnish project. The distant site is also
increasing the continuing education (CE) opportunities in the north central area of the state by utilizing
the interactive video equipment at ASUMH and the
AHEC to transmit CE courses from Little Rock to
Mountain Home and Jonesboro.
Dental hygiene student Stephanie King speaks with her patient
about good oral hygiene.
UAMS as well as program administration. The distant site has a coordinator (who is a master’s degree
dental hygienist), supervising dentist, and administrative assistant who are employees of the AHECNC and provide laboratory and clinical instruction
on-site. The AHEC-NC also provides the budget
support for capital and non-capital expenditures.
The UAMS CHRP provides the financial resources
for the salaries and fringe benefits for the department chairman, who oversees the program and the
faculty in Little Rock who provide the didactic
curriculum. ASUMH provides pre-requisite courses
for applicants to the distant site as well as houses the
classroom and laboratory needed for instruction. The
MHCC provides the facility for clinical instruction,
and four local dentists volunteer their offices as clinical enrichment sites.
The experience of being in the community and part
of a private dental practice provides a valuable learning experience for students as well as an excellent
liaison opportunity for the program. During the first
semester of clinical education, 120 patients from the
local area received reduced or no-cost dental hygiene
services from the dental hygiene students. Students
also conducted oral health screenings and placed
dental sealants for elementary school children and
Other programs using distance learning have found
success in this arena. In a previous study of five
classes consisting of 221 dental hygiene students (105
at the host site and 115 at the distant site), Olmsted
(2002) found no significant difference between the
two groups in regards to achievement and outcomes
assessments. Students currently in the AHEC-NC
program report satisfaction to date and gratefulness
Dental hygiene students in Mountain Home receive instruction
from Dr. Mark Zoeller in Little Rock via interactive video.
for the opportunity to participate. Until the first class
graduates and final outcomes assessments can be
evaluated, programmatic assessments will be conducted. These assessments include student satisfaction
surveys; course evaluations; advisory committee input;
and outcomes assessments such as GPAs (grade point
averages), board examination scores, and employment
rates.
REFERENCES
American Dental Association, ADA Survey Center. (2009). 2008-2009 Survey of Allied Dental Education
(November). Chicago, IL: American Dental Association.
Grimes, E. B. (2002). Use of distance education in dental hygiene programs. Journal of Dental Edication, 66,
1136-1145.
Olmsted, J. L. (2002). Longitudinal Analysis of student performance in a dental hygiene distance education
program. Journal of Dental Educatin, 66, 1012-1020.
30
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Joan Lane, BA, MPH; Vani Anand; and Meredith Ferraro
“Southwestern AHEC does all the work. We just
provide the care . . . which is what we like to do!”
These words from Dr. Jon Davis, President of the
CT State Dental Association and dedicated volunteer with Southwestern (CT) AHEC’s Give Kids A
Smile® program, capture the spirit of the 63 dentists
who enthusiastically donated their time and resources
in February 2010 to provide much-needed dental
care to hundreds of uninsured children in Greater
Bridgeport, CT.
Give Kids A Smile® (GKAS) is the American Dental
Association’s annual volunteer initiative to provide
free educational, preventive, and restorative dental
services to children without any access to dental care.
with a 2006 estimated population of 137,912, has the
following demographic profile (U.S. Census Bureau):
• 45% white (81.6% statewide)
• 30.8% black (9.1% statewide)
• 31.9% Hispanic (9.4% statewide)
Pipeline Partnerships
Keeping Kids Smiling in
Bridgeport, CT
• 1999 per capita income of $16,306 ($28,766
statewide)
• 18.4% of population under poverty level (7.9%
statewide)
• 20.5% foreign-born in 2000 (10.9% statewide)
Background
Tooth decay is one of the most common childhood
diseases—5 times as common as asthma (CDC,
2004). More than 51 million school hours are lost
each year because of dental-related illness (CDC,
2004). Eighty percent of dental decay among U.S.
children is found among 25% of the child population
(U.S. Department of Health and Human Services,
2004).
In Connecticut, a 2007 statewide oral screening survey found minority and low-income children to have
the highest level of dental disease and the lowest level
of dental sealants (CT Department of Public Health,
Office of Oral Health, 2007). Untreated decay was
found in 25% of black children and 27% of Hispanic
children, compared to just 13% of white children surveyed (CT Department of Public Health, Office of
Oral Health, 2007). Bridgeport, the state’s largest city
Joan Lane, BA, MPH, serves
as Oral Health Bridgeport
Initiative (ORBIT) Project
Director at Southwestern
AHEC.
Vani Anand is Oral Health
Care Coordinator at
Southwestern AHEC.
Dr. Bartolone helps improve a patient’s smile
With 95% of Bridgeport’s children eligible for free
or reduced-price lunch, and minority enrollment in
schools at 91% (CT State Department of Education,
2007-2008), Bridgeport’s
profile indicates a child
population disproportionately at risk for dental decay.
Meredith Ferraro is
Southwestern AHEC’s
Executive Director.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Recognizing this disparity, Southwestern AHEC
has made oral healthcare
access one of its key program
areas. In 1999, a coalition
of community organizations
concerned with oral health
disparities formed the Oral
Health Bridgeport Initiative, or ORBIT, chaired by
31
Pipeline Partnerships
Keeping Kids Smiling in Bridgeport, CT
Southwestern AHEC. ORBIT’s mission is “increasing access to quality and affordable dental care
services for underserved and vulnerable populations
in Bridgeport and Stratford, CT.” From 2002-2007, a
grant from a local funder enabled ORBIT to expand
dental safety net capacity through programs in the
Federally Qualified Health Centers (FQHCs) and
the schools resulting in a 356% increase in preventive
and restorative visits by children aged 0-18.
With ORBIT’s focus on Medicaid children, it
became obvious that the needs of children without
either Medicaid or private dental insurance were
largely unaddressed. In 2006, Southwestern AHEC
approached the Bridgeport Dental Association. A
partnership was born between Southwestern AHEC
and private practice dentists to provide free care to
uninsured at-risk children through Give Kids A Smile®
in their offices.
Implementing a Successful Give Kids A Smile®
(GKAS) Program
AHECs are particularly well positioned to run
GKAS programs, because of our extensive reach into
the community and collaborative approach to addressing health disparities. Partnerships with schools,
health facilities, social service agencies, and faithbased organizations enable successful recruitment of
uninsured children who need dental care.
In its four years running a local GKAS program,
Southwestern AHEC has developed a model for successful implementation, which includes the following
steps:
1.Recruiting dentists—with the active endorsement of the local and state dental associations.
2.Recruiting children—through educational partnerships, including health careers programs.
3.Scheduling appointments—accounting for
language and transportation needs.
4.Appointment reminders—resulting in a low
“no-show” rate of just 5-8% each year.
5.The day of care—visiting participating dental
offices, and handling last-minute cancellations
and other issues.
6.Coordinating follow-up to ensure treatment
completion—The goal is to complete all needed
treatment and to find dental homes for the uninsured children. 50-60% of the GKAS children
seen have had their “treatment completed” and
50 children have found dental homes.
Give Kids a Smile® HeadStart group
7.Tabulating and reporting GKAS results—to
participating dentists, current and prospective
funders, and the media to evaluate the effectiveness and impact.
8.Volunteer recognition—at the local dental society’s annual meeting, and through the media.
Program Enhancement through Automation
Coordination of GKAS was a paper-driven nightmare. We turned to technology and developed:
smiles Custom Software, a Microsoft Access-based
application that supports the full spectrum of GKAS
activities. This database has provided the staff with
simpler data entry and appointment scheduling,
simultaneous access by multi-users, data security,
ease of data tracking, tabulation, and reporting. It is a
much “greener” program overall. Increased staff efficiency has enabled the following significant program
growth:
Year
# of Participating
Dentists
# of Children Who
Received
Care
Value
of Free
Services
2007
2008
21
32
86
174
$30,000
$76,000
2009
48
323
$139,077
2010
Total
63
164
452
1,035
$200,899
$445,976
Evaluation: Measuring Success
The success of a Give Kids A Smile® program is evaluated by tracking the data. Specific measures include:
• Participating dentists
• Children seen
• Type and volume of procedures
32
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Keeping Kids Smiling in Bridgeport, CT
• Percentage of children with treatment completed
• Children securing a dental home
• Families enrolled in Medicaid as a result of info
provided through GKAS
• Dentists accepting Medicaid as a result of participating in GKAS
• Families’ evaluations
• Dentists’ evaluations
Testimonials from families, in both English and
Spanish, have been overwhelmingly positive. One
parent wrote, “Thank you for this invaluable free service. It truly changes a child’s life!” Similarly, dentists’
comments reflect their appreciation for the organizational support: “Very well coordinated. Parents came
prepared and all the patients were fabulous.”
Starting a Give Kids A Smile® Program in Your
Community
Give Kids A Smile® has proven to be an important
channel for Southwestern AHEC to promote
AHEC’s mission of increasing access to quality primary and preventive oral health care. It has connected
local dental providers to their communities, and the
community to better health.
REFERENCES
CDC (2004). Children’s oral health. The Surgeon
General’s fact sheet. In Division of Oral Health
[On-line]. Retrieved from www.cdc.gov/oralhealth/publications/factsheets/sgr2000_fs3.htm
CT State Department of Education, Strategic School
Profile 2007-2008.
U. S. DHHS. (2000). Objectives for Oral Health. 21.
In Healthy People 2010 [On-line].Retrieved from
http://www.healthypeople.gov/document/html/
volume2/21oral.htm
CT Department of Public Health, Office of Oral
Health. (December 2007). Every Smile Counts.
Executive Summary, p. i. Retrieved from: http://
www.ct.gov/dph/lib/dph/oral_health/pdf/every_
smile_counts_final_report.pdf.
Pipeline Partnerships
• Value of care provided
U.S. Census Bureau, State & County Quick Facts.
Retrieved from: http://quickfacts.census.gov/
qfd/states/09000.html
For information about starting a GKAS program
in your community, please contact Project Director
Joan Lane ([email protected]), Oral Health Care
Coordinator Vani Anand ([email protected]), or
Southwestern AHEC Executive Director Meredith
Ferraro ([email protected]), telephone (203)
372-5503.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
33
Pipeline Reponses to Unique Community Need
The Aurora LIGHTS Shine Bright
in the Heart of Colorado
Allegra Melillo, MD; Deidre Houston, PhD; and Carol McBride
The Colorado AHEC Program Office has focused efforts on building lasting partnerships in its
new community of Aurora. It has created Aurora
LIGHTS, an innovative and comprehensive health
career pipeline program to develop the next generation of health professionals in the underserved
Aurora community.
Aurora LIGHTS (LeadInG the way in HealTh
Sciences) provides access to disadvantaged students
beginning in elementary, middle, and high schools
and continuing through undergraduate and professional schools. Since 2008, supported through a
HRSA Health Careers Opportunity Program grant,
Aurora LIGHTS has offered health career guidance,
innovative curriculum, educational support, financial
aid information, mentoring, cultural competency
training, and clinical shadowing experience to over
1,600 students.
Aurora: A Community in Transition and New Hope
In the 1990s, Aurora, a neighboring city of Denver,
lost two of its primary economic engines when the
Lowry Air Force Base and Fitzsimons Army Medical
Center closed. The area particularly hard hit is known
as Original Aurora, the city’s urban core populated by
families that are low-income, and primarily minorities.
Many parents of the minority students going to
school in the Aurora Public Schools (APS) district
do not have the skills to support their academics,
and more than 40% of adults do not speak English,
creating another obstacle. As a result, only 59% of
adults 25 years of age or older in the Original Aurora
Allegra Melillo, MD, is
Assistant Professor at the
Department of Family
Medicine.
Deidre Houston, PhD, is
Aurora LIGHTS Evaluation
Coordinator.
area earn their high school diploma or GED (2000
U.S. Census). At North Middle School in Aurora,
the free and reduced school lunch rate, an indicator of
poverty, is over 80%.
Jocelyne Tun-Medina, an Aurora LIGHTS student
and recent graduate of North Middle School, lives
in Original Aurora. Her parents, both from Mexico,
with limited education, work multiple jobs and speak
minimal English. Now in the ninth grade, Jocelyne
balances her high school work with the responsibility of looking after a younger brother in elementary
school.
Tony Van Gytenbeek, Aurora Public Schools (APS)
Deputy Superintendent and Jocelyne’s mentor, says,
“Jocelyne has been a student with great promise.
Before her recent enrollment in the Aurora LIGHTS
program, her vision of the future was limited and her
goals unclear.” Recently, when Mr. Van Gytenbeek
obtained a full scholarship for Jocelyne to attend a
prestigious local private school, she declined because
she did not feel comfortable leaving her community.
Jocelyne found new opportunities in her community
when the University of Colorado medical campus
opened on the site of the old Fitzsimons Army Base.
Aurora LIGHTS: A New Path
The Colorado AHEC Program Office led an effort to create the linkages between the new medical
campus and Aurora. Aurora LIGHTS began from
strong community partnerships with the local school
district, community college, and neighboring federally qualified community health centers, in addition
to the various schools and programs of the University
of Colorado. Colorado AHEC worked with APS to
redesign its curriculum and create a model health career pathway. Students from preschool through high
school are encouraged to pursue an educational path
focused on health sciences and health-related career
exposure in addition to the usual school requirements.
The Aurora LIGHTS pipeline includes multiple
components. Elementary school students are exposed
to various health careers. APS developed new Health
Science and Technology Academies at the middle
and high schools, providing students the opportunity to take advanced math and science courses
with a health science focus. Middle school students
participate in a two-week-long health science sum-
Note: Carol McBride’s photo unavailable.
34
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
mer camp. High school students take a longitudinal
course of hands-on biomedical science training.
Additionally, the Central Colorado AHEC (COAHEC) oversees a ninth-grade Saturday Academy
for 30 students and a Summer Institute for 40 high
school students which provide career planning and
education enrichment in math, science, and reading. APS students also participate in a biomedical
research internship, Colorado AHEC-sponsored
Metro-Denver Regional Science Fair, health fairs,
Health Occupations Students of America (HOSA)
clubs, and job shadow experiences on the medical
campus and at community health center Metro Community Provider Network.
North middle school students in a white coat ceremony on the
medical campus to inaugurate Aurora LIGHTS.
According to Jack Westfall, MD, Director of the
Colorado AHEC, “The partnership between APS
and our health science campus has been transformative for our faculty and staff through community
building, cultural sensitivity, and civic engagement.”
LIGHTS has made me a competitive applicant,” and
provided her a part-time job at Colorado AHEC.
She is now interviewing at multiple medical schools
including Colorado University (CU).
Aurora LIGHTS also supports post-baccalaureate
students with stipends and research opportunities, as
well as supporting the retention of health professions
students through educational support and mentoring. Jennifer Murphy, a medical student and firstgeneration college graduate, says “Aurora LIGHTS
prepared me to pass the USMLE Step 1 and allows
me to give back to the community through mentoring middle and high school students.”
Since its inception, Aurora LIGHTS has involved
1,643 students in its various educational and health
career-focused activities. More than 200 middle
school students and over 180 high school students
have participated in the Academies. APS has fully
integrated these pathways in their curriculum to ensure sustainability. The program at all levels has seen
dramatic improvements in academics from improved
grades and standardized test scores, higher graduation rates, and successful entry and retention at health
professions schools.
A New Star of Aurora LIGHTS
Jocelyne is now motivated to become a pediatrician
and be the first in her family to go to college. Her
mother says, “I only have a sixth-grade education.
Now I push her to do her homework. We want her
to succeed in anything she chooses.” Jocelyne believes
“I am ready for the challenge.” Colorado AHEC and
Aurora LIGHTS know she is ready.
Pipeline Reponses to Unique Community Need
The Aurora LIGHTS Shine Bright in the Heart of Colorado
Aurora LIGHTS is a true pipeline and continues at
the Community College of Aurora (CCA) and the
University of Colorado-Denver (UCD) undergraduate through tutoring, mentoring, and job-shadowing.
Martha Jackson-Carter, Science Chair of CCA, sees
the difference tutoring makes in her students by
saying, “I see the grades improve from 78% to 90%.”
Chris Luckow, an Aurora LIGHTS undergraduate at UCD, says, “Aurora LIGHTS changed my
life. When I first began the program, I viewed it in
terms of what I could get out of it. Now I see [it] in
terms of what I can put into it.” Chris has been an
Aurora LIGHTS mentor, tutor, and counselor at the
high school Summer Institute and participant in the
Aurora LIGHTS MCAT Prep Course.
Racheal Keller, a second-generation Latina who
has worked her way through college, states, “Aurora
Middle school students demonstrating healthy eating habits through
superhero and villain characters at a community health fair.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
35
Pipeline Reponses to Unique Community Need
Army Strong, AHEC Healthy:
Northern AHEC’s Role in Support
of Fort Drum
Richard K. Merchant, MA
Fort Drum, a United States Army installation located
in Jefferson County, MA, administers planning and
support for the mobilization and training of nearly
80,000 troops annually. Interestingly, as big as the
installation is, and with over 38,000 Department
of Defense beneficiaries, Fort Drum has no hospital on post. It is the only installation of its size in
the United States not to have an on-site inpatient
healthcare facility. Fort Drum relies on the surrounding healthcare facilities and systems to meet inpatient
and certain specialty care needs. Given the substantial
need for efficient quality healthcare for soldiers and
their families, it is essential that the healthcare system
surrounding Fort Drum be comprehensive, highly
accessible, and exceedingly well-coordinated.
Initiated and supported by then-Congressman John
M. McHugh, Congress approved the development
of a pilot program for health service delivery in the
Fort Drum region in 2006. The pilot program called
for the formation of the Fort Drum Regional Health
Planning Organization (FDRHPO), a platform to
analyze the existing healthcare delivery options and
to seek new opportunities for leveraging healthcare
resources to carry out a regional healthcare approach
and meet the needs of the expanding military population in the Fort Drum Health Service Area, significantly strengthening the healthcare system.
One of the key areas of focus for the FDRHPO is
mitigating the healthcare workforce shortage in the
region. FDRHPO staff worked to secure community partnerships and funding to support and deliver
programming. Partners included the local community
foundation, the county
board of legislators, five
local hospitals, a community college, and the
Northern AHEC (NAHEC).
Richard K. Merchant, MA,
is CEO of Northern AHEC,
Inc.
36
NAHEC entered into a
formal partnership with
FDRHPO in late 2007
and currently shares equal
cost and management of
the two staff members
assigned directly to the
RREC healthcare workforce project. The partnership forged with FDRHPO has served to more than
double the program deliverables in the region. In the
past two years, over 2,000 secondary students have
received healthcare career presentations. The project
has shepherded 86 of these students through community-based job shadowing and internship programs.
Nearly 75 medical and health professions students
have received clinical training, travel reimbursement,
and housing support. Of great importance in the
effort has been the introduction of eight new local
training programs: Registered Nurse, Family Nurse
Practitioner, Psychiatric Nurse Practitioner, Respiratory Therapy, Medical Technology, Phlebotomy,
Pharmacy Technician, and Bachelor of Social Work.
These programs and the outcomes they foster are
specific to the assessed needs of the military population in the area.
This substantial integration of FDRHPO and NAHEC is illustrative of the common mission shared by
the two organizations, and the commitment of both
to ensure that resources are efficiently leveraged and
efforts are effectively coordinated. From the AHEC
perspective, this arrangement represents a model
for community partnership in support of a military
installation and the surrounding communities.
The presence of a military installation in the region
presents distinct challenges and opportunities for
health care. The AHEC system is uniquely designed
and positioned to participate, if not drive, the process
of working with each of these challenges and opportunities. These issues include:
1.Available, well-trained, and local workforce for
the United States Army Medical Department
Activity (MEDDAC) located on post;
2.Connectivity, coordination, and comprehensive
inpatient and specialty health services in the
region immediately surrounding the installation;
3.Available, well-trained, and local workforce for
the specialty and inpatient health services offered
by the community facilities;
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Army Strong, AHEC Healthy: Northern AHEC’s Role in Support of Fort Drum
4.Recruitment of separating soldiers, retiring
soldiers, and family members into the local
healthcare workforce;
5.Continuing education and professional development training offerings, especially on those subjects common to returning soldiers’ health, such
as traumatic brain injuries and post-traumatic
stress disorder, to local health professionals, and;
6.Clinical training of students and residents on
post in order to obtain knowledge and skills
necessary to care for the unique needs of soldiers
and their families.
Separating and retiring soldiers make favorable
candidates for just about any career in health care.
Similarly, the family members of soldiers are also familiar with the rigors of training and commitment to
an employer. NAHEC and FDRHPO have worked
with the Army to inform and guide these individuals
into health careers. The project has also supported
and/or offered continuing education and professional
development to healthcare professionals serving the
soldiers and their families of Fort Drum, especially
in the area of mental health. Unfortunately, the need
for behavioral health services, and workers, to care for
the needs of returning soldiers and their families is
both substantial and immediate.
AHECs are designed to understand and address the
unique healthcare workforce needs of the communities they serve. The presence of a military installation
is indeed unique in its structure, function, regional
impact, and healthcare workforce needs. AHECs
have an important role to play in meeting these
needs. The FDRHPO – NAHEC partnership may
serve as a viable model for other situations where
a military installation is located within an AHEC
service region.
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Pipeline Reponses to Unique Community Need
Soldiers in training, or returning from deployment, may require specific healthcare services.
37
Learning together in
in the majestic Rocky Mountains
Register early!
Taking education
to new heights at
beautiful
Beaver Run Resort
in Breckenridge
38
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
Journal of the National AHEC Organization Editorial Board
EDITORIAL BOARD
Robert J. Alpino, MIA
Veronnie Faye Jones, MD, PhD, MSPH
Heather Karr Anderson, MPH
Andrea Novak, MS, RN, BC, FAEN*
Thomas J. Bacon, DrPH
Kenneth L. Oakley, PhD, FACHE*
Daphne Byrd-Verizzani, MEd
Rosemary Orgren, PhD, Co-Chair
Lynne Cossman, PhD, MS
Stephen Silberman, DMD, MPH, DrPh
Joel E. Davidson, MA, MPA, Co-Chair
Kelley Withy, MD, PhD
Shannon Kirkland, MBA
Kathy Ellis-English, BBA
Gretchen Forsell, MPH, RD
STAFF EDITOR
Jenny Kasza
*Co-editors of this issue
National AHEC Organization Board of Directors
Robert Trachtenberg, MS – Interim Executive
Director
Carol Giffin-Jeansonne, EdD –
CDCG Representative
Andy Fosmire, MS – President
Brenda Fitzpatrick – CDCG Representative
Mary Sienkiewicz, MBA – President-Elect, PDCG
Vice Chair
Kathleen Vasquez, MS, Ed – PDCG Representative
Linda Cragin – Treasurer
Mary Mitchell – Secretary
Daphne Byrd-Verizzani, MEd – Parliamentarian,
CDCG Representative
H. John Blossom, MD – PDCG Representative
Kelley Withy, MD, PhD – PDCG Chair
Jack Westfall, MD – PDCG Representative
Rick Kiovsky, MD – PDCG Representative
Marty Schaller, MS – CDCG Representative
Edna Apostol, MPH - CDCG Vice Chair
HRSA
Mary Wakefield, PhD, RN – Administrator
Marcia K. Brand, PhD – Deputy Administrator
Diana Espinosa, MPP – Deputy Associate Administrator, Bureau of Health Professions (301) 443-5794
AHEC Program Federal Contacts
Phone: (301) 443-6950
Joan Weiss, PhD, RN, CRNP – Director, Division of Public Health and Interdisciplinary Education (301) 443-0430
Leo Wermers – Staff Assistant, AHEC Branch
Louis D. Coccodrilli – Chief, AHEC Branch
Norma Hatot, CAPT/USPHS – Public Health Analyst, AHEC Branch
Journal of the National AHEC Organization is a publication of the National AHEC Organization (NAO).
Requests for copies of the Journal should be directed to NAO Headquarters, [email protected].
Journal of the National AHEC Organization  Volume XXVII, Number 1  Spring/Summer 2011
39
Journal of the National AHEC Organization
Winter/Spring 2012
Call for Articles
AHECs and the Changing Healthcare Landscape
The next edition of the Journal of the National AHEC Organization will focus on the role of AHECs in the changing
healthcare landscape. As the Affordable Care Act faces numerous challenges with uncertain outcomes, the need to
shape a higher-quality and more cost-effective healthcare system remains. How are AHECs engaged in addressing
this need? How can we most effectively prepare the healthcare workforce of the future? How can we best serve current providers in practice? These are some of the questions that will be addressed in the upcoming edition.
The Journal Editorial Board will seek expert opinion and authorship for articles covering key topics such as: the
integration of prevention, oral health and mental health with primary care; the medical home; accountable care organizations; and healthcare workforce needs. We also invite your ideas for articles on this edition or to submit articles
related to how your AHEC is playing a role in healthcare improvement.
Please contact the editors (Lynne Cossman, [email protected], Rosemary Orgren, Rosemary.Orgren@
Dartmouth.edu and Kelley Withy, [email protected]) with questions or comments, and submit articles by 8/1/2011.
Deadline for First Drafts of Articles: August 1, 2011
Please submit drafts, photos, and accompanying materials to: [email protected]
Submission/Editorial Guidelines can be found on the NAO website at:
http://www.nationalahec.org/documents/EDITORIAL%20GUIDELINES%200210.pdf
Submission Cover Sheet must be included with the article. See details at :
http://www.nationalahec.org/documents/SUBMISSION%20COVER%20SHEET%2022610.pdf
The National AHEC Organization Mission
NAO is the national organization that supports and advances the AHEC network in
improving the health of individuals and communities by transforming health care
through education.
The AHEC Mission
To enhance access to quality health care, particularly primary and preventive
care, by improving the supply and distribution of healthcare professionals through
community/academic educational partnerships.
www.NationalAHEC.org
NAO Headquarters Address:
7044 S. 13th St.
Oak Creek, WI 53154
Phone: (414) 908-4953
Fax: (414) 768-8001
[email protected]
NAO Headquarters Contact:
Paul Rossmann
[email protected]