Degree “Creep” ~ What is the Impact?

Barbara R. Jones, Ph.D.

Dean of Instruction Louisiana Delta Community College

     Health Professionals ~Bureau of Labor Statistics As the largest industry in 2004, health care provided 13.5 million jobs —13.1 million jobs for wage and salary workers and about 411,000 jobs for the self-employed. 8 out of 20 occupations projected to grow the fastest are in health care. More new wage and salary jobs —about 19 percent, or 3.6 million—created between 2004 and 2014 will be in health care than in any other industry. Most workers have jobs that require less than 4 years of college education, but health diagnosing and treating practitioners are among the most educated workers.

~http://www.bls.gov/oco/cg/cgs035.htm

Management, business, & financial 4.4% Physicians & Surgeons (3.2%), Optometrists, Dentists, Chiropractors, Podiatrists, Psychologists RNs LPNs Allied health professionals (therapists, technologists, and technicians) Allied Health service occupations (assistants and aides) Office and administrative support 5.1% 15.2% 4.5% 18.5% 31.8% 18.2%

Allied Health Education

 Taught in 2-year and 4-year higher educational programs in private, public, proprietary and hospital-based programs  43.7 % of all accredited allied health educational program are located in two-year community colleges and schools.

Allied Health Education

 97,206 students in various allied health professions and fields graduated from colleges, universities, medical schools, proprietary schools and hospital based programs in 2002  58,068 of these students (63%) graduated from two-year colleges and schools

Allied Health Education in Two-Year Colleges  Some of the fastest growing occupations in health care include  health information technicians,  dental hygienists,  respiratory therapists,  radiologic technologists,  cardiovascular technicians, and many other occupations that require a two year associate degree or certificate

Allied Health Education in Two-Year Colleges      Radiographer/Radiologic Technologists  48.5% graduated from community colleges Registered Respiratory Therapist and Certified Respiratory Therapists  85% of Respiratory Therapists graduate from accredited programs in two-year colleges Paramedic, Emergency Medical Technicians  96% receive training and education in two-year colleges  62.4% of accredited EMS programs are in two-year colleges Medical Assistants  88% of accredited Medical Assistants programs found in two year colleges Nursing  60% of all new RNs are Associate Degree prepared

Health Care Workforce Shortage Areas      Respiratory Therapy (14.2% vacancy rate) Occupational Therapy (15.7% vacancy rate) Physical Therapy (14.6% vacancy rate)  Bernard Hodes Group Report, 2003 Clinical Laboratory Sciences (9.5% vacancy rate) Imaging Sciences (Radiographers, Sonographers, Nuclear Medicine Technologists, Radiation Therapists) (<7.0 % vacancy rate)  ASRT survey, 2006

Health Care Workforce  Shortage Areas   RN turnover rate in acute care hospitals-21.3%. RN vacancy rate - 10.2%  critical care units (14.6%)  medical-surgical care (14.1%) U.S. Bureau of Labor Statistics ~

Acute Care Hospital Survey of RN Vacancies and Turnover Rates in 2000

(January 2002), American Organization of Nurse Executives

www.aone.org

Buerhaus and colleagues reported in

JAMA

(June 14, 2000) that the US will experience a 20% shortage of nurses needed by the years 2020, translating to a shortage of more than 400,000 RNs .

Health Care Educator Shortage

 U.S. nursing schools turned away qualified applicants in 2003 due to insufficient faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.

~ Southern Regional Board of Education (SREB), February, 2002

What is Degree “Creep”

   Degree expansion Degree migration Upward degree progression ~ Increased degree or credential requirements for entry into a field or profession.

Professional Degrees

         Dentistry Medicine Osteopathy Podiatry Veterinary Chiropractic Optometry Law Theology

Health Professions that have increased degree requirements         Audiology (Doctorate) Occupational Therapy (Masters) Pharmacy (Doctorate) Physical Therapy (Masters/Doctorate) Physician Assistant (Baccalaureate) Pharmacy Technician (associate) Respiratory Therapy (associate) Surgical Technology (associate)

Health Professions considering increased degree requirements      Dental Hygiene Dietetics Nursing (NY, NJ, MI, NM) Respiratory Therapy Others

Health Professions with advanced practitioner clinical degrees     Clinical Laboratory Sciences Nursing Diagnostic Medial Sonography Advanced certifications in Radiography (CTR, MRI, Mammography)  Advanced certifications in Dental Hygiene (Expanded Functions)

Impetus for Degree Creep

 Increased educational and skill requirements of the profession      Increased access for patients Increased recognition of profession Increased salary Profession?

Accreditation?

Adverse Effects of Advanced Degrees       Threaten research Cause faculty to “scramble” for degrees, as many faculty members do not have doctoral degrees Cause a reduction in the number of new graduates during time of workforce shortage cause only more wealthy to seek degrees because of time and cost Create a need for more assistants and technicians Create a decline in job satisfaction and morale if advanced skills and knowledge underutilized.

~ Siler, W. & Randolph, D. (2006). A clinical look at clinical doctorates.

The Chronicle Review

Realities of American Healthcare  Insurance companies pay for service provided, not educational level of the provider

Data to support increased educational requirements

Impact of Degree Creep

       Workforce shortages exacerbated Lack of capacity in colleges in universities (faculty, facilities, funds, clinical sites) Lack of credentialed faculty to deliver instruction Decrease in workforce diversity as inaccessible to minorities and economically disadvantaged Increase in tuition Increase in time in college Access to health care limited in rural areas

Considerations to Degree “Creep”

     Review data and evidence to support increased educational levels Assess educational preparation and performance abilities an requirements Assess job demands and requirements as prescribed by healthcare facilities Determine demographic characteristics of health professionals at various degree levels Consider career pathways and expanded functions gained through educational and practical experience ~ transitional degrees

Degree “Creep” ~ What is the Impact?

Barbara R. Jones, Ph.D.

Dean of Instruction Louisiana Delta Community College [email protected]