UNDERSTANDING THE CURRENT REALITY
Employment opportunities in the healthcare sector are tremendous and this sector is one of the few currently placing large numbers of employees into well-paying jobs with long-term stability and growth opportunities. Over the next five years, the healthcare sector expects a 29 percent national growth rate - five million new jobs – with likely excessive vacancy rates (U.S. Department of Labor, 2015). Further, according to a 2015 JPMorgan Chase Report, approximately 14,500 middle-skill heath care jobs will open each year in Chicago alone until 2019.
As these facts relate to Latina/os in the healthcare profession, there is an even greater need for nurses and other healthcare professionals who have the cross-cultural knowledge critical to the healthcare setting. While Latina/os constitute over 28 percent of the Chicago population, they are still dramatically underrepresented in healthcare professions, making up only 16 percent of new hires in healthcare according to the same 2015 JPMorgan Chase Report. In addition, new hires included 6.2 percent of LPNs and 4.9 percent of RNs, according to a 2010 survey by the Bureau of Labor Statistics. Often, a primary barrier for Latinas/os is low education levels associated with limited levels of English proficiency that prevent community members from entering and succeeding in high-growth industries. The intersection of these multiple realities creates the pressing need for culturally competent bilingual healthcare professionals in the Latina/o community.
In 2005, Instituto del Progreso Latino’s (Instituto) launched Carreras en Salud: A Chicago Bilingual Healthcare Partnership (Carreras), a career pathways program established to bridge limited English-proficient individuals into stable, high-demand healthcare careers. The program provides a solution to the ongoing nursing shortage and the need for bilingual healthcare professionals, offering students seven different entry levels with each level designed as a bridge to the next level. As participants move through the program, they increase their wages, enabling families to improve their financial assets over a relatively short period of time. By doing so, the program helps low-income and immigrant families become self-sufficient.
Through the program, Instituto has proven that when an adult learner is engaged with a culturally relevant and holistic set of core programmatic elements, full integration into a college environment and the workforce can be achieved. Carreras’ approach to career pathways is designed to train and support individuals at each level of entry. The methodology behind the program’s structure of contextualization was thus developed to guarantee that students from the targeted community could acquire applicable technical skills as they improve their academic skills. The model considers several factors in the learning process and the level of basic skills mandates the educational context of the lesson plan. The following components of the program help ensure each student’s success:
Assessment – To enroll in Carreras, students are required to be at a basic skill level as measured by the Test for Adult Basic Education (TABE). Designed primarily for English as a Second Language (ESL) students, the minimum academic level to enter the pathway’s pre-CNA Bridge program, Module One (ESL for healthcare), is language grade level six and Literacy or Beginner level in ESL. Students are required to meet language grade level eight to be admitted to the pre-CNA Bridge program, Module Two (Vocational ESL (VESL)-CNA). Students with lower scores can take traditional Instituto ESL classes that are designed to bridge them towards the Carreras pathway.
In addition to academic assessment, all students entering the career pathway are required to meet with an employment specialist at Instituto. The students take a skills inventory survey and are guided in developing a career plan based on the results. This career plan includes activities focusing on basic, technical, and transferable skills. All results are shared with an academic adviser, who works with the instructors to ensure these needs are addressed in lesson plans and class activities.
Curriculum Components - Carreras utilizes a modular curriculum, where each module is tied to a specific step in the career and academic ladders of a career pathway. The program has two pre-college bridges. The first bridge, pre-CNA, transitions students from grade level six in basic academic skills to a grade level 10, and transitions ESL students from Literacy or Beginning to the Intermediate level in English. At the same time, it transitions participants along the career ladder by moving people who do not work in the healthcare industry into the industry with a CNA certification and job.
Given the characteristics of the nontraditional and limited English-speaking students who need extra academic support, Carreras also offers tutoring in each module. In addition, students are encouraged to talk to their instructors about their progress before and after class. In cases where students are falling behind academically, they are invited to spend an extra day each week with an instructor until they catch up.
Internships and Work Experience - Students are exposed to real workplace experience in healthcare through internships and clinical sessions as they progress to the later stages of the program. Success in these sessions is absolutely essential in order for students to acquire industry certifications and licensing, as it allows participants to obtain experience outside of the classroom. The participation of the Illinois Health and Hospital Association (IHA) helps build the alliances necessary to gain access the healthcare sector for the program’s students.
Certifications - Acquiring industry certifications and licensing confirms that the necessary knowledge and skills have been attained, making the holder of these certifications more employable – which is Carreras’ ultimate goal. For this reason, Instituto carefully chooses accredited higher education partners for degree programs and certifications recognized by the healthcare industry and that offer courses that impart the knowledge necessary to pass state and national certification exams.
Timeline - While traditional adult learners typically rely on extensive homework to cover the required material in the curriculum, this use of time is largely unproductive for the low-literacy, low-income population targeted by Carreras. A study by the program’s administrators determined that more class time and less homework is needed for these students to hone three basic skills -- math, language, and computers. Students meet five days per week for four hours each day for 16 weeks. This is a total of 320 hours per term, which comprises 12 hours of reading/rhetoric, four hours of math, and four hours of computer literacy and/or career exploration throughout the semester. Carreras students advance a minimum of two grade levels in math and language per term, and become computer literate in one term, versus the one level of advancement in a traditional adult education program. The program’s instructors have found this heavy reliance on class time to be quite successful.
Carreras’ pre-college classes meet from 5:30 p.m. to 9:30 p.m. weekdays and during the day on weekends. This schedule works especially well for students whose work schedules vary. Further, the pre-college classes follow a traditional semester format, starting new classes each January, May, and September. As students advance in the program’s pathway and reach the college levels, their scheduling depends on the college class schedule in which they are enrolled.
Partnerships - This program has been successful particularly because of the unique public-private partnerships it has created to leverage the resources and expertise of multiple different types of organizations to deliver for its community. Instituto maintains a close partnership with the City Colleges of Chicago (CCC) which reserves a section of its seats in nursing programs for Instituto students in the higher levels of the career pathway program. Take for instance the organization’s relationship with Wilbur Wright College (a CCC College). These relationships, the success the program has enjoyed, and credibility it has established through its ability to recruit, prepare, and support students as they progress through the nursing career pathway contributed significantly to Wilbur Wright College’s 300 percent growth in course offerings. These results also led to Wright College becoming accredited to administer a Registered Nurse (RN) program. Approximately 20 percent of the seats available in this highly competitive RN program are now reserved for students from the Carreras program’s pipeline. As a demand-driven project, the program also engages area hospitals and nursing homes and works with MCHC, a membership association comprised of over 150 hospital and healthcare organizations, to convene industry alliances. Carreras demonstrates the critical mass that community based organizations, local colleges, policy advocates, and expert researchers can bring to local initiatives.
Since its inception, graduates from Carreras have doubled their salaries, earning on average $40,000 per year. Carreras has a cumulative completion rate of 94 percent across all its bridge programs, a licensing/certification rate of 95 percent for its 230 LPN and 330 CNA graduates, and a job placement rate of 100 percent for LPNs and 80 percent for CNAs. LPNs had an average wage gain of 150 percent, from an average annual salary of $18,720 as a CNA to $46,800 as an LPN.
The program has received significant national recognition due to its success in moving low-skilled individuals through the adult education and workforce development pipeline including:
- 2007 National Council for Continued Education, National Exemplary Program in Workforce Development Award
- Selection as one of ten finalists to receive the 2008 Bellwether Award
- 2008 Innovative Program of the Year Award from the Illinois Council for Continued Higher Education
- 2008 Strengthening Hispanic Families Award from the Annie E. Casey Foundation
- 2008 National Council of La Raza Recognition of Excellence Award.
- 2014 National Council of Workforce Education (NCWE), Non-credit Program of the Year
Carreras en Salud provides a tangible solution to addressing the ongoing nursing shortage and the need for bilingual healthcare professionals. As participants matriculate through the program, they increase their wages significantly, allowing for the entire family to develop its assets over time. This promotes a stronger investment in education and preventative health practices within the Latina/o community. By doing so, Carreras en Salud is moving immigrant families on a pathway to self-sufficiency.