How Minnesota Universities are Accelerating Change in Health Care Education
Minnesota’s population is growing and getting more diverse, and baby boomers are retiring from medical sector jobs and needing more health care as they age.
To meet the expanding demand for care, the number of health care workers in the U.S. will have to increase by nearly 30 percent by 2020. That’s more than 4 million jobs, the most dramatic growth needed for any national employment sector, according to the U.S. Department of Labor.
Like the U.S., Minnesota will need more of virtually every kind of health care worker, from clinicians to educators and administrators. Minnesota’s colleges and universities are finding ways to make health care education more accessible to a variety of students by creating programs that move faster, happen online, serve rural and ethnically diverse communities, engage older students, and disseminate good ideas quickly.
Younger students, faster degrees
Minnesota schools are increasingly accelerating changes in existing programs and beginning new ones that turn out credentialed graduates quickly. The St. Paul-based University of St. Thomas has offered a health care MBA for the past 20 years. “We bring in mid- to senior-level students who are already working in health care, and they come to us for two days every month for two years to get the degree,” says John McVea, director of health care strategy at St. Thomas’ Opus School of Business. The program includes a Washington, D.C., policy seminar and a class on global innovation in health care that’s held in Prague.
Although the two-year master’s degree program is popular, St. Thomas launched a one-year master’s program in April 2018 and filled the first cohort in July. “We’re aiming at people who are a little younger and less experienced than those in our two-year master’s programs,” McVea says.
The school also is seeing more female graduate students and more students from clinical backgrounds who want to assume management jobs. “They used to be all men in their 40s who were moving to be medical group CEOs. Now we’re getting a pharmacist in her 30s or a nurse who would have done a master’s in nursing in the past, and they see business training as the best way to move into management,” McVea says.
Phil Ayeni, a Woodbury resident whose parents emigrated from Nigeria, is working toward a master’s degree in health care innovation at St. Thomas. He’s a research scientist at Bio-Techne in Minneapolis, where he spends his working days concentrating and purifying antibodies.
“I’ve seen how the world is quite different from the U.S. in terms of public drinking water, restrooms, even shoes,” Ayeni says. “What’s being done for people in the developing world? How do they stay healthy?”
Caring about the question, he says, motivates him to get through the short, intense sprint of a one-year master’s program. The online nature of the work—the class only meets in person one Saturday a month—makes it possible for him to work and pursue a graduate degree at the same time.
Like Ayeni, fewer students overall have two years of time and money to invest in a graduate degree. “Speed and cost are important,” McVea says. St. Thomas hopes to ultimately develop a suite of one-year master’s degrees, each focusing on a different aspect of health care: communication, innovation, and analytics, for instance.
On the undergraduate side, St. Thomas plans to open a school of health that will pull together existing programs under a single roof, and it will add a school of nursing. “We see a long-term demand shortage for nurses, and we haven’t had a smooth pathway to a nursing degree,” McVea says. “The University of Minnesota and [St. Catherine University] have been the fly paths to that in the past.”
Paths to nursing degrees
n Minnesota has a nursing shortage that, left unaddressed, will only get worse as the years pass. At St. Catherine University in St. Paul, administrators say they are adding new ways to educate nurses, particularly those who are older than traditional college age.
“We’ve added a bachelor’s program in nursing to our College for Adults,” says Kim Dinsey-Read, interim dean of nursing and assistant professor of nursing at St. Catherine’s Henrietta Schmoll School of Health. “Often students already have a degree or a lot of transfer work, and they’re often older than traditional college students, with families and adult lives.” A master’s degree program for students who already have bachelor’s degrees in other subjects and want to become entry-level nurses is about four years old.
Students in both adult nursing programs do most of their work online, though lab work happens at the university and clinical placements occur at hospitals and other medical practices around the Twin Cities.
St. Catherine also has recently moved its existing nurse educators’ program entirely online. “That’s really increased our enrollment,” Dinsey-Read says. “Students still have to do practicums, but they can do those in the communities where they live.” That allows students who live outside the metro area to enroll without moving to the Twin Cities for the duration of the program.
Making it easier for more nurse educators to earn their degrees will also help ease the nursing shortage, says St. Catherine associate dean of health sciences Lisa Dutton. “It’s hard to recruit nurses out of practice to become educators,” she continues, adding that the lack of nurse educators is a bottleneck in the health care educational system.
Saint Mary’s offers advanced nursing education, too. A new RN-to-BSN leadership program is for students who are already registered nurses. BSN stands for a bachelor of science in nursing degree. “Students don’t have to do additional clinical work for that degree,” says Todd Reinhart, dean of sciences and health professions at Saint Mary’s University of Minnesota, which has a campus in Minneapolis.
Diverse students, diverse communities
n Other new programs at St. Catherine include a master’s degree in health informatics, an expanding field that involves using data to make health care decisions; an online occupational therapy assistant program; and a master’s degree in public health. “This is the only master’s in public health program in the state that focuses on global health,” Dutton says. “We have a local immigrant and refugee community, and we need to prepare a diverse workforce to work with diverse communities.”
Both the undergraduate and graduate programs in public health are very diverse, Dutton adds. Other programs are less so. “It’s harder for some people of color to make the investment, and they may be less familiar with some graduate programs. People who are immigrants know medicine and nursing, but they may not know about some of the other opportunities.”
As reflected in the current health care workforce, most of the students are women—entirely female on the undergraduate side and from 70 to 80 percent female in graduate programs.
Partly in response to needs for diversity, Saint Mary’s will launch a master’s in public health in January and plans to start a master’s in social work in August. “The social work program is 100 percent online, and there’s a big need for it,” says Susan Jarosak, assistant dean of the Graduate School of Health and Human Services at Saint Mary’s. “Our population is growing, and we have more need for social workers to guide people to services, plus an aging population needs social workers in nursing homes, hospitals, and veterans’ centers,” she says. Burnout is a frequent problem for social workers, too, which means greater attrition and more need for replacements.
On average, St. Mary’s adult students are in their mid-30s. They’re often already working in health care positions; a master’s degree can help them move up, especially in larger public health systems, Jarosak says. Many of the adult students are originally from East Africa.
The diversity Saint Mary’s hopes to see includes rural Minnesotans, she says.
n How do medical schools train doctors to offer equitable care, especially to communities that don’t look like them? Rachel Hardeman spends her professional life working to answer that question.
“Our health care system has been built to not serve some communities well. Doctors as a group don’t have the same cultural history that their patients of color have,” says Hardeman, a Minneapolis-based health equity researcher and assistant professor at the University of Minnesota School of Public Health. “I do a lot of work thinking about how people who work in health care can dismantle the structures that contribute to poor health.”
Hardeman and Brooke Cunningham, a physician, sociologist, and assistant professor at the University of Minnesota Medical School, have piloted a curriculum for reducing disparities in health outcomes while improving quality of care. “We’re hoping to scale up,” Hardeman says. “Students are asking for this.”
At every school that offers health care degrees, clinical placements are a significant challenge. “It’s hard to get clinical placements,” Dinsey-Read says. Doctors have internships and residencies, but the health care system needs many more registered nurses, physical therapists, nurse anesthetists, physician assistants, nurse practitioners, and health care workers other than doctors.
Clinical site staff is often overstretched already, so adding teaching duties to their work lives isn’t always possible without shortchanging patients.
“They have to balance bandwidth, caseload, and patient needs,” Reinhart says.
Long-term and mental health care specialists
A 2015 study by HealthForce Minnesota showed that the state needs more mental health specialists. So the center applied for money from the state coffers and helped Winona State University start a psychiatric nurse practitioner program in 2017.
“Winona State’s nursing facility saw this as a need,” says Valerie DeFor, executive director of the HealthForce Center of Excellence. “Without the seed money, it wouldn’t have happened. Now that they have students, the program is self-sustaining.” Five students, most from rural communities, completed the program in 2018, DeFor says.
The center has other ways to fuel health care’s professional pipeline, too. At Minneapolis Community and Technical College, students can participate in a fellows program, which helps students find internships, jobs, and professional connections in the health care field.
Clinicians as researchers
n There’s no need to limit learning to classrooms, says Timothy Beebe, head of the division of health policy and management at the University of Minnesota School of Public Health. A collaboration of the University of Minnesota School of Public Health, Mayo Clinic, and Hennepin Healthcare teaches clinicians how to conduct research embedded in a clinical practice.
“A lot of clinical discoveries happen at the clinic level,” Beebe says. It can take a long time from discovery to widespread use—up to 17 years, by some estimates. A targeted educational program aims to get best practices to clinicians much faster. “We want them to be right, fast, and in contact with more of their peers.” Participants get the word to other practitioners by gathering evidence, writing papers, and passing peer reviews.
“Change can happen overnight if we have enough evidence,” Beebe says. “Potential competitors need to care about the health of the population and share best practices. Let’s make all the boats float.”
Ingrid Case is a Twin Cities-based freelance writer and veteran reporter on business topics.