Sally Pestana, MT(ASCP), Region X Past Director

Gather clinical laboratory science educators together and within a few minutes the conversation is likely to turn to the challenge of securing clinical sites. Gather clinical laboratory science employers together and within a few minutes the conversation is likely to turn to the challenge of staff shortages. Considering this, if one were to bring together an educator and a local employer, one would think the conversation would sound like this:

Educator: “I need to find clinical sites for this coming semester.”

Employer: “What good news! I will take four students. I will rotate them through each of the four departments. I have so many staff openings; this will be a great way to train them in our specific way of doing things as well as assess them for a strong fit into our particular culture.”

In reality, the employer’s response is more likely to be: “Wish I could help. We are so short staffed we cannot possibly take students right now. But please do send them to us after they complete their clinical experience somewhere else. There is a strong likelihood I can offer them employment then.”

This challenge is not unique to the clinical laboratory. This response is the reality of employers in nearly every type of medical education in the U.S. The traditional internship/externship/practicum/fieldwork, etc. model that nearly every person reading this has experienced is no longer meeting the needs of healthcare students, colleges and universities, and employers. 

The good news is there IS another model that HAS worked for centuries in this country and around the world – apprenticeships. In the U.S., the most traditional sector for apprenticeships has been the construction trades – carpenters, plumbers, electricians, welders, etc. It is time for healthcare educators and employers to consider the possibilities this model can bring.

In Fall 2016, the U.S. Department of Labor awarded $50.5 million in grants to help states develop and implement comprehensive strategies to support apprenticeship expansion. The grants are also intended to engage industry and workforce intermediaries, employers, and other partners to expand and market apprenticeship to new sectors; enhance state capacity to conduct outreach and work with employers to start new apprenticeship programs; and expand and diversify participation in apprenticeship through state innovations, incentives, and system reforms. The competitive grants were awarded to 37 successful states with awards ranging from $700,000 to $2,700,000. Twenty seven of the 37 states have identified healthcare as one of the sectors to expand the apprenticeship model in. (Link to all 37 project summaries:

Apprentices are defined by the U.S. Department of Labor as employees who through a combination of on the job learning and classroom instruction, progress through a set of competencies determined by the profession and the employer. That definition should sound familiar, except perhaps for the “employee” part. 

In the traditional internship model, the education institution selects/admits the student and then “places” them with the potential employer. At the end of the clinical experience, the clinical site may choose to offer the student employment, and the student may or may not choose to accept that offer. The employer can be left feeling shortchanged that they provided extensive high-quality training requiring much time and human resource capital with no return on the investment if the student does not accept their employment offer.

In the apprenticeship model, the tables are turned. The employer selects an employee based on the employer’s criteria for the structured and state approved apprenticeship program they have created to meet their needs. The education institution collaborates as a partner of the employer to provide the classroom instruction that supports the on the job learning in the job site – heretofore called the clinical site. Throughout the apprenticeship, the apprentice is earning wages while learning on the job and attending classes at the college or university partnering with the employer.

Data shows employers earn $1.50 for every $1.00 invested in apprentices with a range of benefits from reduced turnover to greater productivity. The U.S. Department of Labor reports 90% of apprentices stay with their employer upon completion of their apprenticeships. Apprenticeships provide opportunities for the apprentice employee to understand the values, the institutional knowledge, and unique systems and processes of his/her employer. Apprenticeship programs support companies in the challenges of attracting, training, and mentoring employees to meet the specific job, skills and performance needs of the employer.

There are more than 21,000 registered apprenticeship programs across the nation, with 1,700 added during fiscal year 2016.

As one of the P.I.s for the Hawaii Apprenticeship State Expansion Grant, I am coordinating efforts to pilot the apprenticeship model in Hawaii for three healthcare professions: Community Health Workers, Pharmacy Technicians, and Optometric Assistants. I look forward to sharing the results of this project with you.