1. INTRODUCTION

Today′s increasing number of aging baby boomers has many implications for society, but perhaps the greatest is the impact they will have on the health-care industry. The first of the boomers turned 65 in 2010, and the U.S. Census Bureau estimates that the nation′s population over the age of 62 will increase from about 46 million now to about 83 million by 2030. As the boomers reach retirement age, they will place an increasing strain on the shrinking pool of allied health-care professionals, i.e., those who have specialized training, but are not doctors or nurses. According to the Bureau of Labor Statistics, more than 6.1 million health-care workers will be needed nationally between 2008 and 2018 to fill new jobs and replace workers who leave their jobs or retire.

At the same time, this growing segment of the population will require quality medical care more than ever. All of this comes together to create a severe shortage of skilled labor in the health-care industry just when more seniors than ever will need care.

Prior learning assessment (PLA) can help address this shortage by documenting the relevant skills and knowledge workers may already have from their work and life experiences, and how they can translate those skills into college credit so that these workers can more quickly earn the credentials they need to fill positions left vacant by the boomers.

2. OVERVIEW OF HEALTH-CARE INDUSTRY WORKFORCE

According to A Universal Truth: No Health Without a Workforce, prepared by the World Health Organization, the world is short 7.2 million health-care workers, and that Figure will grow to 12.9 million by 2035. The report blames the problem on an aging health-care workforce combined with staff retiring or leaving the profession.

At the same time, here in the United States, through the Affordable Care Act, more Americans than ever have access to health-care coverage. And as baby-boomers age, they will likely be experiencing more health issues, which translates into a need for more medical assistants, physical therapists, health information technicians, health-care managers, dental hygienists, paramedics, and pharmacy technicians—all jobs that require either at least an associate degree or program certificate.

There are nondegreed health-care workers with knowledge and skills that may be at the college level. These workers may be great candidates to move up within an organization but may lack the degrees necessary for promotion. Perhaps they earned a phlebotomy certificate and then worked successfully as a phlebotomist for several years, perhaps they did volunteer work heading up community blood drives or have been patient advocates at a hospital, all roles that do not require college degrees.

These workers may have knowledge and skills gained from their experiences that can be evaluated for college credit. If workers have the opportunity to have their skills evaluated for college credit, it will help them more quickly and affordably earn college degrees and certificates. For example, perhaps they bring knowledge and experiences that match what they would have learned had they completed classes such as Patient Care Skills, Foundations of Patient Examinations, or Principles of Administrative Management, which are typically offered in colleges offering a degree in Allied Health professions.

PLA is a promising solution that is helping more people, and especially adults, complete their bachelor′s degree and earn professional credentials. In addition, the Council for Adult and Experiential Learning (CAEL) conducted a study on PLA and adult student outcomes that examined data on 62,475 adult students at 48 colleges and universities across the country. CAEL found that graduation rates are 2.5 times higher for students with PLA credit, and found that PLA students also had higher persistence rates and a faster time to degree completion.

There are many methods of PLA, including standardized exams (like College-Level Examination Program tests, also known as CLEP tests) and previously evaluated corporate or military training (evaluated by organizations like the American Council on Education or the National College Credit Recommendation Service). The PLA method that holds significant promise to assist health-care workers is portfolio assessment, where workers document their skills in a portfolio that includes a written narrative along with other forms of proof of their learning. The portfolio assessment process benefits both the employer and the worker—the employer has access to a wider, richer labor pool, and the worker benefits by earning credits faster and at a fraction of the cost. The key, however, is for qualified faculty portfolio assessors to carefully evaluate the demonstrated learning and skills the candidate brings to the process to ensure credit awarded is meaningful and marketable.

Every college has policies in place to allow students to earn a certain amount of credit through prior learning assessment methods, including prior learning assessment portfolios. However, because many institutions have their own individualized portfolio assessment program, there is no consistency across higher education. In addition, only students attending a college with a portfolio assessment program in place could earn credits using this method.

To help ensure access to portfolio assessment for all students, and to offer a consistent and rigorous process, CAEL created the LearningCounts portfolio assessment program. LearningCounts is a way to make portfolio assessment an option to all appropriate students enrolled at an institution, and even those not yet enrolled.

With LearningCounts, adults can use the knowledge they gained from life, work, and military experience to prepare a portfolio to be evaluated for a possible college credit recommendation at a fraction of the cost and time required to earn conventional classroom credits. Adults can choose from an instructor-led or do-it-yourself online portfolio development course where they learn to identify and demonstrate college-level learning gained outside of the classroom. During the portfolio development course, the instructors guide students through the process of building a learning portfolio that aligns their knowledge to a college course from a regionally accredited college or university. As part of their portfolio, students write a narrative that addresses the learning outcomes of the course for which they are requesting credit. Students also include relevant documentation that helps to demonstrate their expertise. As part of the course, the instructor shares the portfolio grading rubric that assessors will be using to evaluate the student′s portfolio.

Once a student submits his or her portfolio for assessment, a LearningCounts faculty assessor with appropriate subject matter expertise evaluates the student portfolio. If the student receives a credit recommendation for their portfolio, they can order a transcript and have it sent to the registrar at their college or university.

LearningCounts student Jill Powell started off her professional career as an EKG technician and a certified nurse′s aide before opening a small business with her husband in 2002. After the economic recession forced them to close their business in 2010, Jill became interested in pursuing a bachelor′s degree to better her job prospects.

Already possessing an associate degree in science along with other educational certification, Jill had been searching for educational programs that would allow her to receive course credit for skills already learned.

“I stumbled onto LearningCounts, and I′m so glad that I did,” she says.

As part of LearningCounts, Jill enrolled in the instructor-led course teaching her how to develop a portfolio that demonstrated skills learned outside of a classroom. She then built portfolios requesting credit for two courses, namely, Introduction to Electrocardiography and Medical Technology for Health Care Professionals.

A LearningCounts faculty member assessed Jill′s portfolios and determined that she had demonstrated the learning skills necessary to receive credit for the two medical courses. Including the credits Jill earned for the LearningCounts instructor-led portfolio development course, as well as for passing a CLEP test, she earned a total of 15 prior learning assessment credits. In December 2011, she received her bachelor′s degree.

For Jill, the opportunity to save time accumulating college credit for skills already learned was a major selling point of LearningCounts. “[The] instructor was fabulous; he was always available by e-mail. It was just a wonderful, wonderful experience.”

Rolondo Russell, Program Director at Ultimate Medical Academy, is a subject matter expert in the field of health-care administration and serves as a faculty assessor for LearningCounts. With a bachelor′s in health administration, an MBA in health-care management, and over 23 years in the field, Rolando says that a key component for the LearningCounts assessor is the ability to review a narrative from a student who wants credit for what they have done in the past, or curriculum they think they already know, and objectively evaluate whether the student not only understands the knowledge or skills but can apply it.

As part of the process, the LearningCounts assessor evaluates how well the portfolio meets the requirements provided by CAEL as follows:

• Has the student been able to demonstrate a clear distinction between theory and practice through the written narrative?
• Has the student shown the ability to use and learn from his or her past experiences related to the course outcomes and apply it?
• Has the student provided supporting documentation to justify knowledge, understanding, and application of the objectives?

As part of the initial training to become a faculty assessor, Rolondo received hands-on coaching by working through an actual assessment with the director of assessment at LearningCounts. In addition to training on the technology, he was trained on assessment processes and policies and discussed best practices related to evaluating student portfolios. He reviewed portfolios that were approved along with ones that were not, so he could see for himself what the key components were.

He also says one of the most important aspects of his job is evaluating the documentation. “The narrative in the portfolio is a great way for the student to tell his or her story, but you can′t just fall for the story. You need to look at the documentation and the end product to make sure the student truly can apply the knowledge. For example, just because an applicant learned something 20 years ago doesn′t necessarily mean he or she actually remembers it enough to apply it today. At the end of the day, I say to the student, ‘If you′ve done this, let me see that you′ve learned it and applied it.’”

3. CONCLUSION

As the number of older Americans continues to rise, they will increasingly be leaving the health-care workforce and requiring more medical care, which will place an enormous burden on the nation′s health-care delivery system. As a result, the demand for workers will continue to grow. Innovative tools like LearningCounts portfolio assessment can help nondegreed health-care workers earn credits more quickly and more affordably. Getting skilled workers credentialed more quickly can help to ensure we all have access to the health care we will need in the future.