From healthcare provider to healthcare educator strategies for e

FROM HEALTHCARE PROVIDER TO HEALTHCARE EDUCATOR: STRATEGIES FOR EFFECTIVE TRANSITION By Lisa Dianne Legg Approved: Vicki N. Petzko Hinsdale Bernard Professor – College of Health, Professor – College of Health, Education, and Professional Studies Education, and Professional Studies (Chairperson) (Methodologist) David Rausch Tanya Gorman Associate Professor – College of Health, Vice President, Academic Affairs Education, and Professional Studies DeKalb Technical College (Committee Member) (Committee Member) Mary Tanner A. Jerald Ainsworth Dean of the College of Health, Dean of the Graduate School Education, and Professional Studies FROM HEALTHCARE PROVIDER TO HEALTHCARE EDUCATOR: STRATEGIES FOR EFFECTIVE TRANSITION By Lisa Dianne Legg A Dissertation Submitted to the Faculty of the University of Tennessee at Chattanooga in Partial Fulfillment of the Requirements for the Degree of Doctor of Education in Learning and Leadership The University of Tennessee at Chattanooga Chattanooga, Tennessee August 2011 ii Copyright © 2011 By Lisa Dianne Legg All Rights Reserved iii ABSTRACT This study attempted to identify effective strategies for healthcare providers transitioning into educational leadership roles. The study employed a mixed method research design.

The population was selected from colleges and universities, nationally, which sponsored selected healthcare training programs. Healthcare faculty were chosen to participate based on the following criteria: (a) their respective institution was regionally accredited and healthcare program accredited by the appropriate specialty agency, (b) their respective institution was of a college or university status, and (c) their respective institution sponsored five or more of the selected healthcare training programs. Via an online questionnaire, quantitative and qualitative data were collected. Results showed that healthcare educators transitioned into their positions based on their devotion to their profession/desire to promote it and the satisfaction they received through teaching.

These two factors also influenced healthcare educators‘ decisions to remain in academia long term. Data demonstrated that clinical work and academic experiences, previous theoretical educational training, and support from colleagues were the most helpful components of their transition into education. Factors which hindered the transition from healthcare to education included an insufficient background in educational theory/practice, lack of mentoring, lack of orientation, and excessive workload. New healthcare educators explained that they were least iv prepared for activities such as student assessment, instructional design/delivery, administrative responsibilities, counseling/advising, learning environment management, and dealing with conflict.

Data revealed that new healthcare faculty were provided with mentoring opportunities, college in-service activities, and general orientation sessions; however, data further revealed that the educators believed better mentoring, additional educational courses, and more thorough orientation would have been more beneficial during their transition. Effective healthcare educators were described as being prepared with the appropriate level of knowledge/skill, demonstrating excellent communication skills, being sensitive/responsive to students‘ needs, exhibiting professional behavior, and being motivated. Implications of this study related to recruitment of appropriate individuals who would remain in education long term, and thus could (a) improve the competence and success of students, (b) improve patient care, and (c) alleviate the healthcare educator shortage. v DEDICATION This dissertation is dedicated to my family.

I hope I have made you proud. vi ACKNOWLEDGMENTS This dissertation is the result of several years of dedication and hard work. And, without the support of several individuals, I would not have been able to see this research through to conclusion. Firstly, I would like to extend a heartfelt thank you to my committee who were forever present to guide me through this process with unbelievable patience.

I have valued the expertise and input of each; it has been an honor to have worked with them over the course of the past year. Specifically, I would like to acknowledge Dr. Vicki Petzko who chaired my committee. She dedicated herself to numerous readings and edits of my work.

Her leadership kept me focused and on task. I am also grateful to Dr. Hinsdale Bernard who served as my methodologist. He ‗encouraged‘ me to shift my work from regional to national focus and the hard work paid off.

Tanya Gorman, who years ago provided the inspiration for my pursuit of this degree, provided amazing content expertise. David Rausch helped to shape the direction of my study with his quick internet searches. He helped me establish the connection between adult learning theories and competency based education! I also appreciate that he took a chance on a doctoral student he virtually did not know. I also extend my gratitude to the University of Tennessee at Chattanooga Learning and Leadership faculty.

Their collective efforts during my core coursework vii provided me with the foundational knowledge needed for my doctoral journey. Additionally, they instilled in me the confidence to grow as an educational leader. I would also like to extend a special thank you to Becca McCashin, program coordinator. She made my experience, from submitting my initial application to the program to my application for graduation, seamless and pleasant.

Becca was always there to assist with a friendly smile. I also must recognize the incredible members of Cohort 3. Our classes were always educational, lively, and entertaining. I cannot begin to describe the knowledge I gained from my cohort interactions in class discussions and group projects.

I want to thank my colleagues at Chattanooga State Community College for their support. Thanks to Vicky Leather and her staff in the library for their research and assistance with DOIs. And, a special thanks to the Division of Nursing and Allied Health program directors who assisted with the content analysis of my online survey. That particular input served to be invaluable to my progress.

I would also like to extend a special thank you to Lisa Satterfield who contributed to my work on this dissertation. I will someday repay the favor. Lastly, I would like to thank my family for encouraging and supporting my educational endeavors since the age of five; I am really finished, at least for now. And, a special thank you to my husband, Steven, who has cooked a few extra meals over the past year.

viii TABLE OF CONTENTS DEDICATION.vii LIST OF TABLES .xiv LIST OF FIGURES. 1 Statement of the Problem. 2 Purpose of the Study. 3 Rationale of the Study.

4 Significance of the Study. 5 Definition of Terms. 5 Delimitations of the Study. 6 Limitations of the Study.

7 Summary and Outline. REVIEW OF THE LITERATURE. 9 A Brief History of Accreditation in the United States. 9 Accreditation Standards for Healthcare Training Programs and Educators.

11 Current Shortage of Healthcare Educators. 12 Recruitment of New Healthcare Educators. 14 Healthcare Faculty Retention. 16 Characteristics of Effective Healthcare Educators.

17 Healthcare Educator Training and Development. 19 Adult learning theory. 19 Competency-based healthcare education. 21 ix Learning theories applied to healthcare education.

22 Connecting competency-based education and learning theories. 24 A sampling of training and development rograms. RESEARCH DESIGN AND METHODOLOGY. 30 Institutional Review Board Approval.

31 Population and Sample. 31 Data Collection Instrument. 46 Data Relating to Research Questions. 81 Summary of Previous Chapters.

81 Summary of Chapter 1. 81 Summary of Chapter 2. 82 Summary of Chapter 3. 86 Findings and Discussions.

87 Discussion of Research Question 1. 89 Discussion of Research Question 2. 93 Discussion of Research Question 3. 98 x Discussion of Research Question 4.

100 Discussion of Research Question 5. 103 Implications for the Profession. INSTITUTIONAL REVIEW BOARD APPROVAL. ORIGINAL ONLINE QUESTIONNAIRE.

QUESTIONNAIRE PEER REVIEW EMAIL CORRESPONDENCE. FINALIZED ONLINE QUESTIONNAIRE. ONLINE QUESTIONNAIRE PILOT STUDY INFORMATION. INVITATION TO PARTICIPATE IN DOCTORAL DISSERTATION EMAIL.

REMINDER TO PARTICIPATE IN DOCTORAL DISSERTATION EMAIL. RAW DATA ASSOCIATED WITH TRAINING OPPORTUNITIES OFFERED TO HEALTHCARE EDUCATORS AT THE TIME OF INITIAL EMPLOYMENT. EMERGENT THEMES ASSOCIATED WITH TRAINING OPPORTUNITIES OFFERED TO HEALTHCAR EDUCATORS AT THE TIME OF INITIAL EMPLOYMENT. RAW DATA ASSOCIATED WITH THE DESIRED TRAINING OF HEALTHCARE EDUCATORS.

EMERGENT THEMES ASSOCIATED WITH THE DESIRED TRAINING OF HEALTHCARE EDUCATORS. RAW DATA ASSOCIATED WITH FACTORS INFLUENCING HEALTHCARE EDUCATORS TO TRANSITION INTO THE ACADEMIC SETTING. EMERGENT THEMES OF FACTORS INFLUENCING HEALTHCARE EDUCATORS TO TRANSITION INTO THE ACADEMIC SETTING. RAW DATA ASSOCIATED WITH CONDUCIVE FACTORS IN PREPARING FOR HEALTHCARE EDUCATOR POSITIONS.

EMERGENT THEMES ASSOCIATED WITH CONDUCIVE FACTORS IN PREPARING FOR HEALTHCARE EDUCATOR POSITIONS. RAW DATA ASSOCIATED WITH FACTORS HINDERING TRANSITION INTO HEALTHCARE EDUCATION. EMERGENT THEMES ASSOCIATED WITH FACTORS HINDERING TRANSITION INTO HEALTHCARE EDUCATION. RAW DATA ASSOCIATED WITH EXPERIENCES/ACTIVITIES NEW HEALTHCARE EDUCATORS WERE UNPREPARED TO PREFORM.

EMERGENT THEMES ASSOCIATED WITH EXPERIENCES/ACTIVITIES NEW HEALTHCARE EDUCATORS WERE UNPREPARED TO PERFORM. RAW DATA ASSOCIATED WITH OTHER FACTORS INFLUENCING HEALTHCARE EDUCATORS‘ DECISIONS TO REMAIN IN EDUCATION. EMERGENT THEMES ASSOCIATED WITH OTHER FACTORS INFLUENCING HEALTHCARE EDUCATORS‘ DECISIONS TO REMAIN IN EDUCATION. RAW DATA ASSOCIATED WITH CONCLUSIONARY COMMENTS MADE BY HEALTHCARE EDUCATORS.

EMERGENT THEMES ASSOCIATED WITH CONCLUSIONARY COMMENTS MADE BY HEALTHCARE EDUCATORS. 289 xii LIST OF TABLES 2.1 Relationship between Research Questions and Causative Factors .1 Cross-sectional Representation of Healthcare Programs Included in Sample .2 Estimated Number of Study Participants .1 Estimated Number of Study Participants, Actual Survey Responses and Corresponding Percentages.2 Age Distribution of Survey Participants .3 Distribution of Survey Participants by Healthcare Program .4 Factors Influencing the Transition from Clinical Setting to Academic Setting .5 Chi Square Data Relating Age and Factors Influencing Decision to Transition into Healthcare Education .6 Chi Square Data Relating Highest Level of Education and Factors Influencing Decision to Transition into Healthcare Education .7 Chi Square Data Relating Years of Experience in Healthcare and Factors Influencing Decision to Transition into Healthcare Education .8 Conducive Factors in Preparing for a Position in Healthcare Education .9 Chi Square Data Relating Age and Conducive Factors in Preparing for a Position in Healthcare Education .10 Chi Square Data Relating Highest Level of Education and Conducive Factors in Preparing for a Position in Healthcare Education .11 Chi Square Data Relating Years of Experience in Healthcare Education and Conducive Factors in Preparing for a Position in Healthcare Education .12 Factors Hindering Transition into Healthcare Education .13 Chi Square Data Relating Age and Factors Hindering the Preparation for a Position in Healthcare Education .14 Chi Square Data Relating Highest Level of Education and Factors Hindering the Preparation for a Position in Healthcare Education .15 Chi Square Data Relating Years of Experience in Higher Education and Factors Hindering the Preparation for a Position in Healthcare Education .16 Factors Influencing Healthcare Educators to Remain in Education .17 Chi Square Data Relating Age and Factors Influencing Healthcare Educators to Remain in Education .18 Chi Square Data Relating Highest Level of Education and Factors Influencing Healthcare Educators to Remain in Education .19 Chi Square Data Relating Years of Experience in Healthcare Education and Factors Influencing Healthcare Educators to Remain in Education .20 Demonstrated Behaviors of Effective Healthcare Educators .1 Relationship between Research Questions, Causative Factors and Identified Strategies. 109 xiv LIST OF FIGURES 4.1 Distribution of survey participants based on highest level of education .2 Years of experience in healthcare education of survey participants. 41 xv CHAPTER 1 INTRODUCTION Background The difficulty that many healthcare programs experience in recruiting, developing, and retaining qualified healthcare educators is identified by a review of current literature.

In recent years, literature has documented a shortage of healthcare providers wishing to pursue careers in education (Dyson, Greene, & Fraher, 2004; Elwood, 2007; Giordano, 2004; Hilton, 2003; Lyons, 2007; Lyons, Lapin, & Young, 2003; MacKinnon & Leighton, 2002; Majeski, 2004; Morris, 2006; Trossman, 2002; United States Department of Health and Human Services, 2005). Additionally, the literature has identified factors which discourage healthcare providers from transitioning into academia. These include poor salaries offered in academia, lack of educational credentials, and the demands of the educational positions (Swafford & Legg, 2007). It was also documented that the current workforce of healthcare educators was aging (Trossman, 2002) and many current educators were nearing the age of retirement (Gonzalez, Stewart, & Robinson, 2003; Hilton, 2003; Morris, 2006).