The Educator Externship: A Cross-Sector Collaboration to Support Health Academy Educators Prepare Aspiring Nursing Students

The Healthcare Sector Partnership (henceforth: the Partnership) is a collaborative effort between the Healthcare Association of Hawai‘i, the Chamber of Commerce Hawai‘i, and leaders in the Hawai‘i health care community, including the University of Hawai‘i at Mānoa (UHM) Nancy Atmospera-Walch School of Nursing (NAWSON). The Partnership works closely to develop a cohesive approach that aligns and expands statewide efforts to build the health care workforce. This approach includes impactful career exposure, technical career preparation, and support for future employment and career advancement.¹

The Partnership seeks to build a strong local talent pipeline for health care careers in Hawai‘i. Fortunately, high school students can choose to participate in programs called Health Academies to help meet current workforce needs. Health Academies are multi-year high school programs that prepare students to be workforce-ready before or upon graduation and able to pursue post-secondary studies in health services. Students can gain the knowledge and understanding needed to determine their career interests through specialty tracks (eg, certified nursing assistant (CNA), certified pharmacy technician, certified medical assistant), field trips, class projects, mentoring, and work-study.

Nursing is one of the highest health care needs in Hawai‘i, with approximately 1000 open registered nurses (RN) positions in 2022.² Looking more broadly than reported vacancy rates, the US Health Resources and Services Administration approximates a 30% deficit in RNs needed to meet current health care demand in Hawai‘i in 2024.³ Fortunately, many students in a Health Academy CNA track also want to continue their education to become RNs.

Nursing school applications are competitive. Despite declining enrollment, recent national data show that over 55 000 qualified applications were turned away from entry-level baccalaureate programs.⁴ In Hawai‘i, admission into the bachelor of science in nursing degree progam at UHM is the most competitive in the state.^5,6 Therefore, high school students who know they are interested in nursing or other health sciences should prepare early and seek extracurricular learning experiences and internships. Through the Partnership, the Chamber of Commerce Hawai‘i learned of opportunities to engage with and support Health Academy educators and developed the Educator Externship.

Educator Externship

Through the Partnership, the Chamber of Commerce Hawai‘i learned of opportunities to engage with and support Health Academy educators and developed the Educator Externship. The Educator Externship is an educational workshop aimed at helping high school educators better understand various health professional roles to effectively advise students about advancing their education in the health sciences. For example, one component of the Educator Externship involves visiting clinical and university locations to learn about the organization/institution and different health care roles. The Chamber of Commerce Hawai‘i has partnered with 3 organizations to provide Educator Externship experiences: Adventist Health Castle Medical Center, Diagnostic Laboratory Services, and, most recently, UHM NAWSON.

Through conversations within the Partnership, high school educators voiced the need for additional knowledge and skills to teach their students about the nursing profession and how to prepare students to enter bachelor of science programs in nursing. In response, UHM nursing faculty volunteered to help. The first Educator Externship was held in the fall of 2023, with 26 Health Academy educators from Admiral Arthur W. Radford, W.R. Farrington, Kapolei, Mililani, Nanakuli, Pearl City, Waianae, and Waipahu High Schools. The Educator Externship curriculum was informed by a needs assessment from the target educators and areas identified by the NAWSON faculty as deficits observed in incoming students. The curriculum of the 4-hour Educator Externship included:

• Admission criteria for various programs and entry points

• Comparison of various program pathways

• Guidance for advising students about college life, time management, and program rigors

• Review of national models for nursing clinical judgment and decision-making and relevance for nursing practice

• Preparation tips for learning anatomy and physiology

• Tour of the school’s Translational Health Science Simulation Center (THSSC) and hands-on engagement in a clinical simulation scenario

• Talk story with current nursing students panel

This Educator Externship was evaluated following its completion to understand if the program’s goals were met and to solicit feedback on what went well and what other topics were of interest to educators. On the evaluation, participants indicated that they wanted more information on admission criteria for nursing, perspectives on competitive applications, timelines (how early to engage students), high school curriculum development tips, academic rigor, and how to make a student a stronger candidate. A second Educator Externship was developed based on these identified needs. The second Educator Externship occurred in the spring of 2024 with 12 attendees, who were a subset of the original 26 attendees. The curriculum of the second 3-hour Educator Externship included:

• Discussion on admission criteria for various entry into nursing programs and advice from admissions counselors on best practices for mentoring students in the application process

• Bidirectional sharing and idea generation between NAWSON faculty and high school educators so that the faculty can further understand the high school programming and priorities and generate ideas for future priorities and curriculum

• Discussion of tips for how high school Health Academy educators can help students, including communication skills, resiliency, team-based learning, and skills practice

Feedback from Stakeholders

The final evaluation following both Educator Externships showed them to be helpful and informative for the high school educators. Respondents provided more ideas for future offerings, including information about graduate education, best practices for working during college, financial aid, student support options, group time to network and share tactics for teaching nursing so that they can learn from one another, how educators can interact with current nursing students, and simulation equipment recommendations. Additional qualitative feedback included: “[The Educator Externship gave] educators impactful ways to learn from health care professionals and prepare their students for future success in Hawai‘i’s health care workforce. Through the Partnership, the health care industry is coming together to collaborate on workforce development efforts that build a local, skilled health care workforce,” and “[the Educator Externship helped to] share perspectives, clarify misconceptions, and build stronger connections within the educational community. This initiative will help create a more cohesive, seamless, and supportive learning environment.” Finally, a nursing student panelist stated: “[the Educator Externship will help educators] guide high school students to consider nursing, allowing them to make informed decisions about pursuing a career in the field… So, I hope that the information I was able to share will positively impact the prospective students who will follow in our footsteps.”

Conclusion

As the flagship state school in Hawai‘i, the importance and value of partnering with the community to benefit our residents cannot be overstated. We must all work together toward the common goal of meeting the state’s nursing workforce needs. The ongoing collaboration between the UHM NAWSON and the Partnership to provide the Educator Externship will benefit educators, students, and the community. Educator Externships will continue in the 2024–2025 academic year, with plans to expand to include guidance counselors and middle-school educators. Curriculum content will continue to be honed and developed to meet the evolving needs of educators and the next generation of students.