September 2, 2020

Q:

So can you tell us about your career and what brought you to Adtalem and specifically in healthcare education?

A:

Sure. My background is probably nontraditional for this space or somebody in this role. I really have a background of helping to build both companies and new products and grow them. My work has been in consulting, some investment banking, some startup entrepreneurial work, but all really in the healthcare and financial services space. So I actually originally joined Adtalem as a board member about four years ago. And then just over two years ago, Lisa Wardell asked me to take on this role, responsible for medical and health care. I had become such a believer in the mission and the people at Adtalem and what was happening both across the organization, and also within our students, that it was an exciting opportunity I wanted to take on.

So we do bring a lot of scale as an organization, which allows us to both invest in our programs and our students, as well as really impact the supply demand gap that exists across the healthcare spectrum from veterinarians to the nursing and physician area.

Q:

What sets you all apart so that you're able to achieve that scale that you just mentioned?

A:

Well, there's a couple of things. I'll start with our model. Our mission from the beginning of the organization's founding has been to provide students access to education. And when you look at the healthcare vertical, all of our students are coming to us with a particular profession in mind. They are called to caregiving in a way that perhaps those of us who were finance majors or English majors were not quite. And our model is built for not only creating the access, but also for accelerating the timeline in which they will get to their profession. So we actually operate our schools year round. By that I don't mean we offer some summer school, we'll start a new class within that summer school.

What that does is that allows us to really invest in our faculty and our training and our programs in a way that perhaps the traditional higher ed model doesn't. We do not have the same type of faculty model. We don't have the same type of tenure or research model. It's not to say that we don't do research, and it's not to say that we don't reward and retain really high performing faculty members. It's just that our research is really around education, right? How do we do better medical education? How do we do better nursing education across the board?

So all four institutions are built on that kind of core approach about providing access, but then they're also measured singularly on student outcomes. At the end of the day, no one comes to an institution with the idea that they're not going to be successful. And what we really want to do is make sure that we've wrapped our students with all the right tools and techniques and programs and opportunities to ensure greater success for them. But also quite frankly, we measure ourselves in that from a student outcome perspective. And within health care, there's some very clear measures of success, right?

I mean, as you know, med students need to go to residency if they want to become practicing physicians. So our residency match rate is an extremely important measure of our success, a third party measure of our success in producing quality graduates. And so this year, as an example, Ross meds match rate is above the U.S. medical school average, which is fabulous. AUC is just at, or just below that national average. That's pretty great, especially when you consider just the sheer volume of students and the fact that this is a graduating class that has dealt with a fair amount of disruption as have many med students right now.

Chamberlain University is primarily known as a nursing school, although we also have public health and social work and a variety of other graduate programs. So they're measured on two things. One is an FNP pass rate where they have to take a national exam and the other is NCLEX, which is the licensure exam that all nurses have to take. We are at or above national averages on both of those this year. So, we really hold ourselves accountable to that. And that is one way that we can be sure as we continue to evolve our educational programs, that we're on the right track.

And the third really is focusing on this idea that we're trying to bridge the gap between supply and demand and meet the workforce needs. I like to call it, raise the bar, which is similar to raising the line, right? Our employer partners are actually part of our educational delivery because again, as you know, clinical training is an important part of all the degrees that we offer. And so we have an affiliate network, which is really a network of clinical locations that our students go to. And oftentimes those are locations where they'll go on to pursue their residency, or where they'll take full time employment. And working with those partners [crosstalk 00:06:55] what their evolving needs are what the evolving skills or competencies are that graduates need is one way that we keep our educational programs fresh and ready to produce the next generation of practitioners.

Q:

I know the last few years have been incredible for you with the hurricanes completely changing the location of RUSM from Dominica to Barbados, you probably have the most resilient faculty and students on the planet. Can you talk a bit more about first, how they adjusted when they had to even move locations. And now in the COVID environment, how about your students, as well as your clinical sites and faculty have adjusted to the pandemic?

A:

You know, the move from Dominica was not something that any of us were looking for. That really was a reflection of the damage wrought by a hurricane. Having said that, we found a great partner in Barbados and everyone in Barbados has been welcoming and from the Prime Minister through her cabinet, to the local community, and really have rallied around getting our students on island and getting our campus built and finding homes for them to live in, making sure they had access to all the things that they needed to make it their home. It's been an exciting, if not stressful process. It is certainly something that I think prepared us as an organization for COVID. We tested our own resiliency. We also learned about how to communicate with each other, how to work together under circumstances that no one would design on their own.

And I think how to lift each other up, right? Because there are good days and bad days, and all of us have to learn how to manage our stress and come back at it the next day. Again, I don't think any of us would have designed it as a training ground for COVID, but it turned out to be a good way for us to really tackle this challenge even more successfully. We had revised kind of all of our crisis management as a result of the hurricanes and put it to the test in COVID. So COVID has its own challenges because it's less acute, it's more chronic, than a hurricane. But if you look at all of us at our four institutions and you think about the pre-COVID time, so just January and February, we had 28,000 plus students who pursue post licensure degrees at Chamberlain University online.

And we have a long and rich history of doing that successfully. And that includes both the online delivery of learning and then also the coordination of clinical experiences. So it gave us an ability. We didn't have to reinvent anything when we got to this moment in time where we realized we were going to have to shift our students off of campuses.

At the same time, we have built a common technology platform. So all four institutions are on the same student management system, the same LMS, and the technology was there and fresh and ready to go for students who are on campus. So really starting on March 12th, our entire organization turns its attention to the idea that we were going to have to operate for some unknown period of online, kind of across the board. And our singular focus, both in the healthcare vertical, as well as in our financial services space was continuation of student education, making sure that we didn't have disruption, and that we kept our eye on maintaining student outcomes. And so we really kind of quickly turned towards what do we need to do to take our campuses from face to face to online and that involved a wide variety of things.

First, faculty had to think about how they were going to deliver their content using technology that they didn't use on a regular basis. We leveraged training that Chamberlain had for their faculty to teach online, and we leverage that across the vertical. And we helped, I say we in the royal sense, because I certainly was not the beholder of this, but we really helped faculty convert, and in many cases they flipped their classroom, meaning recording lectures and then holding smaller face-to-face dialogue during class time. This was extremely valuable in that we really generated a tremendous amount of data from our students in terms of helping us understand how we can deliver going forward.

But at the same time, because we have the scale you mentioned earlier, and we have these four institutions, we were really able to problem solve across them. If there were two different options, we could test them in different places and then leverage that learning, which was extremely valuable. So for instance, as our medical school students had to leave their clinical rotations, as all med students did for a period of time, we actually had the opportunity and took advantage of it using some of the Chamberlain public health degree content repurposed, and that faculty to deliver some public health electives to our medical school students. Our medical schools also partnered with some of their clinical affiliates to create online learning again in the elective space. I think everybody was pleased with how that went. We did it a short period, it went well. I think that's really actually a strong endorsement of our model as a whole.

And then finally we added tools and content that we perhaps were considering pre COVID, but we needed right then and there, and other things that we weren't considering pre COVID. We needed to proctor exams. We didn't do that pre-COVID for our campus based students. We needed some type of virtual reality, some online lab experiences. We put those things in place. We will absolutely be using those. All of this from my perspective, really did accelerate our learning as educators, but then also continued the learning of our students. So we're pretty excited about where we stand, but I'll also say we're not done. We have more to learn.

I mentioned earlier some of the data that we've gathered as a result of being online. You can see students signing in, you can see when students sign off, you can see what they're engaged in. You can see what tools they're using. And now we have the ability to go back and say, well, how did they do in this summer semester? And are there patterns there that we can share with students on an ongoing basis, that'll help them be better and help them retain more. And how can that be shared with our faculty to make them better and help them deliver more?

So we're excited about it. I won't say, again, anything we would have rooted for, but we're seeing opportunity for our own improvement and for our students' success to come out of this environment.

Q:

There's this Andy Grove quote that you've probably heard of, which is that "Bad companies are destroyed by crisis. Good companies survive them, but great companies are improved and actually thrive because of them." And it sounds based on what you're describing that you all fall in the latter category.

A:

That is certainly what we're holding ourselves accountable to. Out of any type of crisis comes the opportunity for improvement and success. From the beginning, we've been talking about it in that way. At the same time, we're trying really hard to acknowledge the grieving that all of us are going through about the change, right? We had students who graduated without big graduation events, although the teams put together fabulous virtual graduations, we have folks who are not physically where they thought they would be. Luckily we have all of our students who matched the week after COVID, we really had to go remote, are able to get to their residencies and they're having very different experiences. So we all, as people are grieving a loss of what is normal, but taking advantage of the opportunity to make ourselves better in the processes is what we need to do as an organization. And I think we're on that track.

Q:

Do you think that because of COVID, fast forward, six months, 12 months, do you think there'll be more people who are interested in going into healthcare careers or do you think there'll be less? Like people are scared away from these professions?

A:

I think there's no doubt that there'll be people who are made nervous by this., everyone should be aware of the change that this brings. But my observation is that people who are called to caregiver roles are really called to it, that they feel a passion for it. And we've seen just in our own institutions, higher demand, more interest, more inquiries, what's going on? How can I do this? How are you delivering? Can I become a nurse in this environment?

Having said that, I do think over time it may shake out differently. I think that the folks who are caregivers today, especially within areas where we've had significant spikes and we've had dramatic challenges within the hospital settings in terms of capacity, we're going to see burnout in ways that we probably wouldn't have seen previously. You know, they're doing more years of work in one year than probably any of us would have anticipated. So it's going to change the dynamic. I think it's going to exacerbate the gap between supply and demand. But from my perspective, it's going to be more on the folks who are in the space today and who are perhaps closer to retirement who are thinking, well, maybe I'm going to accelerate that, than it is going to be slowing the folks who are saying, I'm called to do this. I want to do this. And there's even more reason now to do that.

The team put together a fabulous website called Care For Caregivers, and it's become a wonderfully curated series of stories about folks who were on the front line and how they see it and what they're doing and what they're experiencing and how they're supporting each other. It's grown beyond any of our wildest imaginations, and I think it's because it does speak to the fact that caregivers are called to what they're doing. And they train long and hard to be doing it. And delivering high quality care for their patients is fundamentally why they're in it. And I don't think this changes that.

Q:

I think one of the things we're hearing about and seeing is that people who are in these professions are celebrated by society more than they were before. And my hope is that that's going to lead to some policy wide changes of why not subsidize more of them for their education, if they're going to go through it and then devote their life to fighting pandemics, like COVID. I think that's definitely something we'd like to see more scalable and cheaper models like you guys have been pursuing. Do you have any advice for people who are considering careers in healthcare at this point?

A:

It's raised the visibility of caregivers. Any of us who've had family events or had exposure to the need have a lasting respect for caregivers. I think this has changed the awareness factor. My advice for folks who are going into healthcare is probably not that much different than my advice to anyone who is entering a new profession, which is bring your passion to your work every day, expect that there are going to be great days and they're going to be tough days and it may be tough weeks, but take care of yourself, go home, get rest. Do as my father used to say, get a good night's sleep and wake up in the morning and do it again, take that mountain one way or the other. But I'd also say that I think this is probably one of the most interesting and dynamic times to enter this space.

Healthcare is always changing and I was drawn to healthcare because it was changing so much. And it was so interesting and there was the opportunity to make that change happen. And now is the time for that as well. At the same time, I think they really need to embrace the core of what drew them to this, which is patient care and really kind of that one-on-one impact. I do believe we will continue to learn and that our healthcare providers, not just providers, but people who are in healthcare, whether that be via public health or social work or administration or enthusiastic participants in that change, because it's complicated and it's going to take a while, but I think we have an opportunity to really make positive change.

Q:

Is there anything else that we should have asked you that you'd like to be able to leave our audience?

A:

The one thing I will add it comes back down to what we see as our mission at Adtalem. And it's an evolution of our strategy, right? We've always been at our core educators and we've always been at our core driven by the value that education brings. I hope that as we continue to see this change, that we don't lose sight of that core value. Because there's a lot of disruption coming to education as a result of COVID, right? There's going to be a lot of tough decisions people are going to have to make in higher ed and K through 12. But education is really fundamental to how we move forward as a society. And I hope that we take the opportunity now to improve. Maybe it's not a blank sheet of paper, but we have the opportunity to make change now and in fundamental ways and do it rapidly because of the disruption. So my hope is that we come out on the other side collectively in a better place than we are today.