Diversity a key goal of healthcare education programs in Rochester

Local healthcare education programs make inroads on diversity.

When it comes to diversity in higher education programs for healthcare, two local institutions have made the grade nationally.

Insight into Diversity magazine gives awards each year to the higher education institutions across the country with the best track records for diversity in their professional healthcare programs. While the University of Rochester’s School of Nursing has won this award for some years running, this year the UR School of Medicine and Dentistry won for the first time, and the College at Brockport’s School of Nursing won for the first time, too.

These three programs were among the 43 nationally that won Healthcare Professions Higher Education Excellence in Diversity (HEED for short) awards from the magazine.

(Insights into Diversity also offers a general diversity award for higher education institutions, and Rochester Institute of Technology was one of 96 winners of that award.)

The awards reflect an institutional commitment to diversity that has been building for years or has recently been amplified. In some cases, the programs feature diversity initiatives similar to those at other schools, including some in the Rochester area, but it appears that a cumulative effort put them over the top.

UR “has been committed to increasing our diversity pool and our outreach for decades,” said Adrienne Morgan, assistant dean for medical education, diversity and inclusion at the UR School of Medicine and Dentistry.

For example, Morgan described a grant program UR participates in that starts recruiting minority and low-income students to science and health majors starting in middle school, with four-week summer intensives.

“That’s where you’re really starting to build your foundation, academically,” Morgan said. “It’s a great entry point for students to begin, hone their skills (and) understand what’s needed to be a researcher, physician, physician assistant (or) nurse practitioner.” While students as young as middle school know about doctors and nurses, they may not be familiar with some of the other professions within healthcare, she said.

It’s important to reach students that young, noted Margaret Kaminsky, dean of STEM and health at Monroe Community College, which also participates in the Science and Technology Entry Program that Morgan described.

“Choices made in middle school are going to determine how far a student can get in math and science through high school,” Kaminsky said. If a student doesn’t take accelerated math at the middle school level, that may prevent them for taking higher math, chemistry and physics later on, all prerequisites to healthcare degree programs.

Morgan recalled one STEP student at UR who shared that the program helped him realize how much he’d have to up his game academically to reach his newly formed goals. He went on to get a science degree in college and a job with NASA. He’s now pursuing a doctorate in a science field outside of medicine.

“Everybody who does the program isn’t necessarily going to enter the medical field,” Morgan said. “But everything they learn can be used in other professions as well.”

UR follows up with a research internship program for high school students that includes shadowing emergency room professionals, group journaling exercises, work in anatomy labs and other opportunities.

“We try to make them understand the steps they’ll need” to purse a degree in healthcare, Morgan said. “Many students who do the (summer) program end up being our students.”

Three key programs at the College at Brockport that helped the nursing program win diversity kudos:

• Conducting an annual poverty simulation for students, an exercise in which participants are given a limited amount of income and resources and must use them to obtain basic needs in a prescribed amount of time.
• Reverse role-playing with deaf actors. Nursing students play the patients who cannot use spoken language to communicate, and deaf actors and sign language interpreters play the caregiving roles. (Similar exercises are conducted at other local schools.)
• Two-week clinical intensives in Costa Rica and Peru during school vacations, allowing students opportunities to study abroad and experience a different culture that their schedules would normally prevent.

All of these programs help sheltered students learn about different perspectives. Of the clinics abroad, Kathy Peterson, chairwoman of the nursing department at Brockport, said, “It really has changed more of their outlook on life, and what we have. It’s been life changing for many of them, and for our faculty.”

Students participating in the role-playing exercise really begin to empathize with the Rochester area’s deaf population, she said, and the poverty simulation teaches them how much hard work it takes to live in poverty.

Brockport, UR and MCC all described a somewhat diverse population of students, with an increasing number of male students entering nursing programs over the last couple of decades. Morgan said UR’s medical school and even nursing school generations ago used to attract mostly well-to-do students

“People are coming from all walks of life now to medicine,” Morgan said. “It’s not like it’s the family business anymore.”

Peterson said Brockport has always attracted more of a middle-class student body, but when she started teaching there 35 years ago, the freshman nursing class typically would have been comprised of 60 white female students.  Today’s class of pre-licensure nursing students at Brockport is about 14.6 percent minority and 16.2 percent male.

MCC’s Kaminsky didn’t have similar figures at her fingertips, but she noted that for some years when she taught basic chemistry, a prerequisite for healthcare majors, about half the students were minorities.

Keeping a diverse student body in school long enough to graduate can be a challenge because of income differences or other barriers.

“We have found — and this is national — that we do lose a higher proportion of our diverse students than our white students,” Peterson said. “We are actively looking at that and trying to support those diverse students with more engagement and more assistance.”

MCC participates in another grant program that provides funding for special programs for diverse healthcare students such as mentoring. It even offers small grants that can help them with expenses that could be roadblocks to their success. Kaminsky said she has approved grants for the $800 textbook that radiology technology students need and even for as little as $10 for printing so a student could print out course materials.

The growing number of healthcare students who are not white and female might find their gender or ethnicity presents an issue for patients.

Philip Phommala, a nursing student at MCC who is Laotian-American, said he hasn’t experienced racial discrimination, but he has been asked to switch out with a female nursing student when working with some patients. It’s usually the patient’s family members, rather than the patient themselves, that makes the request, he said.

“I try not to take it too hard. I do expect to have that happen from time to time,” Phommala said.

A men’s league for male nursing students at MCC provides a place for him to talk over issues like that.

Kaminsky, who has only been the dean over healthcare programs at MCC since August, said she has observed instructors tell students these issues are likely to come up in the context of sensitive issues, such as changing a catheter, and students should be prepared for it, and include a second nurse in the room.

And Peterson has heard reports — albeit rare — including a male cancer patient who didn’t want to be cared for by a male nursing student because he assumed male nurses would be homosexual. Yet she also heard a report from the maternity unit where both mother and father wore confederate flag clothing yet didn’t raise an issue with a black student nurse or black nursing instructor who attended them.

UR includes discussions about patient push-back in its classes, Morgan said, as such events can take a toll on students and professionals in the field, causing what she called “moral distress” over time. They practice coming up with responses to such patient requests, she said.

“Depending on who you are, it can happen on a daily basis,” Morgan said.  Whether hospitals should comply, and in what circumstances, with patient’s objections to being treated by healthcare professionals of different demographics is part of an ongoing national discussion, she said.

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