As I travel to different Career and Technical Education (CTE) health science programs around the country, I hear many questions from health science educators. At AES, while we like to answer as many questions as we can, sometimes it’s better to have an expert share their thoughts.
Phyllis Johnson and Cindy Le Coq at the 2017 NCHSE Board Meeting
I had the chance to interview Cindy Le Coq from the National Consortium for Health Science Education (NCHSE) in order to address some of these questions. Cindy is the Chair of NCHSE and also the Chair of the Assessment Committee within NCHSE. She has been involved in teaching and leading health science education over the last 25 years.
She brings a wealth of experience and lessons about delivering high quality health science programs that address national standards and prepare all students for success in the health care field. Cindy offers a perspective from teaching for many years at the post-secondary level. In addition, she has been deeply involved in secondary health science programs through interfacing with teachers and CTE leaders across more than 20 states.
Cindy has a passion for health science, and strong feelings about how to provide guidance and help new secondary health science teachers trying to survive their first couple of years after coming in from industry. Her expertise in the mission and values of NCHSE along with challenges and issues facing secondary Health Science teachers across the US, signify her as a valuable resource.
Along those lines, I would like to introduce the readers of the AES blog to Cindy Le Coq and have her share some of her insight and expertise:
Jim: I wanted you to give the readers of the AES blog an introduction of yourself.
Cindy: My background is post-secondary. I was responsible for the largest and oldest radiography technology program in the state of Colorado for the Community College of Denver. I got lured over to the “dark side” of the community college system, and was placed in charge of all health science programs, both post-secondary in the community colleges and colleges, and in secondary.
I have to be honest, I'm of the age that I had never heard of HOSA, because it was organized after I graduated from college. I knew nothing of secondary health science programs. I was in charge of criminal justice, public safety, and the Alternative Education for At-Risk and Special Needs Students.
So, I had a lot on my plate, and a huge learning curve to find out about the secondary CTE health science programs: how rigorous they were; how they prepare the students for post-secondary health science programs; or how students actually got to know that maybe health science wasn't what they thought it was.
Because of my post-secondary experience and networking, I was able to unite the two, secondary and post-secondary, health science programs for a dynamite content team so that all community colleges could be aware of what was happening in the high school. So, that in a nutshell is my background.
Jim: A lot of times in my travels, people are not familiar with NCHSE, at the secondary level in some states, or certainly down to the school level, they're really not familiar with it.
If someone asked you, "Hey, what do you guys do? What is it? What's the mission? What's the purpose?" How would you answer a secondary CTE health science teacher or a CTE director if they asked that question?
Cindy: It's a good question, because I didn't know anything about NCHSE. The mission is really to provide leadership and professional development for all health science education, and so it is the national organization for all health science, but mostly concentrating on secondary health science.
It also provides health care industry liaisons and some collaboration, and keeps in tune with the policy makers, namely the Advance CTE group, which is your CTE state directors, and ACTE - That's what we call it in Colorado, ACTE - who makes the policy.
The mission is to provide that leadership, because as you're already aware, in health science we don't produce health science educators. We fill them from business and industry, and that's where I came from. So, it's really not only to provide the leadership, but the guidance to help those new health science secondary teachers survive the first three years, with resources, how-tos, and who to contact when you have a question.
Jim: In the last 60 days, I've visited more than 10 health science programs. It won't come as a surprise to you - probably 20 teachers, and every single one was an RN, came from industry, and then they got into teaching. They'll tell you the first couple years… they were not prepared for it.
They're subject matter experts. However, they don't have the classroom management experience or even know how to develop lesson plans or develop curriculum correlations. That's a real challenge for them. Can you provide insight?
Cindy: I'll say about that, its language. I know that when I came from business and industry, what I considered a standard and a competency was business-related compared to the education definition that was standard and competency. So, there was this language issue that you have to jump through when you first come from business and industry. Now, anybody that survives the first three years, it's hard.
Jim: Let's dive into the difference between industry and education terminology. Talk about maybe a specific example there and talk about your experience or what you know? What does it it looks like when you make the jump from industry to teaching?
Cindy: I'll use the reference of rad tech [radiography technician], so that when you talk about a standard, it is being competent to produce an X-ray of high quality for diagnostic reading. When you talk about a competency, it's actually a process in the X-ray procedure. It is all work-related.
When you say, "Okay, I've met these competencies," it means that the X-ray student has actually performed and demonstrated competence of high-quality X-ray imaging on X-ray procedures and knowledge of anatomy, physiology, and physics; so, they meet that standard.
When you get into the educational realm, it then turns into the pedagogy of education, and the standards are more finite as far as your educational learning, your theory. So, I guess I would say in essence, "One is actual practice-oriented and one is theory."
Jim: When we talk about the benefit of NCHSE, what would you say to a CTE director or a district specialist who doesn't have a background in health science? What would you talk about as far as the benefits for NCHSE to an administrator who doesn't have a background like a teacher?
Cindy: What I would say probably top of the list is that NCHSE provides the guidance for high-quality CTE programs… so how actually to put a high-quality CTE program together, and what the components of that health science program should look like so it would be following that career pathway framework.
So, any CTE director, when they're managing all those different clusters, that's the line, that's the vision for CTE in the next 10-15 years, is this career pathway. NCHSE would be able to provide the framework, of actually what a health science CTE program would look like, and how it would be measured.
CTE directors are responsible for being accountable for all their CTE programs. So, not only do we provide the framework, but we have ways that you can show that we meet those high-quality measurements.
Jim: How does a CTE director, from your point of view, ensure that health science teachers are covering the standards?
Cindy: Well, I'll say right away that, if it's a true, complete health science program, we offer through NCHSE what's called the National Health Science Assessment. It is based on all 11 foundational standards. The National Health Science Standards are foundational to all secondary and all post-secondary health science programs; so it doesn't even matter if they're secondary or post-secondary. It's foundational.
When they take the assessment, we can do a direct report-out on how the students perform per standard. So, if you looked at our standards, you would see, of course, your academic foundation. That's your anatomy and physiology. You would see your legal and ethical. You would see your employability skills, teamwork.
You would be able to see how the student performs on every one. So, not only does it measure what the teacher is covering, and if they are covering all those standards, but it also informs the classroom so that teacher can look at the data and adjust their curriculum and their teaching if they have a low score on one of the standards. So, we have a direct report-out.
We also offer a pre- and post-test so that you can measure student growth. When you're talking measures to a CTE director, it directly correlates to: Have the students been exposed to all 11 foundational standards? Are they minimally competent in each standard?
It informs not only the students on what their learning is; it informs the classroom. So, it informs the instructor where they're really nailing it and where they maybe skipped over.
Jim: How do you explain the difference? In my mind, there is a big difference, but I'd like to hear you explain it: Foundational standards, those measures you just talked about, versus certifications that the students have to pass.
Cindy: They're completely different. Again, it goes back to theory versus professional practice. That certification is a right to work, and so that actually speaks to business and industry for those right-to-work certifications. An example would be a nurse aide. When they achieve the certification - that's where the word CNA comes from, because it's a certified nurse assistant - they are deemed competent to actually work with patients and perform some medical procedures.
That is a right to work, whereas a certificate, or a foundation standard, is knowledge-based. It is foundational, but it's more knowledge-based. It does have technical skills in there, so it does address technical skills, but it addresses far more than just the right to work. It's very knowledge-based.
Jim: You really need both of those. It's not one or the other.
Cindy: Correct. I'd like to also say, it's health science ... This is what you're going to run into nationally. When you talk about career pathways, and you talk about certifications ... I'm going to say two things, Jim. When I went to the Advance CTE meeting ... I've been to many, because I was also Interim CTE Director for the state of Colorado twice, and what I walked away with is there was no acceptance of any national certification for any of the career clusters.
It was a huge takeaway, because I always think there is some nationally recognized certification. You know what? No. There's over 4,000 credentialing or certification organizations across the nation, and there's just no unity. So, what we're talking about is documentation of skills and learning. That's our National Health Science Standards, so that does document learning. Then that certification also documents learning, but it's more on the practical right to work.
The bugaboo with health science compared to the other career clusters is, with health science, you're dealing with patients and you're dealing with real situations where you could help a patient or harm a patient. So in many secondary programs, there are no certifications while they're in high school. They need to be over 18 and they need to be mature.
Jim: What do you say to a state health science leader or the state health science leadership that's currently not involved in NCHSE? How does that conversation go? What do you talk about as far as the reasons a state should consider joining NCHSE?
Cindy: Well, I'll say some factual and then I'll say some anecdotal. The factual is, for the state health science leadership, it gives you access to best practices for you to share with your high school programs. I would say NCHSE is that liaison from what's happening on a national level to break it down into your state level.
What is very evident to me, serving both as a CTE Director for health science and as a CTE Interim Director for all of the career clusters, there was a lot of conversation lost between the national vision and your actual state’s vision.
A lot of times at the state you're just focused on your state and you don't see beyond it; so, it brings that national trend and what's coming down the pike to the forefront so that you can guide your vision and your efforts towards that national trend. It also lends you into the ... We have, as you're aware, the Publishers/Resources Coalition; so, it gives you access.
I came from post-secondary. It was just like, "I have no idea what a good technical school, what's out there on the secondary level. I'm completely lost." So, that Publishers/Resources Coalition is huge. Boy, they're so responsive to whatever your needs are. It's just amazing.
As a member, it gives you access to the assessments at a cheaper cost. It all comes down to funding, so that if you can get these assessments at a much cheaper cost ... Here's the other difference, Jim, between certifications and our certificate, or the Health Science Assessment: certifications are a lot of money. Again, funding, it rules the world.
I did surveys when I first came to the system office, because I needed to go up that learning curve. The only health science programs we had in Colorado were the nurse aide programs. That was it. It was called Med Prep, and it was either Med Prep or nothing. If a student was interested in nurse aide, great; if they weren't, they were up the creek. When I looked into how many students out of all those CTE students in health science actually took the certification exam, it was less than 10%. Then the pass rate I don't even want to go into.
Anecdotally, what it did ... I came back to the system office after joining NCHSE, and after my first meeting. I knew what we were doing direction-wise for the Colorado state as a whole, but I had all this stuff on what was happening on the national level, and I'm very competitive. I was like, "Whoa. Colorado's behind the 8-ball."
So, I went and referenced the Perkins Law. I made a proposal for funding, citing specific parts of the Perkins Law to ask for funding to do some of the initiatives that I learned through being a NCHSE member. Everybody thought I was brilliant. I was just copying and stealing, but I wasn't going to tell them that.
Plus I had that post-secondary piece of my brain. We went from Med Prep to all over the board. Our health science offerings exploded.
Jim: What in your opinion is the biggest obstacle that would prevent a state from joining NCHSE at this point?
Cindy: I would say the biggest obstacle ... Some would say "funding"; but, honestly, when you present the membership of NCHSE and say, "But it covers travel and hotel to the annual board meeting,” I don't think even the funding for the membership is an issue, because Perkins covers it.
I would say the biggest hurdle is what you spoke to, and that's the awareness of what NCHSE is. Because teachers come from business and industry, I didn't know about NCHSE for at least the first three years I was at the system office, had no idea.
So, I would say it's awareness factor and actually conveying what NCHSE brings to you, and just having that concept, that conceptual vision in your head. Until you go, you have no idea how great it is. So, yeah, it's conveying that message.
Jim: How do you reconcile, if you actually talk to a state person, and they say something like this: "Oh, well, we already have our state standards for our health science courses, and that's what we're using"?
Cindy: I would ask them for more clarification, because, again, we're using the word 'standard' so broadly. You would have to ask for more information. "Okay, show me your state standards. Are you speaking to academic standards? Are you speaking to CTE standards? Are you speaking to business and industry workplace standards?"
What I've found ... Gosh, the glory of education in the United States. It's all about that. "Nobody else is like my program" and it has to be all about...
Jim: Does it also go back to what you talked about previously… a really, high-quality program, and from an accountability standpoint, the CTE director is going to be measured on each one of the 16 pathways, as far as the quality of it?
Cindy: Yeah. The other advantage for the teacher, or the state health science program director, or the CTE director is that ... The variances are not going to go away for a long time. I'm going to be long dead but, we have this National End-of-Program Health Science Assessment that covers all 11 foundational standards.
Well, we know some health science programs are one semester, two semesters, two years. It can be emphasized just concentrating on sports medicine. You've got to really tickle that high school student's interest to even get them into health science, and so it might just be sports medicine.
We are now offering what we call Content-Specific/End-of-Course Assessments that'll be stackable so that they can stack and lead to that End-of-Program Health Science Assessment, so that NCHSE will bring to the table an assessment for measuring quality, covering standards from whatever your program looks like.
Jim: We talked earlier about the biggest problem that you saw with secondary health science instructors, and that was making the jump from industry to teaching. Can you think of another problem besides that that you've seen a challenge for secondary health science instructors having success?
Cindy: Oh, yeah. One, of course, is money. In business and industry, you make a lot of money. Everybody says, "You were a rad tech?" I was like, "Yeah. I had a two-year wait to get into nursing school, so I went through X-ray instead, and I made more money!"
You make a lot of money, and so it's one of the career clusters that, with an associate degree, makes a lot of money. So, even luring a really good business and industry person to become an instructor, that's the first step.
I'll tell you, anecdotally, the second step that I saw not only with myself, but with many - This is post-secondary, but it's also secondary teachers - is when you practice in the business and industry world, you work... I'm just going to use the 7 to 3:30 shift… 7 to 3:30, and you left, and you were done for the day, and you went and did what you wanted.
What business and industry turned educators, health science educators, I'll tell you, the big burnout is, you don't get to turn it off when you leave the classroom and turn off the light. You're grading papers... Especially in the first three years, you're working on your curriculum, and your lesson plans, et cetera. It's 24/7.
Then the third thing I will say ... again, this is anecdotally, and I'll speak from Cindy Le Coq's perspective and post-secondary ... is on a secondary level, again, you're dealing with patients, and it's always about the safety of the patient, so that when you have a student in a work situation, work-based learning, so they're in a clinic, hospital, doctor's office, whatever it might be, that patient’s safety is key. If there's any behavior or any poor working attitude or situation… that student's gone in the post-secondary. You're gone. You have a contract. You have what I would call a student handbook, very, very clearly outlined policies and procedures.
In secondary, it's a whole other ball game. I mean, in post-secondary you can't even miss a day. If you miss a day, to have the same clinical experience as all the other students and the number of clinical hours, you make it up. In high school, you can not show up, you can be of poor character or immature, and you don't get kicked out of the program.
If you come from business and industry and you're dealing with secondary, it's just like, "Oh, my goodness," because you'll have a principal. You'll say, "No, no, you're not going back. You're not going back into that situation. It's a danger to the patient." Then you have the principal calling you and saying, "The parents called me, and you will put that student back in that situation." It's a bugaboo in many ways.
Jim: You talked about this at the annual meeting, and I wanted you to talk about what trends to you see in the future regarding secondary health science programs?
Cindy: There's a couple key trends. One is competency-based education. I think that it's going to go down that line -- I'm hoping, again, before I die -- but competency-based. I actually took the time and went through my last couple of meetings with Advance CTE. I always do a report on what bubbles up, what are my takeaways. Competency-based education was a bubble-up of concurrent enrollment, which, again, the competency-based education plays into.
Jim, when you talk about the certification versus certificates, I'm sure you, as you go across the United States, run into badging. It's all one and the same. It's all documentation of actual, authentic student learning. So, that to me is one of the number one trends that you're going to see. It's for all students, so I see the national trend.
CTE was always separate from academics. What I'm seeing is a national trend ... This is a Cindy Le Coq opinion, this is not Advance CTE. This has really been true even in my age, but it's been recognized, finally, that the student has to have a relationship. They have to have a reason for why they're learning something. When you talk about algebra, my algebra sucked until I went into X-ray, and then I could do algebraic equations in my brain, but it was because I applied it. It made sense.
So, the trend that I think we're going to see, but nobody really talks about... Well, they talk about it. You're going to see a blending of academic and CTE together. It's already happening. When you talk about your state standards, we've already cross-walked the foundational standards with academic standards, because to me that's going to be a trend.
The other ones, of course, that you've already heard about are the stackable certificates, the shared language. Perkins is really, really emphasizing the authentic work-based learning and the collaboration with business and industry. That's a huge trend.
Jim: In talking at the secondary health science, do you see a trend where we're pushing it down to the middle school level for pre-medical or pre-health science to get more students exposed to that pathway? Do you see that as a trend, or is that still really a niche with just a couple states?
Cindy: It's a trend. It's not a strong trend. That's going to take a while. That's the hardest thing for me ... Somebody said, "Cindy, you don't have any patience" ... because education rolls so slowly. I'm going to tell you, Jim, it's a trend. It's going to be a slow trend, because, again, health science does not go down to the middle school level as well. It'd be purely exploratory.
When you look at middle school, it's really their interests. So, they do a lot of interest surveys, and not only interests, but what their strengths are, because when you're in junior high... Gah, you don't even know who you are. So, if someone said, "Well, what are your strengths?" they would say, "Uh, sheesh, I don't know. I'm friendly?"
I see on the junior high level exploratory and self-awareness: Where are your interests, your joys, and where ... You have no idea, but you can have strengths at the middle school level. Health science is going to be your hardest, because, again, when you talk about a qualified instructor on the middle school level, we have a lot more hurdles, but that'll happen eventually.
Jim: Now if you can tell us a little bit more about the idea for a national health science teacher organization? Where it is right now; and what is the vision for the organization?
Cindy: It's huge. Again, coming from the post-secondary, when your post-secondary, you're very career-specific; so, all my professional development and my organizations were rad tech-oriented, because, in order to renew my registry, I had to do so much continuing ed. It had to be directed only in radiology.
On the secondary side, there's nothing. You talk about a void. There is nothing for health science teachers of any kind. The Consortium, NCHSE, has already been providing professional development and already provides an every-two-year conference for health science teachers, and it's pure health science. I mean, teachers can't get enough of it.
Again, there's an awareness problem. We haven't grown that curriculum conference since its inception. If you look at every evaluation that we ever received from that curriculum conference, it's stellar. It's 4.5 or higher on a 5-point scale. So, it would bring something. There's a void.
We have the every-two-year curriculum conference, and on the opposing year we have the Institute for Educational Excellence. It's where each state chooses two exceptional health science teachers, and hopefully sponsors them, to attend this special two-and-a-half day conference - I'll call it a 'conference,' but it's this institute - where they get the latest and best teaching strategies, classroom management, top-notch, and it's very individually geared.
The Consortium, NCHSE, cannot afford it. It made us go into the tank every time we offered it. At the same time, it's just been raved about. So, you have that. You would have newsletters on the latest trends, the latest information. A health science teacher doesn't have access to that.
So, another example I'd like to say is, a lot of your business/industry teachers in health science, they don't have the opportunity to go back and hone their skills. And where are they reluctant to go? It's in information technology, because it changes so much, and they're never real confident in the first place. It would give them access, maybe, to some hands-on simulation.
I mean, I gave one conference presentation on ... I set them up so that they were doing medical records: how you would sign in; how do you access the information; which page do you go to, because they hadn't done that or haven't done it in years. It would be an update for skills.
I think it's maybe $30 a year. It would give them a lot of access at an affordable price, lots of professional development.
We have this distribution list. I was developing some program in Colorado and was just like, "Ooh." I just sent out an email: "Hey, has anybody done this program? Do you have anything you can share? Give me some content." Wham! Within 24 hours, I had three responses and a bunch of content. It was great. You don't start from scratch. So, that's the teacher organization in a nutshell.
How You Can Learn More About NCHSE
Are you interested in learning more about the National Consortium for Health Science Education? Get started by visiting their website: www.healthscienceconsortium.org
You can also read about the 2017 NCHSE Annual Board Meeting, based on my interview with Anne Kuser, who attended: Emerging Trends for Health Science Education from NCHSE