Several of our hospital partners had already designed student worksite learning experiences to reflect SCANS and AAI, though they may have used slightly different terminology. For example, academy students enrolled in the Regional Occupational Program are student interns at Alameda County Medical Center and rotate through a number of departments, including EKG, medical laboratory, surgery, admitting, and the medical staff office. These rotations broaden student experience and provide opportunities for training in a range of occupations and departments. The student-rotation design stems from the medical center's need for cross-trained, entry-level employees to meet current and future hospital needs. Additionally, as part of their internship experiences, students attend weekly seminars which are facilitated by medical staff, including administrators, doctors, nurses, technicians, and others. They also complete Work-Based Learning Portfolios and major work-based projects, maintain internship journals, and spend time sharing and reflecting on their growth toward mastery and their learning processes.
Citywide, the Oakland Unified School District is encouraging all employer partners to embrace the AAI framework by specifying the broad range of skills summer and senior year internships should include. Recently, the district brought together educators, parents, and industry partners to develop a Work-Based Learning Agreement that specifies roles and responsibilities for interns, schools, employers, and parents; and a Work-Based Learning Plan that specifies the competencies interns are expected to master. Competencies range from work ethics and values to interpersonal skills, basic skills, higher-order thinking skills, and AAI. Individual Training/Education Plans are developed and assessed by teachers, students, and employers working together.
In this section of the case study, we provide an overview of the worksite experience and learning that is integral to the design of the academy. Then we consider the Health Academy's partnership with Kaiser Permanente and how AAI is used to enhance the career exploration program and internships which take place at Kaiser Permanente. The evolution of the interactive job shadowing program, enhanced internships, worksite coaching and seminars, and cross-training approaches at Kaiser Permanente provides an excellent example of how schools and their employer partners can work together to structure learning experiences that provide students with a comprehensive understanding of industry.
Overview of Worksite Experience and Learning
In partnership with over twenty-five health care and bioscience employers, the academy offers students a plethora of opportunities to apply concepts they are learning in school to different work settings. Through a series of sequenced, structured workplace experiences, students establish relationships with health care professionals, are exposed to diverse health care careers and workplaces, learn about workplace dynamics, and gain hands-on work experience in the health care field.
The work-based learning sequence within the Health Academy is designed to provide students experience in and understanding of all aspects of the health care industry over the three- to four-year academy learning progression. At each stage, work-based learning experiences are complemented by class assignments that require students to demonstrate their knowledge and ability to make sense of how different aspects of the health care industry fit together. In addition to informing the overall design of the work-based learning sequence at the Health Academy, AAI provides a useful tool for organizing and structuring the specific work-based learning activities students engage in with employers. As the academy work experience has evolved from offering basic summer jobs to offering high-quality, structured work-based learning experiences for students, AAI has provided an important framework for teachers and health care managers and supervisors who work together to design cogent experiences for students at the workplace, and to forge needed connections between the workplace and school.
The sequenced nature of the work-based learning experiences provides students with a gradual introduction to workplace dynamics and culture. During their sophomore year, students are matched with industry mentors (adults who work in health or bioscience) with whom they meet at least once a month in person and maintain weekly contact. In addition, each sophomore performs seventy to one hundred hours of service learning related to the health/bioscience focus. During their junior year, academy students participate in a worksite exploration program in which students rotate through a series of clinical, business, and administrative departments at various health facilities. During the summer between their junior and senior years, students work at a paid internship with a local health care employer. Many students also participate in internships during the second semester of their senior year and in the summer following their senior year. Each student intern is matched with an industry mentor/coach who can help students address questions and concerns that arise through the work experience. Education/Training plans designed to provide students with both broad and job-specific skills have been developed for the internship positions by teams of educators, employers, and employees. And, again, student interns also maintain journals, complete special projects and portfolios related to their internships, and participate in reflective seminars.
Kaiser Permanente
Kaiser Permanente is a nationally recognized Health Maintenance Organization (HMO) with 238 medical facilities/offices located across the country. Kaiser's National Headquarters (Program Office) is located in Oakland. In addition, Oakland is home to Kaiser's Northern California Regional Office and to one of fifteen medical centers in California. Together, these three Kaiser locations employ more than 4,000 people, making Kaiser Permanente one of the largest employers in the city.
Throughout California, Kaiser Permanente has a long tradition of community involvement and collaboration with the public school system. For twenty-five years, Kaiser Permanente has employed Oakland youth through its Summer Youth Program. Kaiser Permanente's Summer Youth Program is associated with a citywide summer youth employment effort in Oakland commonly referred to as the Mayor's Summer Youth program which seeks to provide Oakland youth with summer jobs.
The Kaiser Permanente-Oakland Education Initiative
Kaiser Permanente began a partnership with the Oakland Health and Bioscience Academy in 1985--the year the academy was established. Through the partnership, Kaiser representatives became actively involved on the academy's advisory board, providing the Academy with oversight, financial support, instructional supplies, expertise, and resources. In addition, Kaiser provided field trips and summer jobs for some Health Academy students. In 1992, Kaiser Permanente started a new partnership with the Health Academy and included the Health and Environmental Science House located at Fremont High School in this partnership. In partnership with these two schools, the Kaiser Permanente-Oakland Education Initiative was formed in 1992.
The mission of the initiative is to support and influence educational reform in Oakland by strengthening the link between classroom learning and the transition to advanced education, careers, and citizenship. In partnership with students and teachers at Oakland Tech's Health Academy and Fremont High School's Health and Environment House, Kaiser Permanente seeks to expand the opportunities for low-income and minority students to enable them to continue their education in order to compete successfully in an increasingly technological job market. To this end, Kaiser provides a wide variety of school-based, work-based, and connecting activities for students at both schools, including speakers, career awareness material, mentoring, volunteer opportunities at the hospital, research advisors, tutoring, job shadowing/rotations, summer jobs, and internships.
The initiative is governed by a steering committee which has representatives from Kaiser Permanente's Program Office, Northern California Regional Office, the Oakland Medical Center, the Oakland Unified School District, principals and teachers from the Health and Bioscience Academy, Fremont High School, and a representative of Service Employees International Union Local 250. Over the past two years, the steering committee has worked to integrate technical and academic curricula at both schools with work-based knowledge and experience of all aspects of the health care industry.
Designing the Worksite Exploration Program To Encompass All Aspects of the Industry
One of the first goals of the initiative was to determine how to make student worksite experience more "learning centered." While Kaiser had provided summer jobs to Oakland youth for years, these jobs were not structured as learning experiences in any systematic way. Given the rapidly changing labor force needs of the health care industry, the steering committee agreed that student worksite experiences should provide students with broad exposure to the health care industry. Drawing on a network of innovative school-to-work transition programs in health care both in California and nationally, the steering committee assessed different models for structuring students' worksite experiences.
In the fall of 1992, the steering committee began planning a pilot worksite exploration/job rotation program to "expose students to the variety of positions that are involved in the delivery of health care and assist them in understanding how the information they are learning in school is applied to the workplace." The steering committee recognized that job rotations were particularly well-suited for engaging students in AAI because the rotation could simultaneously expose students to all aspects within a single department and to the clinical, administrative, human resource, legal, and business aspects of the health care industry. In addition, the steering committee felt that a job-rotation program would be excellent preparation for summer jobs between the junior and senior years of high school that students need. The job rotations could help students make informed decisions about what department they would like to work in over the summer and could provide student workers with a strong sense of how their individual departments fit into the overall Kaiser Permanente structure.
The Pilot Project
Departments from all three Kaiser locations volunteered to participate in the pilot project launched in the spring of 1993. From the beginning, the steering committee believed that department participation in the job-rotation program should be voluntary to ensure that departments were committed to providing students with a quality learning experience. To engage departments, memos were sent to department managers at the Program and Regional Offices and to the medical center which stated the goals of the program. Administrators responsible for program development at each Kaiser location targeted department heads who participated in the Summer Youth Program in the past as well as those who had expressed interest in working with young people. Departments expressing interest were required to develop learning objectives for students participating in the job rotation (department contacts were provided with sample learning objectives for job rotations from Project ProTech--a Boston-based school-to-work transition program in health care--and from the Cornell School-to-Work Project). Altogether, twenty departments and sixty students participated in the six-week job-rotation pilot program.
Overall, the spring pilot program was successful. Most supervisors said they would participate again, and students enjoyed the opportunity to learn about health careers. Feedback from department supervisors and students indicated, however, that several areas needed improvement to make the program more successful in the fall. In particular, it was clear that departments that participated in interactive exchanges with the students were the most successful; that additional assignments, scenarios, and criteria for portfolio work samples were needed to help students link their school experience with the job rotations in a systematic way; that one visit to a department was not necessarily enough for a student to develop an understanding of its role in the overall system; and finally, that scheduling between the schools and Kaiser needed to be better coordinated.
Fine Tuning the Program
The fall job rotations began in November 1993 and continued through the spring of 1994. All of the eleventh-grade students from both schools (approximately 120 students) attended an orientation session and received binders containing job descriptions from each of the 26 participating departments. Over the course of the year, each student visited between four to nine departments. Job rotations took place every other Thursday.
Kaiser Permanente hired a health care education consultant to assist department managers and supervisors in developing interactive job-rotation experiences. The consultant also met with faculty at both schools. Over the course of the year, program fine tuning revolved around several key concerns: integration of classroom learning with career exploration/job-rotation learning (including pre- and post-activities, assignments, and reflection); scheduling; department assignments; student preparation; participant expectations; and issues related to assessment, evaluation, and follow-up.
The following program developments have helped address implementation issues over the course of the year:
Fine-tuning of the program is naturally an ongoing process. Over the past year, however, several important mechanisms were put in place to incorporate or embed fine tuning into ongoing operations. Overall, the steering committee can be proud of its accomplishments--a strong working partnership between the two schools, Kaiser administrators, department managers, and Kaiser employees has been established; teachers and supervisors will be working together to develop integrated linkages between the worksite experience and school assignments; and students are gaining the exposure to the workplace they need to begin their summer internships with a broad understanding of the industry they are entering.