COVID-19: Impacting Enrollments in Health Science Disciplines

Healthcare worker wears gear and masks while looking exhausted

As the academic year unfolds and faculties assume their teaching roles, they also begin conscripting the next cohorts of students.  Emerging variables which may affect applicant numbers are of concern to faculties, such as the COVID-19 pandemic.  This article poses plausible student-faculty variables health science academicians might contemplate as they focus on enrollment numbers. Additionally, potential actions are offered.

Plausible variables

  • Some students may take a break from school to psychologically and financially recover from the pandemic, or discontinue completing their healthcare degree for fear of contracting COVID-19.
  • National unemployment rates could make school costs hard for students who pay tuition by working while going to school. If federal recovery funds are allocated for tuition costs, will the monies be equable apportioned among all students?
  • Might some students mid-stream in bachelor programs opt out, and instead complete associate degrees figuring they can move into the workforce faster, begin making money sooner, graduate with less tuition dollars spent or owed, and later return for their bachelor degrees utilizing employee tuition benefits?  Similarly, might enrollment numbers in vocational technical programs hosting healthcare-related careers also surge?
  • Could hospitals receiving federal recovery dollars develop new educational programs to address staffing issues leading to competition with higher education programs? For example, using a model like the former hospital-based diploma nursing programs and modernizing the concept, hospitals could offer staffing solutions with minimal cost for themselves and participating students.
  • Will educational institutions returning to mainly on-campus classes see declining admission rates because virtual classes have been shown to be more conducive to adult student lifestyles?  
  • Practitioners dying in the line of duty has become a publicized reality.  Consequently, will admission rates for health science programs begin declining as individuals weigh this concern?  Also, considering practitioners might realize they can work less, be under less stress, and obtain better salaries by making alternative career choices.
  • Healthcare providers considering pursuing their masters or doctoral degrees may now ask themselves if continuing within their disciplines is really what they want.  Today, many COVID-19 stressed healthcare providers are expressing a loss of passion, joy, and commitment once felt for their profession.
  • Consider the student whose parents plan to pay their four-year tuition.  One has to wonder if heroes dying from the coronavirus could cause parents to steer their cherished children away from healthcare degrees.
  • Conversely, perhaps the accentuated hero image during the pandemic will inspire some to pursue medical and nursing fields.  If the federal government supplements personal incentives with financial enticements, like tuition forgiveness programs, higher education institutions could see a surge in health science applicants.
  • With the closure of many public institutions, folding of businesses, and individuals losing their jobs, many financially distressed individuals will be in search of new employment opportunities and/or new careers as the pandemic subsides.  Perhaps some of these individuals, along with the carrot of monies from federally-sponsored tuition forgiveness programs, will seek healthcare degrees as new career choices.
  • Will the home-schooling approach to learning impact the number of graduating high school students who decide to go onto more formal schooling beyond their secondary education?  With so many vacant job positions, will high school graduates opt for job employment over further schooling?  Might the hint of federal supported funding for associate degrees tilt the scale against higher level education programs?

  • What happens when students who are solely enticed into the profession by financial incentives realize mid-stream the academic rigors and hands-on care needs are not for them?  Will there then be high attrition rates?  For those who stick out the academics and graduate, will employers see low retention rates as these new graduates flee the profession when day-to-day job expectations are too challenging?                          
  • What can educators do about enrollment numbers?  Should they put safety nets in place just in case numbers begin to decline? Or, should they sit tight and see what direction the pendulum swings?  If they do begin putting “safety nets” in place, what might they look like?

Potential safety-nets

  • Academic institutions should take the lead installing special heating, ventilation, and air-conditioning systems similar to those used in hospitals and healthcare entities to minimize airborne pathogen transmission from infected people to noninfected people.  Universities and colleges should provide healthcare students extensive practice using the same personal protective equipment utilized in hospitals and endorsed by the Center for Disease Control (CDC) before beginning any clinical rotations and throughout their education. Both of these interventions may offer some safety reassurance.  Unfortunately, academicians can’t guarantee students won’t acquire COVID-19, however, if institutions do make gallant efforts to address germ spreading concerns perhaps students will look closer at these “germ conscious” institutions.
  • Academicians should communicate to the public “the above and beyond” actions they are implementing to create environmentally safe classrooms, plus what their healthcare students are learning to protect themselves while in clinical settings.  Perhaps academic institutions can develop presentations showcasing “safety” initiatives for integration in recruitment programs.         
  • If availability of clinical sites is a problem because of COVID-19, or preceptors not obtainable, maybe schools should consider adjusting admission benchmarks based on availability of clinical slots and preceptors.

  • Should schools in close proximity offering similar health science majors think about consolidating programs instead of being in competition with one another for the same students and clinical sites?  Those schools giving up similar programs might be able to invest in other student-focused majors not taught other local schools. Hopefully, working together, consolidating programs, and implementing new initiatives balances enrollment numbers amongst geographically close schools.                 
  • Often, when novice students think of healthcare, they think of working in hospitals rather than in outpatient/community settings.  Undergraduate healthcare programs like medicine and nursing typically complete a fair percent of clinicals in hospital/inpatient settings where the potential of COVID-19 exposure could be greater.  Students, particularly those who contemplate foregoing a health science major because of the perceived increased risk of COVID-19 exposure in hospitals, should be educated that not all clinical experiences occur in hospitals.          
  • Perhaps in the future, healthcare programs like generic nursing programs might want to redesign how nurses are taught.  Since community care has flourished and taken on new value during COVID-19, many new job opportunities in community settings have emerged.  In the best of both inpatient and outpatient worlds, wouldn’t it be ideal if employers were able to hire registered nurses who completed a generic nursing program and a program specialized within one of two tracks: Inpatient/Hospital Care or Outpatient/Community Care? Students would graduate and secure positions in their area of specialty.  If at any point in their career they desired to work in the other specialty, they would return for certification in the desired area.  Highlighting a community option might attract future nurses who shy away from the career because they have no desire to work in hospital settings post-graduation. 

  • Faculties are experts in their professions – they know the good, the bad and the ugly.  Therefore, all must work together to design recruitment materials providing realistic pictures of the profession including realities of working as clinicians during crises like COVID-19. 

  • Students and potential students need perceptive teachers who are mentally open to brooch these tough issues.  Counseling and “hearing what students are thinking” might provide students the support they need to identify options not entertained in their own minds.  Conducting focus groups with high school students could help project future academic initiatives for healthcare majors.

As academicians struggle through these difficult times, we have to remember health science majors will continue to exist.  We, as humans, need others to assist us with our healthcare needs.  As long as we exist, individuals will look to others who have learned the scientific principles of diagnosing, caring, and treating to assist in addressing the nation’s healthcare needs. 

Brenda Condusta Pavill, PhD, is professor emeritus following teaching in higher education for 30 years and clinical practice for 40 years. Pavill is the recipient of Teacher of the Year awards, has published a number of academic articles in peer-reviewed journals, authored the book Nursing Shoes, and penned professional articles for healthcare entities and nursing organizations. Pavill’s main focus is the education of future nurses and nurse practitioners, and has taught in both classroom and clinical settings.