Tag: Health

  • The Grand Irony of Nursing Education and Burnout in U.S. Health Care

    The Grand Irony of Nursing Education and Burnout in U.S. Health Care

    Nursing has long been romanticized as both a “calling” and a profession—an occupation where devotion to patients is assumed to be limitless. Nursing schools, hospitals, and media narratives often reinforce this ideal, framing the nurse as a tireless caregiver who sacrifices for the greater good. But behind the cultural image is a system that normalizes exhaustion, accepts overwork, and relies on the quiet suffering of an increasingly strained workforce.

    The cultural expectation that nurses should sacrifice their own well-being has deep historical roots. Florence Nightingale’s legacy in the mid-19th century portrayed nursing as a noble vocation, tied as much to moral virtue as to medical skill. During World War I and World War II, nurses were celebrated as patriotic servants, enduring brutal conditions without complaint. By the late 20th century, popular culture reinforced the idea of the nurse as both saintly and stoic—expected to carry on through fatigue, trauma, and loss. This framing has carried into the 21st century. During the COVID-19 pandemic, nurses were lauded as “heroes” in speeches, advertisements, and nightly news coverage. But the rhetoric of heroism masked a harsher reality: nurses were sent into hospitals without adequate protective equipment, with overwhelming patient loads, and with little institutional support. The language of devotion was used as a shield against criticism, even as nurses themselves broke down from exhaustion.

    The problem begins in nursing education. Students are taught the technical skills of patient care, but they are also socialized into a culture that emphasizes resilience, self-sacrifice, and “doing whatever it takes.” Clinical rotations often expose nursing students to chronic understaffing and unsafe patient loads, but instead of treating this as structural failure, students are told it is simply “the reality of nursing.” In effect, they are trained to adapt to dysfunction rather than challenge it.

    Once in the workforce, the pressures intensify. Hospitals and clinics operate under tight staffing budgets, pushing nurses to manage far more patients than recommended. Shifts stretch from 12 to 16 hours, and mandatory overtime is not uncommon. Documentation demands, electronic medical record systems, and administrative oversight add layers of clerical work that take time away from direct patient care. The emotional toll of constantly navigating life-and-death decisions, combined with lack of rest, creates a perfect storm of burnout. The grand irony is that the profession celebrates devotion while neglecting the well-being of the devoted. Nurses are praised as “heroes” during crises, but when they ask for better staffing ratios, safer conditions, or mental health support, they are often dismissed as “not team players.” In non-unionized hospitals, the risks are magnified: nurses have little leverage to negotiate schedules, resist unsafe assignments, or push back against retaliation. Instead, they are expected to remain loyal, even as stress erodes their health and shortens their careers.

    Recent years have shown that nurses are increasingly unwilling to accept this reality. In Oregon in 2025, nearly 5,000 unionized nurses, physicians, and midwives staged the largest health care worker strike in the state’s history, demanding higher wages, better staffing levels, and workload adjustments that reflect patient severity rather than just patient numbers. After six weeks, they secured a contract with substantial pay raises, penalty pay for missed breaks, and staffing reforms. In New Orleans, nurses at University Medical Center have launched repeated strikes as negotiations stall, citing unsafe staffing that puts both their health and their patients at risk. These actions are not isolated. In 2022, approximately 15,000 Minnesota nurses launched the largest private-sector nurses’ strike in U.S. history, and since 2020 the number of nurse strikes nationwide has more than tripled.

    Alongside strikes, nurses are pushing for legislative solutions. At the federal level, the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act has been introduced, which would mandate minimum nurse-to-patient ratios and provide whistleblower protections. In New York, the Safe Staffing for Hospital Care Act seeks to set legally enforceable staffing levels and ban most mandatory overtime. Even California, long considered a leader in nurse staffing ratios, has faced crises in psychiatric hospitals so severe that Governor Gavin Newsom introduced emergency rules to address chronic understaffing linked to patient harm. Enforcement remains uneven, however. At Albany Medical Center in New York, chronic understaffing violations led to hundreds of thousands of dollars in fines, a reminder that without strong oversight, even well-crafted laws can be ignored.

    The United States’ piecemeal and adversarial approach contrasts sharply with other countries. In Canada, provinces like British Columbia have legislated nurse-to-patient ratios similar to those in California, and in Quebec, unions won agreements that legally cap workloads for certain units. In the United Kingdom, the National Health Service has long recognized safe staffing as a matter of public accountability, and while austerity policies have strained the system, England, Wales, and Scotland all employ government-set nurse-to-patient standards to protect both patients and staff. Nordic countries go further, with Sweden and Norway integrating nurse well-being into health policy; short shifts, strong union protections, and publicly funded healthcare systems reduce the risk of burnout by design. While no system is perfect, these models show that burnout is not inevitable—it is a political and policy choice.

    Union presence consistently makes a difference. Studies show that unionized nurses are more successful at securing safe staffing ratios, resisting exploitative scheduling, and advocating for patient safety. But unionization rates in nursing remain uneven, and in many states nurses are discouraged or even legally restricted from organizing. Without collective power, individual nurses are forced to rely on personal endurance, which is precisely what the system counts on.

    The outcome is devastating not only for nurses but for patients. Burnout leads to higher turnover, staffing shortages, and medical errors—all while nursing schools continue to churn out new graduates to replace those driven from the profession. It is a cycle sustained by institutional denial and the myth of infinite devotion.

    If U.S. higher education is serious about preparing nurses for the future, nursing programs must move beyond the rhetoric of sacrifice. They need to teach students not only how to care for patients but also how to advocate for themselves and their colleagues. They need to expose the structural causes of burnout and prepare nurses to demand better conditions, not simply endure them. Until then, the irony remains: a profession that celebrates care while sacrificing its caregivers.

    Sources

    • American Nurses Association (ANA). “Workplace Stress & Burnout.” ANA Enterprise, 2023.

    • National Nurses United. Nursing Staffing Crisis in the United States, 2022.

    • Bae, S. “Nurse Staffing and Patient Outcomes: A Literature Review.” Nursing Outlook, Vol. 64, No. 3 (2016): 322-333.

    • Bureau of Labor Statistics. “Union Members Summary.” U.S. Department of Labor, 2024.

    • Shah, M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M., Ali, M.K. “Prevalence of and Factors Associated With Nurse Burnout in the US.” JAMA Network Open, Vol. 4, No. 2 (2021): e2036469.

    • Nelson, Sioban. Say Little, Do Much: Nursing, Nuns, and Hospitals in the Nineteenth Century. University of Pennsylvania Press, 2001.

    • Kalisch, Philip A. & Kalisch, Beatrice J. The Advance of American Nursing. Little, Brown, 1986.

    • Oregon Capital Chronicle, “Governor Kotek Criticizes Providence Over Largest Strike of Health Care Workers in State History,” January 2025.

    • Associated Press, “Oregon Health Care Strike Ends After Six Weeks,” February 2025.

    • National Nurses United, “New Orleans Nurses Deliver Notice for Third Strike at UMC,” 2025.

    • NurseTogether, “Nurse Strikes: An Increasing Trend in the U.S.,” 2024.

    • New York State Senate Bill S4003, “Safe Staffing for Hospital Care Act,” 2025.

    • San Francisco Chronicle, “Newsom Imposes Emergency Staffing Rules at State Psychiatric Hospitals,” 2025.

    • Times Union, “Editorial: Hospital’s Staffing Violations Show Need for Enforcement,” 2025.

    • Oulton, J.A. “The Global Nursing Shortage: An Overview of Issues and Actions.” Policy, Politics, & Nursing Practice, Vol. 7, No. 3 (2006): 34S–39S.

    • Rafferty, Anne Marie et al. “Outcomes of Variation in Hospital Nurse Staffing in English Hospitals.” BMJ Quality & Safety, 2007.

    • Aiken, Linda H. et al. “Nurse Staffing and Education and Hospital Mortality in Nine European Countries.” The Lancet, Vol. 383, No. 9931 (2014): 1824–1830.

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  • One-third of U.S. public schools screen students for mental health

    One-third of U.S. public schools screen students for mental health

    This press release originally appeared on the RAND site.

    Key points:

    Nearly one-third of the nation’s K-12 U.S. public schools mandate mental health screening for students, with most offering in-person treatment or referral to a community mental health professional if a student is identified as having depression or anxiety, according to a new study.

    About 40 percent of principals surveyed said it was very hard or somewhat hard to ensure that students receive appropriate care, while 38 percent said it was easy or very easy to find adequate care for students. The findings are published in the journal JAMA Network Open.

    “Our results suggest that there are multiple barriers to mental health screening in schools, including a lack of resources and knowledge of screening mechanics, as well as concerns about increased workload of identifying students,” said Jonathan Cantor, the study’s lead author and a policy researcher at RAND, a nonprofit research organization.

    In 2021, the U.S. Surgeon General declared a youth mental health emergency. Researchers say that public schools are strategic resources for screening, treatment, and referral for mental health services for young people who face barriers in other settings.

    Researchers wanted to understand screening for mental health at U.S. public schools, given increased concerns about youth mental health following the challenges posed by the COVID-19 pandemic.

    In October 2024, the RAND study surveyed 1,019 principals who participate in the RAND American School Leader panel, a nationally representative sample of K–12 public school principals.

    They were asked whether their school mandated screening for mental health issues, what steps are taken if a student is identified as having depression or anxiety, and how easy or difficult it is to ensure that such students received adequate services.

    Researchers found that 30.5 percent of responding principals said their school required screening of students with mental health problems, with nearly 80 percent reporting that parents typically are notified if students screen positive for depression or anxiety.

    More than 70 percent of principals reported that their school offers in-person treatment for students who screen positive, while 53 percent of principals said they may refer a student to a community mental health care professional.

    The study found higher rates of mental health screenings in schools with 450 or more students and in districts with mostly racial and ethnic minority groups as the student populations.

    “Policies that promote federal and state funding for school mental health, reimbursement for school-based mental health screening, and adequate school mental health staff ratios may increase screening rates and increase the likelihood of successfully connecting the student to treatment,” Cantor said.

    Support for the study was provided by the National Institute of Mental Health.

    Other authors of the study are Ryan K. McBain, Aaron Kofner, Joshua Breslau, and Bradley D. Stein, all of RAND; Jacquelin Rankine of the University of Pittsburgh School of Medicine; Fang Zhang, Hao Yu, and Alyssa Burnett, all of the Harvard Pilgrim Health Care Institute; and Ateev Mehrotra of the Brown University School of Public Health.

    RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

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  • Half of college students say their mental health is ‘fair’ to ‘terrible,’ survey finds

    Half of college students say their mental health is ‘fair’ to ‘terrible,’ survey finds

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    Half of college students rate their mental health as fair, poor, or terrible, according to a recent survey from The Steve Fund, a nonprofit that focused on the mental health of young people of color.

    The survey also found about 40% of students were “very or extremely stressed about maintaining their mental health” while in college. About 1 in 5 students said the same about connecting with other students and finding their niche in college.

    Moreover, about one-third or more of students experienced a range of challenges such as changes in sleeping habits and difficulty concentrating and learning.

    Students struggling with mental health in college isn’t a new phenomena, but “the severity and pervasiveness have clearly worsened,” Annelle Primm, The Steve Fund’s senior medical director, said in an email.

    “We’re not just seeing higher levels of stress — we’re seeing a rising sense of disconnection,” said Primm. “The need for campuses to respond thoughtfully and urgently is more pressing than ever.”

    The mental health issues students face may also impact their graduation trajectory. About half of students considered reducing their classload, 40% considered transferring, and 30% considered dropping out of college altogether due to “negative experiences on campus,” the report stated.

    Steve Fund researchers surveyed about 2,050 college students between ages 18 and 24 who were attending four-year institutions and largely taking in-person classes.The survey was conducted last year between February and April.

    There isn’t a single cause behind the mental health challenges that students are facing, but “several powerful stressors are converging,” said Primm. That includes discrimination on campus, encounters with campus security or a lack of belonging, according to the report.

    Many college students also grew into adulthood during the COVID-19 pandemic, a uniquely disruptive period that had significant impacts on emotional development and social connection, Primm said. Some of those students struggled with isolation caused by remote learning, while others had limited opportunities to meaningfully interact with their peers during their formative years, she said.

    “Layered on top of this are longstanding financial pressures like student loan debt, and broader societal stressors — from political divisiveness to global conflict,” said Primm. 

    Racial differences

    Negative experiences on campus — which were more prevalent among students of color — impacted mental health, the report found.

    About half of Black and Indigenous students reported having a negative experience with cyberbullying on campus, the highest of any racial groups, the report stated. And a higher percentage of students of color reported threats of physical violence on campus and being stopped by campus police and security than their White peers.

    About 60% of Black and Asian students and nearly half of Hispanic students reported negative racial comments on campus, and similar shares said the same about facing different forms of discrimination, the report stated. That’s higher than the 43% of White students who experienced discrimination and 29% who experienced racial comments.

    Among all students, two-thirds pointed to other students as their source of their negative experiences on campus, while 20% identified faculty, the report stated. 

    More than 4 in 5 students also said their institution “helps students from various racial and ethnic backgrounds feel welcome.”

    But Black, Hispanic, and Asian students reported their campus climate as inclusive at lower rates than White students. And about half of Black and Indigenous students said they experienced difficulty being themselves in college.

    Encouraging progress

    Colleges may be making strides in providing better mental health resources to students, the survey suggested.

    Student access to and awareness of college mental health services improved significantly since 2017, when the Steve Fund last surveyed college students about their mental health. That survey drew responses from 1,056 college students between ages 17 and 27 attending both two- and four-year colleges.

    Primm said the two surveys can be considered comparable, as the majority of students who completed the 2017 survey were also attending four-year colleges.

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  • Transforming Classroom Discussions with Communication Practices from Health Coaching – Faculty Focus

    Transforming Classroom Discussions with Communication Practices from Health Coaching – Faculty Focus

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  • Transforming Classroom Discussions with Communication Practices from Health Coaching – Faculty Focus

    Transforming Classroom Discussions with Communication Practices from Health Coaching – Faculty Focus

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  • Mental health screeners help ID hidden needs, research finds

    Mental health screeners help ID hidden needs, research finds

    Key points:

    A new DESSA screener to be released for the Fall ‘25 school year–designed to be paired with a strength-based student self-report assessment–accurately predicted well-being levels in 70 percent of students, a study finds.  

    According to findings from Riverside Insights, creator of research-backed assessments, researchers found that even students with strong social-emotional skills often struggle with significant mental health concerns, challenging the assumption that resilience alone indicates student well-being. The study, which examined outcomes in 254 middle school students across the United States, suggests that combining risk and resilience screening can enable identification of students who would otherwise be missed by traditional approaches. 

    “This research validates what school mental health professionals have been telling us for years–that traditional screening approaches miss too many students,” said Dr. Evelyn Johnson, VP of Research & Development at Riverside Insights. “When educators and counselors can utilize a dual approach to identify risk factors, they can pinpoint concerns and engage earlier, in and in a targeted way, before concerns become major crises.”

    The study, which offered evidence of, for example, social skills deficits among students with no identifiable or emotional behavioral concerns, provides the first empirical evidence that consideration of both risk and resilience can enhance the predictive benefits of screening, when compared to  strengths-based screening alone.

    In the years following COVID, many educators noted a feeling that something was “off” with students, despite DESSA assessments indicating that things were fine.

    “We heard this feedback from lots of different customers, and it really got our team thinking–we’re clearly missing something, even though the assessment of social-emotional skills is critically important and there’s evidence to show the links to better academic outcomes and better emotional well-being outcomes,” Johnson said. “And yet, we’re not tapping something that needs to be tapped.”

    For a long time, if a person displayed no outward or obvious mental health struggles, they were thought to be mentally healthy. In investigating the various theories and frameworks guiding mental health issues, Riverside Insight’s team dug into Dr. Shannon Suldo‘s work, which centers around the dual factor model.

    “What the dual factor approach really suggests is that the absence of problems is not necessarily equivalent to good mental health–there really are these two factors, dual factors, we talk about them in terms of risk and resilience–that really give you a much more complete picture of how a student is doing,” Johnson said.

    “The efficacy associated with this dual-factor approach is encouraging, and has big implications for practitioners struggling to identify risk with limited resources,” said Jim Bowler, general manager of the Classroom Division at Riverside Insights. “Schools told us they needed a way to identify students who might be struggling beneath the surface. The DESSA SEIR ensures no student falls through the cracks by providing the complete picture educators need for truly preventive mental health support.”

    The launch comes as mental health concerns among students reach crisis levels. More than 1 in 5 students considered attempting suicide in 2023, while 60 percent of youth with major depression receive no mental health treatment. With school psychologist-to-student ratios at 1:1065 (recommended 1:500) and counselor ratios at 1:376 (recommended 1:250), schools need preventive solutions that work within existing resources.

    The DESSA SEIR will be available for the 2025-2026 school year.

    This press release originally appeared online.

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  • Autistic College Students Face Dramatically Higher Rates of Mental Health Challenges, New Research Shows

    Autistic College Students Face Dramatically Higher Rates of Mental Health Challenges, New Research Shows

    Autistic college students are experiencing anxiety and depression at significantly higher rates than their non-autistic peers, according to new research from Binghamton University that analyzed data from nearly 150,000 undergraduate students across 342 institutions nationwide.

    The study, published in the Journal of Autism and Developmental Disorders, represents one of the most comprehensive examinations to date of mental health challenges facing autistic students in higher education—a population that researchers say has been historically underrepresented in academic research despite growing enrollment numbers.

    “What we found is really staggering—autistic individuals endorse much higher rates of anxiety and depression compared to their non-autistic peers,” said Diego Aragon-Guevara, the study’s lead author and a PhD student in psychology at Binghamton University.

    The research team analyzed data from the National Survey of Student Engagement (NSSE), which in 2021 became the first year that autism was included as an endorsable category in the survey. This milestone allowed researchers to conduct the first large-scale comparison of mental health outcomes between autistic and non-autistic college students.

    “We were really excited to see what the data would tell us. It was a big opportunity to be able to do this,” said Dr. Jennifer Gillis Mattson, professor of psychology and co-director of the Institute for Child Development at Binghamton University, who co-authored the study.

    The findings come at a critical time for higher education institutions as autism diagnoses continue to rise nationwide and more autistic students pursue college degrees. The research highlights a significant gap in support services that could impact student success and retention.

    “We know the number of autistic college students continues to increase every single year,” Gillis-Mattson noted. “We really do have an obligation to support these students, and to know how best to support these students, we need to look beyond just autism.”

    The study reveals that campus support systems may be inadvertently overlooking mental health needs while focusing primarily on autism-specific accommodations. Aragon-Guevara, whose research focuses on improving quality of life for autistic adults, said this represents a critical oversight in student services.

    “Support personnel might address an individual’s autism and, in the process, overlook their mental health issues,” he explained. “More care needs to be put into addressing that nuance.”

    The research underscores the need for institutions to develop more comprehensive support frameworks that address both autism-related needs and concurrent mental health challenges. The findings suggest that traditional disability services approaches may need significant enhancement to serve this population effectively.

    “We want to provide the best support for them and to make sure that they have a college experience where they get a lot out of it, but also feel comfortable,” Aragon-Guevara said.

    Dr. Hyejung Kim, an assistant professor in Binghamton’s Department of Teaching, Learning and Educational Leadership, noted that the complexity of factors affecting autistic students requires deeper investigation. 

    “This population often skews male, and interactions between personal factors and conditions such as anxiety and depression may shape overall well-being in college,” she said.

    Kim also pointed to additional considerations that institutions should examine. 

    “Autistic students are also more likely to pursue STEM fields, and many report different experiences with faculty and staff across institutional settings,” she said. “We still have much to learn about how these and other contextual factors relate to mental well-being.”

    The Binghamton team views this study as foundational research that confirms the scope of mental health challenges among autistic college students. Their next phase will investigate specific contributing factors, including social dynamics, faculty support, campus accessibility, and other environmental elements that influence student well-being.

    “There are so many elements that go into being comfortable in the new environment that is college,” Aragon-Guevara explained. “We want to look into that and see if there are any deficits in those areas that autistic college students are experiencing, so that we know where we can help support them, or create institutional things to help improve quality of life as a whole.”

    The research is part of a broader effort at Binghamton to better understand and support autistic students in higher education, with plans to collaborate with campus partners to develop targeted interventions based on their findings.

     

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  • Peer Mentors Help Students Navigate Health Graduate Programs

    Peer Mentors Help Students Navigate Health Graduate Programs

    As a first-year student at Emory University, Leia Marshall walked into the Pathways Center to receive advice on her career goals.

    She was a neuroscience and behavioral biology major who thought she might go to medical school. But after meeting with a peer mentor, Marshall realized she was more interested in optometry. “I didn’t really know a lot about the prehealth track. I didn’t really know if I wanted to do medicine at all,” she said. “Getting to speak to a peer mentor really affected the way that I saw my trajectory through my time at Emory and onwards.”

    Emory opened the Pathways Center in August 2022, uniting five different student-facing offices: career services, prehealth advising, undergraduate research, national scholarships and fellowships, and experiential learning, said Branden Grimmett, associate dean of the center.

    “It brings together what were existing functions but are now streamlined to make it easier for students to access,” Grimmett said.

    The pre–health science peer mentor program engages hundreds of students each year through office hours, advising appointments, club events and other engagements, helping undergraduates navigate their time at Emory and beyond in health science programs.

    The background: Prehealth advising has been a fixture at Emory for 20 years, led by a team of staff advisers and 30 peer mentors. The office helps students know the options available to them within health professions and that they’re meeting degree requirements to enter these programs. A majority of Emory’s prehealth majors are considering medicine, but others hope to study veterinary medicine, dentistry or optometry, like Marshall.

    How it works: The pre–health science mentors are paid student employees, earning approximately $15 an hour. The ideal applicant is a rising junior or senior who has a passion for helping others, Grimmett said.

    Mentors also serve on one of four subcommittees—connect, prepare, explore and apply—representing different phases of the graduate school process.

    Mentors are recruited for the role in the spring and complete a written application as well as an interview process. Once hired, students participate in a daylong training alongside other student employees in the Pathways Center. Mentors also receive touch-up training in monthly team meetings with their supervisors, Grimmett said.

    Peer mentors host office hours in the Pathways Center and advertise their services through digital marketing, including a dedicated Instagram account and weekly newsletter.

    Peer-to-peer engagement: Marshall became a peer mentor her junior year and is giving the same advice and support to her classmates that she received. In a typical day, she said she’ll host office hours, meeting with dozens of students and offering insight, resources and advice.

    “Sometimes students are coming in looking for general advice on their schedule for the year or what classes to take,” she said. “A lot of the time, we have students come in and ask about how to get involved with research or find clinical opportunities in Atlanta or on campus, so it really ranges and varies.”

    Sometimes Marshall’s job is just to be there for the student and listen to their concerns.

    “Once I met with a student who came in and she was really nervous about this feeling that she wasn’t doing enough,” Marshall said. “There’s this kind of impostor phenomenon that you’re not involved in enough extracurriculars, you’re not doing enough to set you up for success.”

    Marshall is able to relate to these students and help them reflect on their experiences.

    “That’s been one of my favorite parts of being a peer mentor: getting to help students recognize their strengths and guide them through things that I’ve been through myself,” she said.

    In addition to assisting their classmates, peer mentors walk away with résumé experience and better career discernment, Grimmett said. “Often our students learn a lot about their own path as they’re in dialogue with other students. It’s a full circle for many of our peer mentors.”

    “It’s funny to think about the fact that our role is to help others, but it really helps all of us as peer mentors as well,” Marshall said. “We learn to connect with a variety of students, and I think it’s been really valuable for me to connect with the advisers myself and get to know them better.”

    If your student success program has a unique feature or twist, we’d like to know about it. Click here to submit.

    This article has been updated to correct the spelling of Branden Grimmett’s name.



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  • Pa. Clinic Run by Students Supports Community Health

    Pa. Clinic Run by Students Supports Community Health

    Experiential learning opportunities provide students with a space to connect in-classroom learning to real-world situations. A student-run clinic at Widener University provides graduate health science professional students with hands-on learning and career experiences while supporting community health and well-being for Chester, Pa., residents.

    The Chester Community Clinic was founded in 2009 for physical therapy services but has since expanded to cover other health and wellness services, including occupational therapy and speech-language pathology. The clinic gives students studying those fields leadership opportunities, experience working with diverse clients and the confidence to tackle their professional careers.

    What’s the need: Before the clinic was established, physical therapy students at Widener would volunteer at a pro bono clinic in nearby Philadelphia. But students pushed for a clinic within Chester, which is considered a primary care health professional shortage area, meaning it lacks enough providers to serve the local population.

    For some patients, a lack of health insurance can impede their ability to receive care. In Pennsylvania, 5.4 percent of residents are without private or public health insurance, roughly two percentage points lower than the national average. The clinic addresses gaps in health care by providing services for free while educating future health science professionals.

    How it works: The clinic is led by a board of 12 to 14 students from each class and supervised by faculty and community members who are licensed physical therapists. Students begin service in their second semester of the program and participate in the clinic until their final clinical placement.

    Most clients are referred by a physician but have been turned away from local PT clinics due to a lack of health insurance or because they exceeded the allotted insurance benefits for PT.

    During appointments, students provide direct physical therapy services to patients, including making care plans, walking them through exercises and creating medical records.

    Over the years, the clinic has expanded to include occupational therapy, speech-language pathology, clinical psychology and social work services. In 2024, Widener included a Community Nursing Clinic to provide pro bono services as well.

    All students studying physical therapy, occupational therapy and speech-language pathology at Widener volunteer at the clinic as part of the program requirements. PT students are required to serve a minimum of three evenings per semester; board members typically serve more hours.

    The clinic’s multifaceted offerings increase opportunities for students to work across departments, engaging with their peers in other health professions to establish interdisciplinary plans for care.

    Free Talent

    Other colleges and universities offer pro bono student services to support community members and organizations:

    • Gonzaga University has a student-led sports consulting agency that offers strategy ideas and tools to sports brands and teams.
    • Utah Valley University students can intern with a semester-long program that provides digital marketing to businesses in the region.
    • American University’s Kogod School of Business has a business consulting group that provides students with project-based consulting experience.
    • Carroll University faculty and students in the behavioral health psychology master’s program run a free mental health clinic for those in the area.

    The impact: Since the clinic began in 2009, students have provided over 12,000 physical therapy appointments to community members, worth about $1.3 million in costs, according to a 2024 press release from the university.

    A 2017 program evaluation, published in the Internet Journal of Allied Health Sciences and Practice, found that PT students who served in the pro bono clinic felt more equipped to launch into clinical work. They were prepared to manage documentation, use clinical reasoning and engage in interprofessional communication.

    A 2020 study of the clinic also found that students performed better than expected in cultural competence, perhaps due to their experience engaging with clients from a variety of ethnicities, socioeconomic backgrounds, health literacy levels, religions and languages.

    Both Widener and students in the health science professions continue to support the development of other pro bono clinics. The class of 2015 created The Pro Bono Network, facilitating advancement of student-run pro bono services among 109 member institutions across the country. This past spring, Widener’s annual Pro Bono Network Conference welcomed 250 individuals working at or affiliated with pro bono clinics, and featured 32 student leaders presenting their work.

    How do your students gain hands-on experience and give back? Tell us more.

    This article has been updated to reflect the addition of a pro bono nursing clinic in 2024, not the creation of it, and to identify students as health science professional students, not health professional students.

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  • How Labour’s 10-year health plan for England joins up with higher education and research

    How Labour’s 10-year health plan for England joins up with higher education and research

    The government wants to reinvent the NHS (in England) through three radical shifts – hospital to community, analogue to digital, and sickness to prevention.

    Whether like the chief executive of the NHS you believe Labour’s 10-year health plan for England is about creating “energy and enthusiasm”, whether like the secretary of state you believe this is about building a NHS which is about “the future and a fairer Britain,” or whether across its 168 pages you find the government’s default to techno-optimism, AI will solve everything, one more dataset will fix public services, approach to governance to be somewhere between naive and unduly optimistic, it is clear that the NHS is expected to change and do so quickly.

    This is a plan that is as much about the reorganisation of the economy as it is about health. It is about how health services can get people into work, it is a guide to economic growth through innovation in life sciences, it is a lament for the skills needed and the skills not yet thought about for the future of the NHS.

    Elsewhere on the site, Jim Dickinson looks at the (lack of) implications for students as group with health needs – here we look at the implications for education, universities, and the wider knowledge economy.

    Workforce modelling

    One of the premises of the plan is that the 2023 Conservative long-term workforce plan was a mistake. The NHS clearly cannot go on as it currently is, and to facilitate this transformation a “very different kind of workforce strategy” is needed:

    Until 2023, [the NHS] had never published a long-term workforce plan. The one it did publish did little more than extrapolate from past trends into the future: concluding there was no alternative than continuation of our current care model, supported by an inexorable growth in headcount, mostly working in acute settings.

    A new workforce place is being put together, to appear “later this year” and taking a “decidedly different approach”:

    Instead of asking ‘how many staff do we need to maintain our current care model over the next 10 years?’, it will ask ‘given our reform plan, what workforce do we need, what should they do, where should they be deployed and what skills should they have?’

    The bottom line is that, therefore, “there will be fewer staff in the NHS in 2035 than projected by the 2023 workforce plan” – but these staff will have better conditions, better training, and “more exciting roles”.

    So one immediate question for universities in England is what this reduced staffing target means for recruitment onto medical, nursing and allied health degrees. Places have been expanding, and under previous plans were set to expand at growing rates in the coming years, including a doubling of medical school places by 2035. There were questions about how optimistic some of the objectives were – the National Audit Office last year criticised NHS England for not having assessed the feasibility of expanding places, in light of issues like attrition rates and the need to invest in clinical placement infrastructure.

    We won’t get a clear answer of what Labour is proposing until the new workforce plan emerges – especially as there is an accompanying aspiration in today’s plan to reduce the NHS’ dependence on international recruitment. But there are some clear directions of travel. Creating more apprenticeships gets a mention – though of course not at level 7 – but the key theme is a tight link between growing medical student numbers and widening participation:

    Expansion of medical school places will be targeted at medical schools with a proven track record of widening participation… The admissions process to medical school will be improved with better information, signposting and support for applicants, and more systematic use of contextual admissions.

    This is accompanied by endorsement of the Sutton Trust’s recent research into access disparities. And in one of those “holding universities to account” measures that everyone is so keen on, part of reinforcing this link will be done via work with the Department for Education to “publish data on the relevant background of university entrants, starting with medicine.” If you are thinking that we already did that – yes we did. The UK-wide HESA widening participation performance indicator was last published in 2022 – each regulator now has their own version (for example this from the Office for Students) which doesn’t quite do the same thing.

    Education and students

    Of course, creating more pathways into working in the NHS is one mechanism to grow its workforce. The other is to unblock current pathways that prevent people from getting into and getting on with their chosen careers in health.

    For example, there is a (somewhat tepid) commitment on student support: the plan commits to “explore options” on improving the financial support on offer to medical students from the lowest socioeconomic backgrounds.

    For nursing students, the offer is slimmer still – a focus on the “financial obstacles to learning”, including faster reimbursement of placement expenses, and tackling the time lag between completing a course and being able to start work. This latter measure will involve working with higher education institutions to revise the current approach to course completion confirmation, and is billed for September 2026. The Royal College of Nursing has suggested that these “modest” changes go nowhere near far enough.

    Nursing and midwifery attrition also comes under scrutiny – the government spots that reducing the rate of non-continuation by a percentage point would result in the equivalent of 300 more nurses and midwives joining the NHS each year. But rather than looking deeper at why this is a growing issue, the buck is handed over to education providers to “urgently address attrition rates.”

    Elsewhere the interventions into education provision are more substantial. There’s an already ongoing review of medical training for NHS staff, due to report imminently. On top of this, the plan sets out how the next three years will see an “overhaul” of education and training curricula, to “future-proof” the workforce. There’s lots of talk about faster changes to course content as and when needed, to reflect changes in how the NHS will operate. This comes with a warning:

    Where existing providers are unable to move at the right pace, we may look to different institutions to ensure that the education market is responsive to employer needs.

    Clinical placement tariffs for undergraduate and postgraduate medicine will be reformed – the plan suggests the tariff system currently “provides limited ability to target funding at training where it is most needed to modernise delivery,” and wants to do more in community settings and make better use of simulation. There will also be expansion of clinical educator capacity, though this will be “targeted” (which is often code for limited).

    And course lengths could fall – the plan promises to “work with higher education institutions and the professional regulators as they review course length in light of technological developments and a transition to lifelong rather than static training.” While this does not explicitly suggest shorter medical and nursing programmes – and a consequent growth in provision aimed at professionals – the preference is pretty obvious.

    On that last point every member of NHS staff will get their own “personalised career coaching and development plan” which will come alongside the development of “advanced practice models” for nurses (and all the other professional roles in the NHS: radiographers, pharmacists, and the like).

    Data and (wider) employment

    The plan stretches much wider than simply making commitments on training though and, as the plan makes clear, if the answer isn’t always going to be more money there has to be more efficiency.

    There’s a fascinating set of commitments linking health and work – one of those things that feel clunky and obvious until you note that “getting the long-term sick back into work” has just been a soundbite with punitive vibes until now.

    Of course, everything has a slightly cringeworthy name – so NHS Accelerators will support local NHS services to have an “impact on people’s work status”, something that may grow into specific and measurable outcomes linking to economic inactivity and unemployment and link in other local government partners. And health support in the traditional sense will link with wider holistic support (as set out in the Pathways to Work green paper) for people with disabilities.

    There’s also a set of commitments on understanding and supporting the mental health needs of young people – although the focus is on schools and colleges, there is an expectation that universities will play a part in a forthcoming National Youth Strategy (due from the Department of Culture, Media, and Sport “this summer”) which will cover support for “mental health, wellbeing, and the ability to develop positive social connections.”

    All these joined up services will need joined up data, so happy news, too, for those looking for wrap-around support in transitions between educational phases – there will be a single unique identifier for young people: the NHS number. And for fans of learner analytics, a similar approach (with a sprinkling of genomics) will “tell [the NHS] the likelihood of a person developing a condition before it occurs, support early detection of disease, and enable personalised prevention and treatment”.

    For some time, universities and other trusted partners have benefited from access to deidentified NHS healthcare administrative data via ADRUK – which has been used for everything from developing new medicine to understanding health policy. This will be joined by a new commercially-focused Health Data Research Service (HDRS) backed by the Wellcome Trust. This is not a new announcement, but the slant here is that it will support the private sector – and as such there will be efforts to “make sure the NHS receives a fair deal for providing access”, which could include a mix of access charges and equity stakes in new developments.

    Research, research, research

    In effect, the government’s proposals set out how improving the conditions, configurations, and coordination of the NHS workforce, and the information provided to them and their partners, can improve healthcare. The next challenge then is targeting the right kinds of information in the right places, and this depends on the quality of research the NHS can access, make use of, and produce.

    The health of the nation does not begin and end at the hospital door. As The King’s Fund points out, “we can’t duck the reality that we are an international outlier with stagnating life expectancy and with millions living many years of life in poor health.” The point of this plan is not only about making health services better but about narrowing health inequalities and using life sciences research to grow the economy.

    The plan talks about making up for a “lost decade” of life sciences research. In doing so, it cites an IPPR report (the author is now DHSC’s lead strategy advisor) which demonstrates that the global research spend on life sciences in the UK has reduced and that this has had an impact on life sciences GVA. Following this line of thought suggests that if the UK had maintained levels of investment the economy would have got bigger, people’s lives would have been better and because of the link between poverty and ill health, the NHS would be under less pressure.

    The issue with this citation is that the figures used are from 2011–16 and some of the remedies, like association to Horizon Europe, are things the UK has done. Though the plan makes clear that “the era of the NHS’ answer always being ‘more money, never reform’ is over,” it is in fact the case that the government has ploughed record levels of public money into R&D without fundamental reform to the research ecosystem. The premise that economic growth can be spurred by research and leads to better health outcomes is correct – but it isn’t necessary to reference research carried out in 2019 to make the case.

    This isn’t merely an annoyance – it speaks to a wider challenge within the plan which oscillates widely between the optimism that “all hospitals will be fully AI-enabled” within the next ten years (80 per cent of hospitals were still using pagers in 2023 despite their ban in 2019), and the obviously sensible commitment to establish Health Innovation Zones which will bring health partners within a devolved framework to experiment in service innovation.

    The fundamental challenge facing innovation within health is the diffusion of priorities. There are both a lot of things the NHS and life science researchers might focus their time on, and a lot of layers of bureaucracies that inhibit research. The plan attempts to organise research priorities around five “big bets” (read missions but not quite missions). These include the use of health data, the use of AI (again), personalised health, wearables, and the use of robots. One of the mechanisms for aligning resources will be:

    a new bidding process for new Global Institutes. Supported by NIHR funding, these institutes will be expected to marshal the assets of a place – industry, universities, the NHS – to drive genuine global leadership on research and translation.

    It’s very industrial strategy – the government is setting out big ideas with some incentives, and hoping the public and private sector follows.

    There are some more structural changes to research aside from the political rhetoric. Significantly, there is a proposal to change the funding approaches of the Medical Research Council and National Institute for Health and Care Research to pivot funding toward “prevention, detection and treatment of longterm conditions”. The hope is this approach will drive private investment. Again, like the industrial strategy, the rationale is that the state can be an enabling force for growing the economy.

    Ten years’ time

    The ten year plan, if it is to mean anything, has to be focused on delivering a different kind of health service. The fundamental shift is about moving toward personalised community orientated care. The concern is that the plan is light on delivery, which would tally with reports that a ninth chapter on delivery is missing all together.

    The NHS is stuck in a forever cycle of reform, failing to reform, entering crises, and then being bailed out from crises. The mechanisms to break the cycle includes changes to the workforce, new skills provision, using data differently, and reorientating life sciences research toward prevention and economic growth.

    The higher education sector, research institutes, and companies working in research are not only central to the new vision of a NHS but with the amount of investment placed on their capacity to bring change they are no less than the midwives of it. The government’s biggest bet is that it can grow the economy, improve people’s lives, and in doing so reduce pressure on public services. Its biggest risk is that it believes it can do this without fundamental reform to higher education or research as well.

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