Title: Wisconsin
1Wisconsins Statewide Clinical Placement Summit
Meeting the Challenge of Expanding Clinical
Nursing Opportunities
- Roberta Gassman, Secretary
- Department of Workforce Development
2Wisconsins Economy
3Wisconsins Economy
- Fiscal house in order and economy on track
- Jobs up, unemployment down -Gained 187,400
jobs 9,000 employers since Jan 03 - Natl Honor Roll twice -1 of 6 states Corp for
Enterprise Dev. - Exports up 60 since 2003
4Governors Opportunity Budget for Working Families
- Fiscally Responsible
- Invests in Shared Priorities
- Creates Opportunities
- Tax Relief for Middle Class Families-Health
Insurance, Child Care, Tuition, Social Security - Create Jobs
- Save Taxpayers 1.7B in 4 yrs
- Helps Communities and Businesses
5Governors Opportunity Budget for Working Families
- Education
- Tripling School Breakfast
- Quality Child Care
- Funding 2/3 of K-12
- Special Ed increase by 54M
- 4 yr old K SAGE
- 3rd year Math Science
- Wisconsin Covenant
- Tech College/Worker Training increased x 4
- Doubling Youth Apprenticeship
6Governors Opportunity Budget for Youth
Apprenticeship
- 30 in Health Care Careers
- Youth ApprenticeshipFunding Doubled
7Governors Opportunity Budget for Higher Education
- To increase nurse capacity
- 225 M to UW System
- Covenant Office
- Financial aid increased by 44M
- Limited tuition increase to 4
- 21M UW Growth Initiative
- Funding for emerging and essential occupations
nurses, teachers, scientists, engineers
8Governors Opportunity Budget for Working Families
- Affordable Health Care
- Expand BadgerCare Plus
- -all children
- -low wage adults, pregnant women
- Catastrophic coverage
- Anti-smoking
9DWD Efforts
- 2nd Annual WI Health Care Workforce Report
- This document represents our yearly checkup
- Defines challenges
- Provides updates
- Copies available on-line at dwd.wisconsin.gov/hea
lthcare
10Health Care Occupationsin High Demand
- Nationally - 30.3 growth and 4.7 million new
jobs by 2014, 3 of every 10 jobs will be in
health care - Wisconsin Specifically for nursing, we will
need RNs to fill 1,600 new jobs and 1,010
replacements every year to 2014
11The Top Jobs by 2014
- Top jobs in new job growth
- Health Diagnosing and Treating Practitioners,
Registered Nurses, Health Technologists and
Technicians, Nursing/Psychiatric/Home Health
Aides, Home Health Aides, Other Healthcare
Support Occupations - Top jobs in growth
- Physician Assistants, Registered Nurses,
Respiratory Therapists, Dental Hygienists,
Diagnostic Medical Sonographers, Surgical
Technologists, Medical Records and Health
Information Technicians, Home Health Aides,
Dental Assistants, Medical Assistants - Top job growth in overall s
- Health Diagnosing and Treating Practitioners,
Registered Nurses, Health Technologists and
Technicians, Nursing/Psychiatric/Home Health
Aides, Home Health Aides, Other Healthcare
Support Occupations
12Collaboration
- Health Care stakeholders must work together to
avoid potential shortages of nurses and other
health care workers - Working together, we can make the health care
sector more attractive by building career ladders
and bridges to family supporting jobs
13Summit Resolution
- Let us reaffirm our commitment to finding
solutions to the challenges facing the health
care sector - Please join with me in the signing of this
Resolution
14DWD Efforts
- Select Committee on Health Care Workforce
Development formed in 2003-key stakeholders -
- ? Health Care Organizations Advocacy
Groups- home health, nursing homes, long-term
care - ? Labor
- ? Education
-
- ? Other government agencies
15DWD Efforts
- Workplace Issues - Developing best practices to
improve retention rates. - Stronger Data for Planning To improve
projections of health care occupations in demand.
- Clinical Site Capacity and potentially developing
an on-line product to assist with placement and
reservation.
16DWD Efforts
- Governor Doyles Safe Lifting Initiative
- 325,000 WIA funds-18 projects around the state
- 7,500 nurses other health care workers recd
training in proper lifting
Employees from Gunderson Lutheran Hospital, La
Crosse, demonstrate a safe lifting device to
Secretary Gassman
- Bureau of Labor statistics-6 of top 10
occupations at highest risk for back injuries are
in health care
17- Working together keeps our Health Care Workforce
1
18Senator Herb Kohls Health Care Agenda
- JoAnne Anton
- State Director
- Senator Kohls Office
19Overview of Clinical Placement Issue
- Nancy Sugden, Director
- Wisconsin Area Health
- Education Centers
20Health Workforce Concerns
- ?Changing healthcare needs of the population
- ?Current and projected shortages in the
healthcare workforce - ?Chronic maldistribution of the workforce -
number of rural and urban underserved areas
(HPSAs) - ?Limited access of students from minority and
rural backgrounds to health professions careers
21Initial Statewide Efforts
- April 2000 -
- Formation of Health Care Workforce Coalition
- joint project of WHA, AHEC and many other
partners - April 2002 -
- WTCS organized conference
- Taking Action! Creating Healthcare Workforce
Solutions - Spring 2003 -
- Formation of Governors Select Committee for
HealthCare Workforce Development
22Initial Statewide Efforts
- Health Care Workforce Coalition
- early conversations about actions needed to
address anticipated shortages - initial focus on health careers
recruitment/pipeline, career ladders,
apprenticeship programs and longterm care needs - quickly found major roadblock - limited capacity
of training programs to expand, in part due to
need for clinical placements - WTCS activities
- standardization of health professions curricula
and pre-requisites across campuses,
transferability of courses, development of
on-line options, expansion of facilities and use
of sophisticated patient simulators
23Academic Program Initiatives
- support for health careers activities and
pipeline programs in underserved areas and
populations - several grant-funded projects focused on
increasing the number of masters-prepared nurses
available to teach in the health professions
programs, especially nursing - NET
- SWIFT
- LEAP
- Other grant-funded initiatives to develop
capacity of community-based sites and providers -
to provide learning opportunities for health
professions students
24Regional Efforts
- Development of regional collaborations under
leadership of several different groups - Regional AHECs and academic partners
- health careers
- continued effort to develop new community-based
training sites - Local Workforce Boards giving increasing
attention to health workforce issues -
- Fox Valley Health Care Alliance
- La Crosse Health Science Consortium
25Current Status
- Diminishing federal grant resources available to
academic programs to address healthcare workforce
issues (Title VII Health Professions funding) - Increasing appreciation of
- the challenge posed by current and impending
health workforce shortages - the need for a collaborative, regionally-focused
approach with broad external statewide support to
get the job done - Must expand capacity for clinical placement
26Clinical Placement
- What are clinical placements?
- Coursework involving hands-on, direct care or
service - experience and evaluation of the students
skills, - variously referred to as
- Clinical
- Clinical rotation
- Clerkship
- Fieldwork experience
- Community placement
- Practicum
- Internship
27Clinical Placement
- Why are clinical placements so important?
- Couldnt we fill the need through expanded use of
manikins, clinical simulators and standardized
patients? - Students need experiences outside the formal
classroom, in community and patient care settings
under the supervision of skilled practitioners,
to develop their critical thinking and clinical
judgment skills and learn to use those skills in
a dynamic work environment.
28Clinical Placement
- What kind of students?
- Technical college associate degree and technical
training programs - Undergraduate health professions degree programs
- Advanced degree programs
- What fields?
29Clinical Placement
- What kind of facilities?
- direct patient care (inpatient or ambulatory)
- technical and support services such
as pharmacy radiology dietetics social
work - long-term care facilities
- mental health facilities
- hospice
- home health
- other community agencies
- schools and public health agencies
30Clinical Placement
- How scheduled?
- Time blocks of 2 hours to a full day
- A few days a week, integrated into a general
education curriculum and a regular campus course
schedule - or
- A full-time block of several weeks when students
may be engaged in the field experience full time
31Clinical Placement
- Who teaches and supervises the students?
- faculty from the academic program who accompany
students to the site - or
- staff at the clinical site in consultation with a
faculty clerkship director who makes occasional
site visits - On-site staff are often called preceptors,
mentors - or community faculty and may have volunteer
- appointments with the academic program.
32Clinical Placement
- What are the expectations of the student?
- The student may be merely observing, or may be
participating directly in patient care or service
delivery. -
- The independence expected of the student in
carrying out assigned tasks evolves as the
students training progresses. - Sites and preceptors must be prepared to evaluate
the students progress and permit increasing
responsibility appropriate to the students level
of development.
33Focus on Nursing
- Summer of 2006 survey of health professions
programs indicated a need for more clinical
placements in many disciplines. - Why initial focus on nursing?
- nursing shortage affects so many different care
settings and agencies - training site requirements so varied within just
one discipline - expectation that lessons learned and regional
collaborations developed will speed efforts for
other disciplines.
34Nursing Curriculum
- Diverse curricula, but in general
- ADN and BSN students need 4-5 clinical placements
- at least one every semester (except BSN
sophomore entry programs). - One clinical placement may involve scheduling
experience for the student on more than one
service within a facility. - Students spend from 12-24 hours per week at the
clinical site, in 2-6 hour blocks of time. - PN, first year ADN and junior year BSN students
are taught in groups of 8, usually by a faculty
member who travels with the students to the site.
- Second year ADN and most senior year BSN programs
use preceptors on site for one of the clinicals.
The transition or practicum experiences
provide a 11 relationship of student to
preceptor, and an opportunity for the student to
exercise more independence.
35Nursing Clinical Placements Needed
- Core clinical skills
- Hospitals
- Long term care facilities
- Community health and service learning
- Public health
- Community agencies
- Other
- School health clinics
- Mental health facilities
36 Challenges for Nursing Programs in
Arranging Clinical Placements
- Will the patient or client mix at the site meet
the needs of the specific component of the
training program for which a training site is
needed? - Is the site able to provide space for students to
meet as a group? Will students be able to access
computers and on-line information resources at
the site if needed? - Are there staff at the site qualified to
teach/precept/supervise students? Can they get
release-time for preceptor development
activities? - Is housing available on-site if students will be
there full time and must travel a distance to the
site? - Does the site understand the role of the student
as learner, not as an extension of the workforce?
- Does the site understand its obligation to
provide emergency care for students who become
ill or are injured? - What are the requirements of the partnership
agencies regarding documenting students,
affiliation agreements, and risk management,
liability and malpractice issues?
37Challenges for Healthcare Organizations and
Providers
- Meeting the needs of different occupations,
educational programs and levels of student. - Assuring that the patient to student ratio is
acceptable and that patients are agreeable to
student-delivered/observed care. - Establishing and verifying both school and
facility expectations regarding staff role with
students. - Coping with the lack of standardization in record
keeping processes and expectations among the
educational programs. - Providing clinical time around academic program
schedules. - Clarifying risk management/liability and all
other variables relating to the relationship. - Educating managers and staff regarding their own
responsibilities, school expectations and student
abilities. - Small or specialty units and facilities far
removed from the school location may have
additional special issues to address.
38Barriers
- lack of trained community preceptors with time to
teach - barriers of time and distance for students and
faculty - limited scheduling flexibility
- lack of classroom space and equipment for
students at smaller facilities - administrative burden on smaller facilities
without an education coordinator - some academic programs are proprietary about
sites - unwillingness to change from the way we have
always done things
39- Opportunity to explore these challenges in our
regional discussions over lunch
40Update on Nursing Shortage 2007
- Ann Cook, RN, PhD
- Board Member,
- Wisconsin Center for Nursing
- Professor, Columbia College of Nursing
41(No Transcript)
42Nursing Workforce National Picture Overall
Trends
- Shortage easing somewhat?
- Latest projection is 340,000 (vs. 1 million)
shortfall by 2020 - Health Affairs, Jan/Feb 2007 Auerbach,
Buerhaus, Staiger - Age of entry into profession has increased
- Vacancy rate 8.5 (Down from 13)
- Demand continues to increase
- Salary increases have slowed
- Aging workforce
- Looming PMD shortage ? Demand for NPs
43Current RN WorkforceNational Sample Survey of
RNs 2004
- 2.9 million registered nurses
- Increase of 7.9 from 2000
- 2.4 million (83.2) employed in nursing
- Increase of 10 from 2000
- 58 employed full-time
- 25 employed part-time
- 16.8 not employed in nursing
- 56 employed in hospitals
- Decrease of 3 from 2000
- 11.5 employed in ambulatory care
- Increase of 2 from 2000
44Aging Workforce National Picture
- Average age of RNs is 46.8 years
- 26.6 under age of 40
- 16.6 under age of 35
- 2000 31.7 under age of 40
- 1980 40.5 under age of 35
- 25.5 over age of 54
- 2000 24.3 over age 54
- 1980 17.2 over age 54
- Largest age cohort in 2004 is 45-49
45Age Distribution of RNs in U.S.
46Nursing Workforce Wisconsin
- 73,073 licensed RNs (As of Sept. 2006 Dept of
Regulation and Licensing) - Estimate 60,000 in workforce (based on National
Sample Survey figure of 83) - 41 of RNs work part-time (2004 RN National
Sample Survey) - 54 of RNs work in hospitals (2001 WI RN survey)
- Average age of RNs is 47.6 years
- 27 of RNs are under 40 years of age
- 44 of RNs are 50 years or older
- Average age of nurse educators is 50.3 years
-
47(No Transcript)
48Will there be enough RNs in 2015 and 2020 to care
for you and your family?
- Aging Population and Aging RN Workforce
- Increased demand in outpatient, home health, long
term care, hospice settings - Impact of technology
- Could make nurses more efficient and able to
manage more patients - Could also increase demand
49Employment ProjectionsOffice of Economic
Advisors, WI DWD, July 2006
- RN is one of top 5 occupations with most openings
- RN is one of top 30 fastest growing occupations
- RNs are the top occupation with most new jobs
- From 2004-2014 26,100 jobs (2,610/year)
- 16,000 new jobs
- 10,000 replacements
- Many new jobs are in Ambulatory Health Care
Services
50Current State Demand RN Jobs
- Based on quick web site search 3/26/07
- Approximately 1000 RN openings
- Many openings required advanced education or
specialty area experience - Nurse Practitioner
- Clinical Nurse Specialist
- Critical Care or ER
- Hospice and home care
- Surgery services
- Behavioral health
- Floating or PRN pool
- Management
- Long term care
51Contributing Factors Supply
- Increasing supply now
- School enrollments increased after 2000
- Partnerships between clinical settings and
nursing schools - Increasing options for students to enter
profession - Johnson Johnson campaign
- Decreasing supply in future
- Aging nursing school faculty
- Increased average age of nurses
- Increased number of RNs retiring in next ten
years
52Contributing Factors Demand
- Increasing elderly population
- Outpatient services
- Long term care and home-based services
- Physician office practices
- Nurse Practitioners Acute care and Community
Clinics - Specialty areas Surgery, Oncology
- Management
- Faculty
53Wisconsin Residents
- 1 in 8 residents over age 65 in 2005
- 1 in 6 in 2020, 1 in 5 in 2030
- Age group 55-64 grew by 27 from 2000-2005
- Those 64 in 2005 will be 79 in 2020
- Many nurses in this group
- Age group 85 grew by 22 from 2000-2005
- Fastest growing age group
- (Health Care Wisconsin Report from the
Governor's Health Care Workforce Shortage
Committee, 2005 Wisconsin Department of Health
Family Services)
54Faculty Shortages National
- Vacancy rate of 7.9 in BSN and graduate programs
most positions required a PhD (AACN, 2006) - Vacancy rate of 5.6 in associate degree programs
(NLN, 2006) - Nursing schools turned away gt 41,000 qualified
applicants for baccalaureate and graduate
programs (AACN, 2006) - Insufficient faculty, clinical sites, classroom
space, clinical preceptors and budget constraints - Troubling Trends (NLN, 2006)
- Increase in part-time faculty
- Aging of faculty
- Decrease in doctorally prepared faculty
55Faculty Shortage WI
- Vacancy Rate as of October 2006 6
- BSN and graduate programs 9
- Associate degree 2.4
- Projected Retirement in next 5 years
- Administrative positions 23
- Faculty positions 18
- Source Survey conducted by Wisconsin Center for
Nursing, 2006
56Nursing Schools Have Responded
- 2001-2005 National (AACN, 2006)
- Enrollment increased by 57 in generic entry
level BSN programs - Graduation increased by 37.7
- 2001-2005 Wisconsin
- NCLEX first time pass rate increase by 45
- Associate degree increase 49
- BSN increase by 39
- UW Schools by 37
57Nursing School Strategies
- Clinical simulations
- Collaborative learning environments
- Distance education
- Sharing of resources
- Academic-service partnerships
- More part time, temporary, adjunct faculty,
faculty overload
58Question for WI Will SupplyDemand?
- WI does not have coordinated, systematic method
of collecting nurse workforce data - Supply
- Demand
- Without this information - cannot develop a plan
to meet the needs of the citizens of WI - Healthcare marketplace is slow to respond to
needs - Marketplace creates surpluses and shortages that
do not meet needs of population - Specialty areas
- Geographical areas
-
59WI Prepare for the Future
- Need to answer these questions
- Is the supply of nurses adequate to meet the
health needs of the citizens of WI? - Does the nurse workforce have the right skills
and education to provide quality care in the
right locations and specialties? - Does the nurse workforce reflect the cultural and
racial make-up of the state? - WI must have basic nurse workforce data
- Supply Demographics, Work settings, Education,
Hours of work - Demand Across all settings available positions
and requirements, turnover and vacancy rates,
projected needs
60Break
- Please be back in 10 minutes
61Fox Valley Healthcare Alliance (FVHCA)
Retirement and Departure IntentionSurvey Data
Clinical Placement Efforts
Presenters Cheryl Welch and Norma Tirado
62FVHCA Partners
- ? Affinity Health System ? Ripon Medical
Center - ? Agnesian HealthCare ? UW-Fond du Lac
- ? Aurora Health Care ? UW-Fox Valley
- ? BrightStar Health Care ? UW-Oshkosh
- ? Circle of Care Co-op ? Winnebago County
Health Department - ? Community Health Network ? Wisconsin Center
for Nursing - Berlin
- ? Fox Valley Technical College
- ? Fox Valley Workforce Dev. Board
- ? Marian College
- ? Moraine Park Technical College
- ? Northeast WI AHEC
- ? Park View Health Center
63Clinical Placement Efforts of the FVHCA
64- From an October 2006 FVHCA Clinical Placement
Summit, the three top issues surrounding clinical
placements, were identified by attendees. - They centered around the areas of
- 1) Preceptors
- Uniformity/Standardization
- 3) The vast number of clinical placement
requests (most wanting the same time/place)
65Three workgroups were formed for each issue and
brainstorming started immediately!
- During the next 6-9 months, the Preceptor
Committee (1) will focus their efforts on - Preceptor education (What is a preceptor? What
qualities/skills should someone have? How do we
promote/market being a preceptor?) - Uniform evaluation (of preceptors and of the
entire experience, so preceptors have a voice) - Recognition (reward system, what would a
preceptor appreciate as a token of thanks?
Luncheon? Preceptor of the year? Pin for
nametag? Gift certificates?)
66Uniformity/Standardization committees (2) areas
of concentration
- A Universal/Uniform orientation across area
facilities - Development of a Skills Checklist (For precepted
experiences, will help everyone know what a
student can really do) - Consistency in what area facilities require from
students (paperwork, healthcare requirements,
etc.) - Development of a concise, collaborative process
of how to submit and request a clinical.
67And finally, the Clinical Placement subcommittee
(3) will work on
- Researching innovative clinical placement models
that promote thinking outside the box. - Data gathering (Need to know what schools and
healthcare facilities want/need/already do/can do
to identify matches and mismatches) - Securing funding for possible projects
- Simulation center for all to share
- On-line clinical placement system
68Each workgroup meets 1-2 times before each full
FVHCA meeting and reports on its progress, while
also asking for input/ suggestions from all
members.
A Partial List of Successes to date
Development of FVHCA website www.fvhca.org
Job shadow requirements/paperwork has been
standardized with major healthcare systems
involved. Healthcare requirements have been
standardized. Criminal background check group
has been formed as a resource for schools.
69Retirement and Departure Intentions Survey
- Our goal was to gather relevant data to identify
the specific healthcare workforce needs (in all
areas, not just nursing) for the seven county
region of the Fox Valley WDA Calumet, Fond du
Lac, Green Lake, Outagamie, Waupaca, Waushara,
and Winnebago Counties.
70Update/Results
- Survey of nearly 7,800 Fox Valley healthcare
employees. - Six healthcare organizations represented in
initial data. - Averaged 60 response rate.
- Margin of error /- 0.5 (finite population
calculation)
71Respondent Demographics
- 70 full-time employees
- Occupational setting
- 22 Registered Nurses
- 6 Nursing Aide/Assistant/Attendant
- 5 Licensed Practical/Vocational Nurse
- 4 Medical Transcription/Coder
- 3 Medical Records/Health Information
Technician - Employment Setting
- 47 work in hospitals
- 29 work in clinical outpatient
- 7 long-term care.
- Years of healthcare employment
- 25 - 5 years or less
- 45 - 6 to 20 years
- 30 - more than 20 years
72Retirement Intentions
73Major factors in retirement decision
- Of respondents 5 years or less from retirement
- Financial security at time of retirement (59)
- Reaching appropriate retirement age (41)
- Reaching eligible retirement age (40)
- Desire to pursue leisure activities (36)
- Job stress/pressure (34)
74Departure Intentions
- Just under 4 plan to leave within 24 months.
- 2 of RNs
- 2.9 of LPNs
- 5.9 of CNAs
- Major reasons in departure decision
- 45 insufficient salary and benefits
- 42.5 desire for a career change
- 39 job stress / pressure
- 31 emotional demands of the job
75Healthcare Staffing Assessmentstill working on
it!
- These surveys will
- Assess current number of positions staffed and
the age ranges of employees at each facility. - Assess anticipated staffing level changes over
the next 5 years. - A total of 7 occupational clusters and a
miscellaneous cluster. - These surveys are completed by individual HR
departments.
76Any Questions?
- For more information, please contact
- Cheryl Welch or
- Jen Meyer at the Fox Valley Workforce Development
Board - (920) 720-5600
- or
- jmeyer_at_fvwdb.com
77Western Wisconsin Clinical Placement
- La Crosse Medical Health Science Consortium
- Mary Lu Gerke, RN, PhD
78Shortage of Clinical Sites
- Bring the Stakeholders to the Table
- Schools of Nursing
- Western Technical College
- UW- Western Campus
- Viterbo University
- Winona State University
- Representatives of Clinical Sites
- Franciscan Skemp
- Gundersen Lutheran
- Tomah Memorial
- VA Medical Center
- Onalaska Care Center
- Mile Bluff Medical Center
- Vernon Memorial Hospital
- Professional Organization
- Wisconsin Hospital Association
79Create the Vision Set the Target
- Expand the number of clinical sites in the
regional areas - To better facilitate nursing clinical site
scheduling - To increase the amount of nursing faculty
available
80Whats the Process
- Assess/Analyze Capacity Demand Ratio
- Assure Competent Preceptors
- Develop a Memorandum of Agreement with
- Academic and Service Facilities
- Standardize Contracts
- Create Software Data House
- Develop a Clinical Placement Center
81Assess the Capacity - Demand
- Created a data base with all hospitals, nursing
homes, community health agencies, any potential
clinical site in 20 counties - Total 202 potential sites
- Created a Survey regarding Clinical Site and
Preceptor Availability (See handout) - Mailed out survey 50 completed mail out
reminders after two weeks 65 to date response
82On Line Preceptor Training
- Telehealth grant dollars from the LMHSC
- 30 students for the Winona online preceptor
program - 30 students for the UW-Madison online preceptor
program.
83Create an Agreement
- Sign by partners academia service
- To continue to the next steps
- Human resources to work on development
- Seeking funding for a Clinical Placement Center
84Development of a Clinical Placement Website
- Contract with Web Master Ken Graetz
- Estimate Cost 16,000 20,000 initial build
and start up - Need to Determine On-going structure cost
85Status of Software Programming
- Ken Graetz
- E-Learning Director
- Winona State University-Minnesota
86Supporting Online Collaboration
- Easy collaboration and coordination are the keys
to supporting clinical placement - The challenge is not as much technical as it is
human - What is needed
- Flexible online tools that allow partners to
collaborate and coordinate efforts themselves - Build capacity to collaborate at a distance
87Online Community Pilot
- 12 partners
- Tools
- Microsoft SharePoint
- Adobe Acrobat Connect Professional (Breeze)
- Use tools to
- Allow partners to build the solution that best
meets their needs - Allow partners to support the process themselves
without hefty license fees or a lot of
maintenance - Provide a framework and capacity for further
collaboration
88An Online Communispace
89Collaborative Documents
90Meeting at a Distance
91Clinical Placement On-line Software
- Elizabeth Biel
- Program Planning and Development Director
- Healthcare Education-Industry Partnership-Minnesot
a
92Box Lunches
- Please be back in 25 minutes
93Small Group Discussion
94Group Report Outs
95Next Steps
96Resolution Signing
97Thank you for your Participation