Maintaining Experiential Learning Continuity and Integrity During a Global Pandemic
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Maintaining experiential learning continuity during a pandemic 351
Maintaining Experiential Learning
Continuity and Integrity During a
Global Pandemic
Kimberly L. McVicar, DHA, MSA, MT(ASCP) & Gail L.
Bullard, DHEd, MSA, RN
Abstract
The purpose of this article is to describe the dynamics of the undergraduate
and graduate health administration programs at Ferris State University, a mid-
sized university in rural West Michigan, during the coronavirus pandemic.
Specifically, the authors address the management of concerns from students
whose experiential learning activities were interrupted during the spring 2020
semester as well as from students who planned to begin their experience in
the summer 2020 semester. Also highlighted are the specific programmatic
changes made to accommodate interns during this time of uncertainty.
While undergraduate and graduate students were encouraged to continue
their experiential learning activities remotely, this was not feasible for many
healthcare organizations as preceptors were furloughed or overwhelmed with
duties. The undergraduate internship design is largely project-based so interns
could complete their projects under the direction of a faculty mentor, utiliz-
ing email and the Zoom platform for communication. In lieu of missed hours
on-site, students were assigned research on the effects of COVID-19 on the
healthcare system in the United States. Graduate capstone alterations included
options for students to continue with virtual experiences when possible, an
extension of the project for a second semester, or a choice of three options for
remote completion: a retrospective-prospective thesis, a quality improvement
case study thesis, or a qualitative analysis thesis, each to include perspectives
from current healthcare leaders, a relationship to COVID-19, and direct align-
ment with program and course outcomes. Faculty and students navigated
Please address correspondence to: Kimberly L. McVicar, DHA, MSA, MT(ASCP), Associate
Professor, HCSA and MHA programs, College of Health Professions, Ferris State University,
200 Ferris Drive VFS 410, Big Rapids, MI 49307, Phone: (231) 591-2280
Email: kimberlymcvicar@ferris.edu352 The Journal of Health Administration Education Spring 2021
these changes amid other confounds such as a change from Blackboard to
the Canvas learning management system and preparation for a Commission
on Accreditation of Healthcare Management Education (CAHME) virtual
accreditation site visit for the graduate program in November 2020.
The article concludes with author evaluation of alternate deliverable quality
and reflection upon useful resources, maintenance of preceptor relationships,
and student feedback. Lastly, authors reveal how fall 2020 course delivery will
be impacted.
Background
According to the National Association of Colleges and Employers (NACE,
2020a), in April 2020, only 35% of employers reported moving forward with
on-site internships as planned prior to the COVID-19 pandemic. Congru-
ently, health systems in Michigan, like many other states, strained to adapt
to the rapidly changing coronavirus landscape. Henry Ford Health System
temporarily furloughed up to 2,800 employees (Greene, 2020). Beaumont
Health temporarily laid off 2,475 employees and permanently eliminated
450 positions (Greene, 2020). To adjust to the industry, economic, and health
impacts of the virus, academic programs were pressed to quickly develop
contingencies to their traditional experiential learning formats. The purpose
of this article is to describe the programmatic changes made to the internship
and capstone project/thesis experiences for students completing undergradu-
ate and graduate degrees in health administration at Ferris State University
in Big Rapids, Michigan.
Ferris State offers a bachelor’s degree in Health Care Systems Administra-
tion (HCSA) within its College of Health Professions (COHP). The traditional
HCSA internship requirements include six weeks (240 hours) on-site in a
hospital setting and ten weeks (400 hours) on-site in a healthcare organization
(these ten weeks do not have to be in a hospital; students are free to select
healthcare organizations that match their career goals, such as long-term care
facilities or private practices). Both internships are project intensive; students
are required to compose weekly memos and complete up to 14 projects per
internship in addition to their daily on-site activities.
To conclude and enhance their didactic requirements, Ferris State’s Master
of Health Administration (MHA) program requires students to complete a
160-hour internship in a clinical setting of their choice to design either a spe-
cialized healthcare leadership or a healthcare quality and safety leadership
capstone project, from which their thesis is devised. Additionally, students
are required to complete a portfolio project highlighting two primary ele-
ments: coursework that exemplifies competency in all program outcomes andMaintaining experiential learning continuity during a pandemic 353
evidence demonstrating aptitude related to each of the 26 National Center for
Healthcare Leadership Model 2.0 (v2.1) (NCHL, 2006) competencies. (Model
2.0 was used as the program curriculum revisions to upgrade to Model 3.0
were not finalized at the time this article was written.) This program is actively
seeking Commission on Accreditation of Healthcare Management Education
(CAHME) accreditation and is preparing for a virtual site visit in November
2020.
Programmatic Changes—Undergraduate Program
Most of the spring 2020 HCSA interns were fortunate enough to be able to
complete portions of their experiential learning on-site at their respective
healthcare locations prior to pandemic-related modifications. As suspensions
arose, students were advised to complete the traditional projects. Only three
students were able to continue working on their projects remotely under the
direction of their site preceptors. The remaining 14 interns transitioned to
finishing projects in collaboration with faculty mentors.
Students were advised of additional resources available to them as faculty
became aware. For example, students were encouraged to utilize the free re-
sources extended to them by VitalSource (including Health Administration
Press eTextbooks) between the dates of March 16 and May 25, 2020 (AUPHA,
2020a; VitalSource, 2020). Similarly, the American College of Healthcare
Executives (ACHE, 2020) made career resource webinars on topics such as
resume and LinkedIn profile optimization available to students for free. The
American Hospital Association (AHA, 2020) shared hospital recovery, reopen,
and other communication examples. The Association of University Programs
in Health Administration (AUPHA, 2016) offered webinars on topics such as
projected short- and long-term impacts of the pandemic on health manage-
ment careers. Inherently, agencies such as the Centers for Disease Control and
Prevention (CDC, 2020) maintained updated coronavirus resources such as
toolkits, pandemic planning scenarios, and communication resources. These
resources proved invaluable to the altered student experience. Additionally,
to account for missed face-to-face hours, students were assigned a research
paper on the effects of COVID-19 on healthcare in the United States.
The HCSA program had 27 registrants for summer 2020 internship. Note
that this number does not necessarily equate to 27 students as a single student
could be registered for both the six-week and ten-week internship in the same
semester. One student elected to delay her internship to fall 2020 hoping for
a traditional face-to-face experience. Three students were able to work on
projects with site preceptors: two students completed projects by working
with their preceptor remotely and, as an employee of the organization she354 The Journal of Health Administration Education Spring 2021
was completing her internship at, one student enjoyed face-to-face encounters
with her preceptor during her regularly scheduled shift hours. The alternate
internship experience for the remaining 23 students was devised participatively
and composed of the following five primary elements:
Weekly memos: Students sent weekly memos to faculty mentors highlighting
concerns, time spent on tasks, deliverable progress, and any other items the
student wished to address. Literature reinforces the importance of schedule
adherence and structure for the virtual intern (NACE, 2020b).
Projects: Students were required to complete a designated number of struc-
tured projects (six-week interns completed two projects, and ten-week interns
completed four projects). Project options included managerial skills, finance,
human resources, process improvement, privacy, data security, materials
management, reimbursement methods, professionalism, medical staff, regula-
tory agencies, departmental functions, marketing, volunteer services, meeting
observations, and outpatient clinical services. If students elected to complete a
meeting observation project, they were directed to credible meeting archives.
For example, the Central Michigan Regional Rural Health Network, a collab-
orative that includes healthcare providers, academic institutions, and health
and social needs organizations, shares recorded meetings publicly (Together
We Can, 2020).
Leadership book reviews: Students were required to read and review leader-
ship books that were chosen with faculty mentor guidance (six-week interns
reviewed two books and ten-week interns reviewed three books). Examples
of books, suggested by faculty for originality, freshness, and lack of use in
program courses, included:
• Five Disciplines for Zero Patient Harm: How High Reliability Hap-
pens (Molwell, 2019).
• The Price We Pay: What Broke American Health Care and How to
Fix It (Makary, 2019).
• Intangibles: The Unexpected Traits of High-Performing Healthcare
Leaders (Kaissi, 2018).
• Health Systems Thinking: A Primer (Johnson, Anderson, & Rossow,
2020).
• Reframing Healthcare: A Roadmap for Creating Disruptive Change
(Neuwirth, 2019).
• Diversity on the Executive Path: Wisdom and Insights for Navigating
to the Highest Levels of Healthcare Leadership (Dixon, 2020).Maintaining experiential learning continuity during a pandemic 355
Coronavirus research: Students developed a traditional research paper or
original case study addressing the impacts of the coronavirus on healthcare
in the United States.
Zoom meetings: Consistent with best practices, interns were provided op-
portunities to interact with one another (NACE, 2020b). Zoom meetings were
utilized to share project ideas and content and promote meaningful interactions.
Students were introduced to resources such as interventional radiology and
emergency department YouTube videos presented in Health Administration
Press’s (HAP, 2020) Middleboro as Internship product to potentially assist
with projects and inspire talking points.
Programmatic Changes—Graduate Program
Ferris’s MHA students spend a great deal of time conceptualizing their cap-
stone project/thesis ideas. They compose a paper in all 12 primary program
courses highlighting which explicit curricular concepts contribute to their
overall project goals. Accommodations for spring 2020 MHA interns were very
individualized as adjusting partially completed capstone projects can be both
challenging and disappointing for students. Most interns in the spring 2020
cohort elected to extend their work an additional semester due to constraints
related to the coronavirus pandemic. One student who was collecting chart
preparation error data was able to complete her thesis on time by settling for
one less month of data than originally planned.
The following programmatic changes were developed participatively
(in concurrence with COHP-level leadership) and documented internally (as
documentation may be requested by a CAHME site visit team) for the MHA
program for the summer 2020 semester:
• Graduate students not currently employed in healthcare were advised
to postpone the capstone project until fall 2020 or spring 2021, when
they would projectably be able to complete a traditional 160-hour
internship experience. This impacted one student.
• Students currently employed in a healthcare setting were permitted
to utilize that setting for capstone project work provided supervisory
permission was granted and documented.
• To gain perspective on applicability of thesis projects in healthcare
settings, students not able to complete projects on-ground were ad-
vised to incorporate a minimum of two healthcare leader interviews
into their work.356 The Journal of Health Administration Education Spring 2021
• The following thesis formats were implemented to facilitate remote
and independent work:
Retrospective or prospective thesis: Students could elect to com-
plete a retrospective or prospective thesis based on their previously
conceptualized project topic. In addition to investigating existing
data or newly generated data (or both) (Forister & Blessing, 2020),
the study must include a minimum of two virtual interviews with
healthcare leaders and reference the COVID-19 pandemic. The
study would conclude with students’ reflection on how the work
relates to all program outcomes and to a minimum of four NCHL
competencies.
Quality improvement thesis: Students could select a quality im-
provement thesis based on their previously conceptualized project
topic. This project would be written as a case study using the A3
model to facilitate decision making, problem solving, and/or process
improvement (Mohd Saad et al., 2013). Scholl (2017) contends case
study research affords writers a high degree of flexibility compared to
other qualitative methods as it can be tailored to a variety of research
purposes while affording researchers the opportunity to explore
their creative abilities. This study would also include a minimum
of two virtual interviews with healthcare leaders, discussing the
feasibility and application of this topic in healthcare, and reference
the COVID-19 pandemic. The study would conclude with students’
reflection on how the work relates to all program outcomes and to
a minimum of four NCHL competencies.
Qualitative analysis thesis: Students could choose to complete
a qualitative analysis thesis using credible data repositories and
content analysis to examine textual data for recurrent words or
phrases to extract themes (Watzlaf & Forrestal, 2017). An example
repository: The United States Department of Health and Human
Services (HHS, 2020) released detailed COVID-19 testing plans from
all states, territories, and localities.
Forister and Blessing (2017) reinforce the impact of qualitative
research in healthcare: its naturalistic, participatory approach
allows researchers to explore reality as defined by individuals’
experiences in natural settings. As with the previous two options,
this study would highlight a minimum of two virtual interviews
with healthcare leaders, discussing the feasibility and applicationMaintaining experiential learning continuity during a pandemic 357
of this topic in healthcare, and reference the COVID-19 pandemic.
This choice would also conclude with students’ reflection on how
the work relates to all program outcomes and to a minimum of four
NCHL competencies.
The summer 2020 MHA intern cohort embraced a narrow window of time
to develop contingency plans for their capstone projects. Students communi-
cated with the program coordinator to conceptualize capstones that could be
realistically accomplished despite the uncertain healthcare industry landscape.
Students and faculty also brainstormed and collaborated via Zoom sessions.
Five of the eight interns are completing quality improvement projects while
the remaining three planned qualitative analysis theses.
Discussion and Reflection
Both the HCSA and MHA programs extended the aforementioned internship
modifications into the fall 2020 semester. We were pleased with the quality of
work submitted during the spring and summer semesters. Students expressed
their partiality to the flexibility of the alternate internship, communication via
Zoom meetings, and the plethora of online resources afforded to them. Al-
though face-to-face interactions are expected to resume in modified capacities
at Ferris, fall 2020 interns began to articulate concerns about healthcare site
availability. While faculty desire a return to a traditional on-site internship
approach, we remain mindful and respectful of the uncertainties faced by
healthcare professionals and preceptors and understand why returns would
not be immediate. We had affiliated sites that were unable to accept interns for
fall and one site that accepted students for clinical programs only, suspending
nonclinical prospects. At the time this article was written, only 2 of our 18 fall
interns (13 HCSA and 5 MHA) had secured a traditional internship experience,
one in a hospital setting and one at the student’s place of employment. The
remaining 16 students moved forward with the alternate internship designs.
Research suggests academic programs may benefit from establishing intern-
ship opportunities with sectors of healthcare that have potentially absorbed
lesser financial impacts relative to the pandemic, such as health insurers,
medical device companies, and pharmaceutical companies (AUPHA, 2020b).
One alternate project idea we entertained but did not have sufficient
time to develop involved the use of Tableau Public. Tableau is a global leader
in analytics and data visualization software (Tableau Public, 2021; Health
IT Outcomes, 2008) that not only connects users with data sources but also
enables them to create unique data visualizations such as charts, maps, and
dashboards via a simple drag-and-drop interface (Tableau Public, 2021; Ko358 The Journal of Health Administration Education Spring 2021
& Chang, 2017). Tableau Public extends these tools to users free of charge
(Tableau Public, 2021). Our MHA students are introduced to Tableau in their
informatics course. Because student feedback in terms of its hands-on nature
and appeal to visual learners has been positive, we will continue to explore
this idea for the future.
University-level changes to assist students and faculty ensued concurrent
with the program changes described earlier. As the pandemic progressed,
students raised financial, technological, emotional, and other individual
concerns. University resources available to students included tips for coping
with the anxiety surrounding COVID-19, tips for working remotely, hardware
and software access, online tutoring, food pantry connections, distribution
of Coronavirus Aid, Relief, and Economic Security (CARES) Act funding,
and virtual assistance from the Center for Leadership, Activities, and Career
Services Center (FSU, 2020a). Resources for faculty included accessibility,
collaboration, communication, digital media, and engagement tools (FSU,
2020b). The university also provided support to faculty and students as the
scheduled transition from the Blackboard learning management system to
the Canvas platform took place campus-wide effective May 2020. Although
this transition was well planned for, it was still an additional adjustment for
students and faculty to wade through.
The authors found CAHME and AUPHA resources very helpful. For ex-
ample, Town Hall opportunities for program leadership and faculty to share
challenges and potential solutions for managing internships, capstone projects,
and residencies, where applicable, were informative. CAHME standards require
students to have field-based experience within a program (CAHME, 2020).
However, during the pandemic, colleges were granted flexibility to design
alternate options for students to complete their program while still meeting
designated outcomes. This flexibility was appreciated by faculty and students.
Although virtual internships were imminent in the current work environ-
ment, literature reveals important concerns with the dynamic. The authors
agree virtual interns, particularly those with little or no healthcare experience,
could be missing out on vital opportunities to enhance key soft skills such as
understanding professional cultures and networking (NACE, 2020c). Alter-
natively, we also contend most students have portrayed a commendable level
of adaptability and resilience. Ruggiero and Boehm (2016) contend digital
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