Empowering students to find their career passion 395

From the Classroom to the Workforce:

Empowering Students to Find Their
Career Passion
Diane M. Howard, PhD, Joanne E. Howard, PhD & Leodis
Scott, EdD

Abstract
A six-year retrospective analysis of graduate students in the Rush University
Health Systems Management program shows how their employment decisions
were affected by career programming. The study tracked 126 students and
assessed their career decision-making after being presented with 137 educa-
tional activities in the form of lunch and learns, site visits, American College
of Healthcare Executives’ events, book club meetings, and case competitions,
among other strategies. While the time period and number of students and
educational events were insufficient to draw conclusions, it was clear that
students need to visualize and discuss their career interests with practitioners
who can assist them in formulating their career interests. The article supplies
a survey used to track student interests upon entering an undergraduate or
graduate program that can serve to assist faculty in framing student career
interests. Educational programming around student career interests can be
developed to empower students in identifying and cultivating career choices.

Please address correspondence to: Diane M. Howard, PhD, Department of Health Systems
Management, College of Health Sciences, Rush University, 1700 W. Van Buren St., 126B TOB,
Chicago, IL 60612. Phone: (312) 942-5402; Email: diane_m_howard@rush.edu
396 The Journal of Health Administration Education Summer 2017

Overview: Directing Students to Careers

There are numerous opportunities in healthcare management for students to
consider. The difficulty for academic institutions and faculty is determining
best strategies to get students from the classroom to work (Pappano, 2016).
Academic institutions have often been considered ivory towers (Shapin, 2012)
that transmit book knowledge, but convey limited information about how
the world of work actually functions. Students are often ill-informed about
the career opportunities presented in healthcare so they pursue occupations
that receive the most notoriety – medicine and nursing (Viswanathan, 2014).
Students pursuing health management can often stumble into the field
after performing poorly in organic chemistry or physiology and deciding the
sciences are not for them (Matthews, 1965). They may take a public health or
health management course and feel comfortable with the subject matter. They
find information on access to healthcare, insurance reform, electronic medical
records, medical technology, quality, and practice management of interest.
But, what route is best to explore their interests and decide on a specific career
path (Margolis and Fisher, 2002)?
Providing students with career opportunities to explore and then im-
mersing them in the industry are the best strategies to move students from
the classroom to the world of work (ACHE, 2014; Lomperis, 2014). Students
have to see themselves in a career field if they are to pursue employment that
has meaning in their lives (Howard, 2015). The Commission on Accreditation
of Health Management Education criterion (2017) on career preparedness,
integrative experiences, and field-based applications reinforce the strategies
academic institutions deploy in moving students from the classroom to work.

The Theory of Rationalization

Stephen Kalberg (1980) analyzes Max Weber’s theories of rationalization
processes in history. Weber, the noted German sociologist and philosopher,
examined four types of rationality – practical, theoretical, substantive, and
formal. In the context of healthcare, Ritzer and Walczak (1988) analyze Weber’s
formal and substantive rationality as they describe the deprofessionalization
of physicians and the impact changes in government policies, the changing
nature of medical delivery systems, and changes within medical delivery sys-
tems have exerted control over them and caused the decline in their medical
autonomy. On the other hand, practical rationality is when actors calculate
all possible means available to them, choose the alternative that best allows
them to reach their ultimate end, and then follows that line of action (Ritzer,
 Empowering students to find their career passion 397

2007; Margolis & Fisher, 2002). Gerth and Mills (1946) described Weber’s
practical rationality as a person’s mundane, day-to-day activities that reflect
their world interest.
Accidentally or consciously, universities and faculty direct students to the
world of work through internships, lunch and learns, mentorships, educational
programs, and other activities. In moving students from the classroom to work,
perhaps we are immersing students into day-to-day activities and directing
them to occupations rather than allowing them to explore various career paths.
The structured approach may limit exploration and send students down a
path that may be a forced choice. While we can debate the consequences of
various strategies, a teaching tip from one program may provide insights into
student career choices and employment.

Addressing Employment in a Conceptual Model

The Rush University Health Systems Management (HSM) strategy of allowing
students to advance through graduate education while keeping post-graduate
employment in mind was enhanced in 2011 to add structure to student career
planning. Of the six operating HSM departmental committees with student
membership, the Career Services Committee (CSC) functions to oversee
student employment, develop job opportunities, and prepare students for
the job search process (HSM Strategic Plan, 2016). The CSC examined how
it was operating and assessed the components for what made the path easier
in advancing students from the classroom to work. The variables included
guest speakers at lunch and learns, visits to employment sites, negotiated in-
ternships, designation of student career mentors/advisers, professional skills
classes, and skills inventory analysis. The intervening variables of family
status, support system, climate, and employment location were beyond the
control of the CSC, but the committee recognized that it had an impact on the
student’s decision-making.
The CSC is composed of five first-year and five second-year graduate
students, six healthcare practitioners, and one full-time faculty committee
chair. The CSC meets monthly and plans, organizes, and evaluates lunch
and learns and site visits, and serves as the clearinghouse for student career
development. The second-year students serve as the committee leaders to
introduce speakers, recruit students for attendance, order lunch, and manage
the event. They are also responsible for educating the first year students about
selecting topics and speakers, and managing the event calendar.
398 The Journal of Health Administration Education Summer 2017

Figure 1
Conceptual model of employment decisions

Who Are the Students and What Do They Say They Want?
In the summer prior to campus arrival, the first-year students are required
to complete a 300-word essay on their career aspirations. Based on the key
words in their essay, students are matched with three on-campus intern-
ships. The students interview with prospective campus employers during
orientation week. The students rank their job prospects and the employer
ranks the students. Through the matching process, the student receives an
internship for the first academic year. Summer and second-year employment
opportunities are optional and can be on or off-campus. While the first-year
experience is mandatory and structured by the HSM department, the sum-
mer and second-year work experience are facilitated by various faculty and
the students themselves.
In addition to the job-matching process, a career survey is administered
to the incoming graduate class. The onboarding survey includes demographic
information on the student including questions on where they grew up, their
undergraduate major, their rationale for pursuing healthcare management
as a career choice, what geographic area of the US or international site they
prefer to work post-graduation, their favorite climate, the hours they prefer
to work in a day, travel preferences, and employment preference in for-profit
or non-profit organizations (Table 1).
 Empowering students to find their career passion 399

Table 1
Career preferences - Who are you? (n=126)

1. Where did you grow up?

2. What was your major in college?
3 .Why healthcare?
4. Prioritize your place of employment? Prioritize from 1 to 3; only 3 choices

Ambulatory care – Home care, hos- Group practice

pice, therapies
Association management Group purchasing
Benefits management Hospital
Consulting Insurance company
Data warehouse, Information tech- Marketing and Sales
nology
Entrepreneurial venture Pharmaceuticals
Facility Design/Construction Man- Quality/Patient safety
agement
Finance Other: specify Medical School
Dental School
Teach/research

6. Where do you want to live? East Coast, West Coast, Midwest, International site
__________, No preference (please circle your preference)
7. Favorite climate? fall, spring, summer, no preference
(please circle your preference)
8. How many hours will you work/day? 8 hours, 10 hours, 40 hours/week, 50
hours/week, 60 hours/week, for as long as it takes (please circle your preference)
9. Do you like to travel? Yes, No, Sometimes (please circle your preference)
10. Employment preference – Non-profit, For-profit, No preference
(please circle your preference)

From the surveys, a profile of the student and class as a whole is devel-
oped. The question on favorite climate may appear to be random, but it gives
insight to where the student will eventually seek employment. Rush HSM
attracts a high percentage of its student base from universities in a four-season
region in the Midwest. When a student indicates that their favorite climate
is summer and their post-graduate preference is to live in California, we can
reasonably assume that the student will seek employment with an organization
400 The Journal of Health Administration Education Summer 2017

in a warm-weather state and we work to match the student with an organiza-

tion on the West Coast. If a student’s favorite season is fall and the student
selects Florida as an employment location, we recognize that the student will
require additional career guidance and we assume the student is not sure of
their choice. While this is an inexact perspective, in tracking the graduates
where their weather preference did not match their post-graduate career
location, the former students relocated to their favorite climate within three
years. Out of the 126 students, 27% relocated to another state; 10% relocated
to a warm-weather state; and 54% of those who relocated to a warm-weather
state relocated within three years to a climate with four seasons.
The question on daily work hours provides insight into their employment
preference. Inquiring about their willingness to work 8 hours a day, 14 hours
a day, or until the job is done provides insight into which students are suited
for the long hours of consulting and travel in the context of their work. Over
the five-year period, 52% reported that they would work until the job was
completed, followed by 26% who indicated they would work up to 50 hours
a week. Finally, for the student who indicates their employment preference
is with a non-profit organization, the student will more than likely avoid for-
profit hospitals and insurance firms. In all, 14% indicated their employment
preference was with a for-profit company in their first year of graduate stud-
ies, and 28% of the students accepted positions with for-profit companies in
consulting, group purchasing, and insurance. The Career Services Committee
worked to present for-profit opportunities to the students over the course
of their two-year studies. The Committee is uncertain if presenting these
opportunities to students influenced their career choice, but the Committee
worked to enhance how the students viewed consulting, group purchasing,
and insurance opportunities.
How the students rank their career preferences serve as the guide for
invited speakers at lunch-and-learn events, site visits, internships, and men-
tor/adviser matching. Lunch-and-learn sessions are scheduled at noon and
lunch is provided. Speakers have included hospital and insurance CEOs,
association executives, marketing and sales leaders from pharma, partners
from consulting firms, and practice management executives from individual
and multi-specialty group practices. Site visits to insurance companies, pub-
lic hospitals, federally qualified health centers, and Veterans Administration
ambulatory care sites are also scheduled.
The HSM Book Club meets quarterly. Students select the book and faculty
facilitate the session, providing added commentary and insights. For example,
the book club invited a pathologist to facilitate discussion on Stiff: The Curious
Lives of Human Cadavers by Mary Roach; an emergency medicine administrator
 Empowering students to find their career passion 401

presented on Five Days at Memorial by Sherri Fink, M.D.; a psychiatric nurse

presented on Weekends at Bellevue by Julie Holland; and a health policy expert
presented on Reinventing American Health Care by Ezekiel Emanuel, to name a
few. While these activities are voluntary, students are strongly encouraged to
attend. The book club prepares the student to respond to a random interview
question when asked about the last book they read and why they enjoyed it.
Students are also encouraged to join professional associations including
American College of Healthcare Executives (ACHE), Healthcare Financial
Management Association (HFMA), Health Information Management Systems
Society (HIMSS), and Medical Group Management Association (MGMA).
Students are encouraged to attend their local and national meetings and take
advantage of student discounts for membership and education programs. The
HSM department provides 50% of the registration fee for students attending
at least two local events to expand their network.
From 2014 to 2016, the CSC inquired about knowledge gaps the students
perceived themselves to have. Using the National Center for Healthcare Lead-
ership’s 26 competencies across three domains of transformation, people, and
execution allows the student to focus on career competencies in leadership
that they need to acquire as they move through their career. The rank order
of their knowledge gaps appear in Table 2. Eight competencies were identi-
fied, with 50% in the Transformation domain, 50% in the Execution domain,
and none in the People domain.
The competency inventory is distributed to faculty advisors/mentors, and
internship preceptors to assist the student in closing competency gaps. For
example, the rank order of competencies has been used as a method to close
knowledge gaps in the areas of finance, strategic thinking, and community
services. This information on knowledge gaps is also communicated to class-
room instructors and internship preceptors to assist in whatever way possible
to close these gaps through course instruction and project work.

Table 2
Competency gaps to close 2014-16

Rank 2014 2015 2016

1 Financial skills
2 Project management
3 Analytical skills
4 Innovative thinking
5 Strategic orientation
Financial skills Financial skills
Strategic orientation Innovative thinking
Project management Project management
Analytical thinking Change leadership
Communication Process Management
402 The Journal of Health Administration Education Summer 2017

Using Data for Career Planning

To examine the introduction and outcomes of this practical rationality strategy,
the authors examined six-years of data. Over the six-year period, 126 students
matriculated and graduated from the Rush University HSM program. The
gender of the students was 56% female and 44% male. In an onboarding orien-
tation survey administered to students from 2011 to 2014, 39% of the students
expressed an interest in being hospital administrators followed by consulting
(23%), quality management (16%), practice management (16%), and other
(7%), as shown in Table 1. In assessing where the students were employed
post-graduation from 2011-2016, the year the aforementioned classes would
graduate, the rank order of their employment was administrative fellowships
in hospitals (37%), non-fellowship hospital management (21%), consulting
(25%), practice management (6%), other (6%), and association management
(4%), shown in Figure 2 (note that the sum total is greater than 100% due to
multiple selections by student respondent).
As shown in Figure 3, there were 137 career programming events from
2011 to 2016 that appear in Figure 3. Over the period, 30% were lunch-and-
learns, 15% were site visits, 12% were case competition participation, 12%
were book club sessions, and 9% were mentor luncheons coordinated by the
HSM department. The remaining sessions included alumni events, consulting
and fellowship programming, ACHE local chapter meetings, and competency
inventories.
Figure 2
Career Preference Upon Entering Program vs. Post-Graduate Employment
 Empowering students to find their career passion 403

Figure 3
Career programming events, 2011-16

Conclusion
The Rush HSM program is one academic approach to using its committee
structure to move students from the classroom to work. The Career Services
Committee, with its student participation and faculty guidance, provides a
menu of services to which students can voluntarily participate. The menu
of services includes lunch and learns, site visits, education sessions, a book
club, and case competitions. In addition, surveys administered to entering
first-year students assess their knowledge gaps and career aspirations. This
information is used systematically to enhance student skills in the classroom
and through the student internship experience.
While there are insufficient data to determine if any one career programming
event is more beneficial than the other (e.g., lunch and learn versus site visit),
there is evidence that educating and providing students with opportunities
to see and visit with leaders and organizations in health management helps
frame their interest and leads to employment in the field. Future research
involves the continuation of administering the survey and tracking student
career choices at Rush University. The authors propose to expand the analysis
beyond one university and beyond the healthcare management field. The au-
thors plan to expand their research to high schools to test the hypothesis that
educational variables impact employment and to further determine whether
employment brings employment satisfaction.
404 The Journal of Health Administration Education Summer 2017

The strategies used in the Rush HSM program can be used at the un-
dergraduate and graduate level. Organizing career opportunities to include
site visits and guest lecturers in a specific healthcare area helps the student
visualize the environment and determine if they should pursue a specific
employment opportunity.

References
American College of Healthcare Executives. (2014). Public policy statement:
Appropriate preparation for healthcare executive management positions
for all new entrants to the field. Retrieved December 3, 2016, from
http://ache.org/policy/preparation-new-entrants.cfm

Commission on Accreditation of Health Management Education. (2017). Section

II.A.5, Career preparedness; Section III.B.3, Interdisciplinary exposure; and
Section III.B.4, Field-based applications. In 2017 CAHME eligibility
requirements and accreditation criteria. Rockville, MD: Author.

Gerth, H. H., & Mills, C. W. (1946). Elective affinities. In From Max Weber:
Essays in sociology (pp. 284-285). New York, NY: Oxford University Press.

Health Systems Management Strategic Plan. (2016). Faculty retreat (August

31, 2016). U.S. Cellular Field.

Howard, J., Howard, D., & Dotson, E. (2015). A connected history of health and
education: Learning together towards a better city. In L. Scott (Ed.),
Learning cities for adult learners. New directions for adult and continuing
education. San Francisco, CA: Jossey Bass-Wiley.

Kalber, S. (1980). Max Weber’s types of rationality: Cornerstones for the

analysis of rationalization processes in history. American Journal of
Sociology, 85(5), 1145-1179.

Lomperis, A. T., Howard, D., & Turner, J. S. (2014). The future of healthcare
management fellowships: Opportunities, needs, and recommendations.
Journal of Health Administration Education, 31(4), 385-404.

Margolis, J., & Fisher, A. (2002). Unlocking the clubhouse: Women in computing.
Boston, MA: MIT Press.
 Empowering students to find their career passion 405

Matthews, D. (1965, February 3). Med school admission: Pitfalls and myths. The
Harvard Crimson. Retrieved from http://www.thecrimson.com/
article/1965/2/3/med-school-admission-pitfalls-and-myths/?page=1

Pappano, L. (2016). Education life: Career coaching for the playdate generation.
New York Times, p. ED16.

Ritzer, G. (2007). The Weberian theory of rationalization and the

McDonaldization of contemporary society. In Classical sociological theory
(pp. 41-59). Thousand Oaks, CA: Sage Publications.

Shapin, S. (2012). The ivory tower: The history of a figure of speech and it’s
cultural uses. British Society for the History of Science, 45(1), 1-17.

Viswanathan, V. (2014, September 29). The rise of the M.D./M.B.A. degree.

The Atlantic. Retrieved from https://www.theatlantic.com/education/
archive/2014/09/the-rise-of-the-mdmba-degree/380683/