What is Degree Creep? (Hyper Credentalism) Mandating higher degrees that may not necessarily be needed to perform the job.

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1 Degree Creep!! Dorothy P. Bethea, ED.D, MPA, OTR L Chair and Professor Occupational Therapy Winston Salem State University What is Degree Creep? (Hyper Credentalism) Mandating higher degrees that may not necessarily be needed to perform the job. Source: Degree Creep: Are entry level doctorate degrees and most postgraduate doctorate degrees in the PA profession s future? 1

2 Professional Maturation vs Degree Creep WHY AN ISSUE? Maturation occurs because a field advances and proper patient care requires advanced knowledge and learning new skills (scientific data) Degree creep occurs due to factors external to patient care and may not be research data based. Opposition: the move to the clinical doctoral level is professional aggrandizement rather than a response to market demand. Source: Anne Loochtan, NN2 Annual Meeting 2011, Cheyenne, Wyoming Reasons for Degree Creep Perceived need for a profession to increase education and skill requirements Perception! Competition among disciplines and attempt to expand scope of practice Perceived access to patients Increased professional recognition Increased salary Reimbursement 2

3 Clinical Doctorate Distinguished from the research doctorate by its emphasis on clinical practice, clinical competencies Types of Clinical Doctorates 1. mandated by the accreditation process for educational programs to change the entry level for practice Ex. PharmD, AuD (also called professional doctorate or practice doctorate) 2. Elected advanced entry level practice. Ex. DPT Disciplines w/ changing degrees Disciplines Pharmacy Audiology Physical Therapy Nursing Occupational Therapy Clinical Laboratory Science Other Physician Assistant Degrees PharmD Entry level AuD Entry level DPT Entry level DNP Advanced practice degree OTD Advanced practice degree CLS Advanced practice degree Mostly masters level 3

4 Degree creep could create The Perfect Storm Source: Anne Loochtan, NN2 Annual Meeting 2011, Cheyenne, Wyoming Degree Creep Site Shortages /qualified persons Boomers Aging Faculty Shortage Poor Economy Those who support the move. Expanding knowledge base Technological Advancement Scientific advancement Parity in status with physicians (use of title doctor ) Need for patient centered care Desire for autonomous practice Increased prevalence of chronic disease; increased patient acuity Many educational programs have expanded program length and credit hours beyond that required for comparable degrees in other fields Natural change in degree level associate level has transitioned to the bachelor s degree level (Radiology) bachelor s degree level has transitioned to the master s degree. (Physician Assistant) 4

5 Consequences of Degree Creep Education Issues with enough qualified faculty, # of faculty & decrease credentialed faculty to deliver instruction A decline in students and workforce diversity Deceased access to health care in rural areas Decreased access to education in health care Increase tuition and other costs Increase time in college Issues w/capacity in institutions (faculty, facilities, funds, clinical sites) Create public confusion with introduction of new types of doctors Consequences of Degree Creep Continues Workforce Workforce shortages exacerbated. staffing will be more costly and difficult. A decline in job satisfaction and morale if health care workers feel their skills and knowledge are not fully used. Decrease in workforce diversity as inaccessible to minorities and economically disadvantaged. 5

6 Effects on cost of health care. General Concerns Accrediting agencies express concerns about justification, lack of consistency with length, substance and rigor of some programs Since third party payers reimburse for the services provided and not the degree held by the provider, it is not possible to differentiate between the services provided by professionals who hold several different levels of degrees Conversion to a doctoral level can constitute a substantive change in an institution s mission. Some institutions proposing the change does not have existing authority to grant a doctorate. Some research universities that do have doctoral granting authority have chosen to close program s rather than convert to a clinical doctorate due to a concern with cost or a philosophical opposition to clinical doctorates. (Source: From Education to Regulations: Dynamic Challenges For the Health Workforce Associations of Academic Health Centers) Justifying the need for new credentials Professionals and the academy have yet to state clearly the problems for which the new professional doctorates are the solution Leaders of graduate education need to find effective ways to include industry in the discussion about the role and nature of these new degree. Source: Taskforce on the Professional Doctorate, the Higher Learning Commission, North Central Associations of Colleges and Schools...(Shep Center) 6

7 Resources: Programs/Communitycolleges concerned about degree creep.aspx Holmes, D.E, Editor. From Education to Regulations: Dynamic Challenges For the Health Workforce Associations of Academic Health Centers. Fraher, E. (2007). The move toward the clinical doctorate in allied health professionals in north carolina. UNC The Cecil G. Sheps Center for Health Serves Research. 7