Portland Community College collaborated with five assisted living and residential care facilities to prepare frontline direct care staff for a first-of-its-kind, industry-recognized credential, resulting in higher quality care delivered to residents. Workers completing the training become certified resident assistants, responsible for helping residents undertake activities of daily living, maintain their emotional well-being, and prevent infections, falls, and skin problems, among other tasks.
“I think what we’ve learned is how to break down barriers related to how we acquire
knowledge. Traditionally, we assign knowledge to people in positions of authority. Now,
we’re learning from each other and we’re learning from the people we’re taking care of.
We are a learning culture here.”
—Linda Bifano, Health Services Director and Trainer, Rose Schnitzer Manor
The Portland project was implemented as state regulations set the first formal training expectations for direct care staff at assisted living facilities. Assisted living staff now must demonstrate knowledge and proficiency in a wide variety of areas and complete a minimum of 12 hours of in-service training on topics relevant to community-based care.
Leading up to the Jobs to Careers project, Portland Community College and several assisted living employers conducted a formal job analysis: they identified tasks performed and the competencies or skills required for entry-level, unlicensed direct care positions, codifying the first- and second-rung occupations as Resident Assistant I and Resident Assistant II. A curriculum was then developed for training resident assistants in the competencies.
PCC, which managed the Jobs to Careers project, adapted the resident assistant curriculum for delivery through work-based learning. The college’s Customized and Workplace Training Department collaborated with the Department of Gerontology to develop the training materials, provide career exploration workshops for direct care workers, and develop opportunities for workers to receive academic credit for participating in the training.
The curriculum consists of 27 work-based learning modules, covering such topics as roles and responsibilities, resident service plans, personal care, self care, and diabetes care. The curriculum incorporates a wide variety of skills associated with ensuring residents’ emotional well-being, such as emotional care, problem solving, and written and verbal communication. On average, workers completed 30 hours of training over the course of several months.
Direct care workers learned important skills and knowledge in a systematic and consistent fashion. They acquired keener observation skills, as well as a greater understanding of residents’ health and emotional needs. They went on to play a stronger role in planning and implementing resident service plans, creating the potential for more personalized and sensitive care.
The college trained professional staff at each facility to become workplace instructors for the program. Professional staff (i.e., nurses, administrators, other supervisors, and experienced direct care workers) attended a three-day workshop on how to teach workers with different learning styles and with varying levels of English language skills. They had the discretion to teach the modules as they saw fit but typically delivered the training in small group settings during regular work hours.
PCC granted two credits for attaining Resident Assistant I status and one additional credit for attaining Resident Assistant II status. Both certificates articulate with Associate’s and Bachelor’s degrees in gerontology. PCC also worked with project partners to develop short-term credentials in specialized topics around aging, including activities assistance and advanced behavioral and cognitive care, to prepare graduates for jobs in elder-serving settings like assisted living. In addition, the college and the project partners assisted frontline staff interested in pursuing further academic studies.
PCC and the long-term care providers implemented several other strategies to help frontline workers succeed in Jobs to Careers. Employers prepaid tuition rather than reimbursing workers after they completed courses, enabling more workers to take advantage of education opportunities. The college also offered career development workshops for frontline workers and supervisors, which addressed the need for coaching and peer support and provided information on resources and opportunities available to attend college.
Oregon’s state agency that provides oversight to assisted living facilities (Oregon Seniors and People with Disabilities) recognizes the resident assistant certifications—as do the state’s two major employer associations in long-term care—the Oregon Health Care Association and the Oregon Alliance for Senior and Health Services. The Jobs to Careers project team began meeting with state funders and regulators of community-based care to gain recognition for the curriculum and work-based learning model as a statewide standard. Eighteen other long-term care facilities signed up professional staff for training to become instructors.
“Understanding why and how insulin works has improved caregivers’ ability to handle
people with complicated diabetic problems, especially when blood sugars go low. We have
a lady now who just recently had to change her diet because of swallowing issues. Her
blood sugar dropped low, and the caregivers pointed out what was happening and why.
That wouldn’t have happened before.”
—Deana Wentworth, Director, Orchard House
- 86 individuals completed the training and received certificates, or 75 percent of all enrolled; an additional 30 workers are in the process of completing training.
- 30 supervisors received training to deliver work-based learning at the 5 participating centers; 61 supervisors at 18 other facilities around the state signed up for training.
- At least 10 percent of the direct care workforce at the five long-term care facilities was attending school and training off site to become certified nurse assistants, pharmacy technicians, or nurses. Others sought Associate’s degrees.
Benefits to Frontline Employees
- A stronger role in planning and carrying out service plans for residents, creating the potential for more personalized and sensitive care
- Improved self-confidence and performance appraisal
- Satisfaction with the training program, contributing to higher job satisfaction and career aspirations
Benefits to Employers
- Higher resident satisfaction with the care and services they receive
Changes to Institutional Practice
- Portland Community College established eight short-term, job-focused certificates in gerontology.
- The project formed a relationship between PCC’s noncredit unit (the Customized and Workplace Training Department) and a for-credit academic department (the Department of Gerontology), resulting in the awarding of academic credit for workplace training.
- The employer sites became more proactive in designing in-service education in response to new state rules governing assisted living, in some cases using the Jobs to Careers training modules (e.g. infection control, alternatives to restraints, ergonomics lifting).
- Managers at several sites are assessing potential changes in their systems for hiring, orientation, and human resources. At least three sites are using (or planning to use) the work-based learning modules to train new hires as well as incumbent staff.
- The Oregon State Board of Nursing examined the resident assistant curriculum and found it leads directly to Certified Nursing Assistant 1 work responsibilities.