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Like many other health care facilities across the U.S., sites within CommonSpirit Health have been increasingly concerned that minority populations are underrepresented on their staffs.

Such introspection has led hospitals in two CommonSpirit regions to develop internships that invite high school and college students of minority backgrounds to experience firsthand what it is like working in a health profession. They also get support from on-staff clinicians and receive hand-holding and other help to get started in a health care career.

Though the programming at the hospitals is in its infancy, it already is showing strong potential to build minority students' awareness of and to steer them toward those roles, while also providing a needed morale boost to the students' mentors on staff, say executives heading the programs.

"From the student perspective, they're exposed to the health care field, and seeing it in action … and this is showing them that this is within their reach," says Dr. Lynn Jeffers, chief medical officer of CommonSpirit's Dignity Health – St. John's Regional Medical Center in Oxnard, California, and Dignity Health – St. John's Hospital Camarillo in California. She says from the hospitals' perspective, "We're serving the community in a new way. And this is reinspiring the people involved about why they went into health care in the first place."

Saida Selene Espinoza is the program director of a similar effort at a CommonSpirit hospital about 1,600 miles away at CHI Health Midlands hospital near Omaha, Nebraska. She says through that hospital's internship programs, Hispanic students "are seeing it is possible to dream big, and they don't have to let their background be a limiting factor" in their future careers.

Unequal access
Espinoza says there were several sources of inspiration for the Omaha-area program. For one, when she assisted with a COVID-19 vaccination program at a local meatpacker, she saw a lack of Spanish-speaking health care professionals available to serve the majority-Hispanic workers getting the vaccine. In subsequent talks with others at CHI Health facilities and with the Latino Center of the Midlands, she learned there is a lack of diversity in staff across Omaha's health care sector and that is causing a chasm between providers and patients.

Espinoza adds that populations have self-segregated in Omaha. She says students at high schools serving the mostly white areas traditionally have had much more access to health care career programs than students at high schools serving minority communities.

Collaborating with Omaha Public Schools and the nonprofit Latino Center, Espinoza and colleague Lucia Rodriguez Alvizo developed two paid internship programs designed to help increase CHI Health's diversity. Rodriguez Alvizo is Healthier Communities & Community Benefit coordinator for CHI Health, Omaha. CHI has 14 hospital campuses in and around Omaha; most of the internship activity is at the CHI Health Midlands campus.

One internship program, started in 2019 with CHI Mission and Ministry Fund grant dollars, recruits Hispanic high school students to be community health interns, shadowing CHI Health Midlands community health workers. The interns communicate with, educate and provide resources to Hispanic community members, especially about topics prioritized by the workers.

The other internship, started in 2021 with another installment of mission and ministry funding, is the health career shadowing program. Hispanic high school and college students get an introduction to health care, are paired with mentors and spend time shadowing clinicians at CHI Health Midlands.

Students apply online for the programs, provide a letter of recommendation from their school, take part in a phone interview and then are selected for participation.

Students from both the community health worker and health care careers tracks can apply to move on to a certified nursing assistant program. It includes coursework at a local college, practical experience at CHI Health Midlands and assistance from a recruiter with job placement at CHI Health after the student is certified. Students have the opportunity to pursue other health care careers at CHI Health after becoming a CNA.

Fewer than 20 students total can participate annually in the two internship programs. Espinoza says a goal is to increase the programs' capacity.

From reflection to action
Similar programming in CommonSpirit's Southern California region began at Dignity Health – Glendale Memorial Hospital and Health Center. In early 2021, colleagues there viewed the documentary Black Men in White Coats for Black History Month and were challenged to reflect on the lack of Black representation on clinical staffs in the U.S. and what they could do about it.

Rev. Cassie McCarty, the Glendale hospital's director of mission integration and spiritual care services, explains that hospital leadership came up with the idea of an internship for students in underrepresented groups, including those of racial and ethnic minority status, those who identify as part of the LGBTQ+ population and those who are first in their family to go to college as well as those with lower socioeconomic status.

The resulting program that began in late 2021 has local high school and community college students applying to participate in a yearlong internship. The interns go to the hospital for several hours once a week for two semesters. They spend the fall semester circulating among numerous hospital departments, including the intensive care unit, emergency department, physical therapy, respiratory therapy, pharmacy and radiology. They then focus on three preferred departments for the spring semester. All along they are paired with a physician mentor. The college students take a biology course at their school while participating in the hospital internship.

CommonSpirit hospitals in Camarillo and Oxnard replicated the program and began their own cohorts this past year. Another system facility, in Long Beach, is considering doing so.

Win-win-win-win
Those involved with the minority internship programs in the Omaha and Southern California regions say the initiatives are a win not just for the students but also for the facilities and their staffs, patients and community members.

Rev. McCarty in Glendale says many participating students had not previously known about the variety of roles available in a hospital. Jeffers in Oxnard and Camarillo notes that many students hadn't considered that they could pursue hospital roles.

Espinoza in Omaha says that it's important for minority students to have mentors whose backgrounds, life experiences, language, family life and faith are similar to their own. This helps them see themselves in the roles their mentors hold.

In Omaha, Gustavo Servin-Maciel is the Siembra Salud program coordinator at the Latino Center. Seimbra Salud translates to "sowing health." He says through the shadowing programs, students are believing in themselves, getting out of their comfort zones and building the essential soft skills they'll need throughout their future careers, whether or not they work in health care. Rodriguez Alvizo, with Omaha's CHI Health, says students who are interested in health care roles are gaining career readiness through shadowing.

While the initiatives in both the Omaha and Southern California regions are new, both promise to in time boost the pipeline of candidates for health care positions at a time of widespread worker shortages.

And, facilities, patients and communities will benefit as staffs get more diverse, those interviewed say. Rev. McCarty notes the documentary that inspired the Southern California program shows that if patients don't see themselves in their providers, they can lose trust in them. Conversely, when patients see themselves in their providers, they may develop more trusting relationships which can lead to better patient health, she says.

Jeffers in Southern California says a perhaps unanticipated benefit of the programming has been the positive impact on staff members who are mentoring the interns. Rev. McCarty agrees that the addition of fresh, young, motivated and curious minds has been energizing for the facilities.