EPISODE 104

The Benefits of Blended Learning - Scott Shaw, CEO of Lincoln Tech

01-12-2021

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SHIV GAGLANI:

Hi, I'm Shiv Gaglani and today on Raise the Line, I'm happy to be joined by Scott Shaw who's the president and CEO of Lincoln Tech. Scott has held other senior leadership positions in his 20 years at Lincoln Tech, including executive vice president and senior vice president of strategic planning and business development. So Scott, thanks so much for taking the time to be with us today.

SCOTT SHAW:

Thanks, Shiv, it's a pleasure to be here.

SHIV GAGLANI:

Can you first start by telling our audience a bit more about your background and what led you to join Lincoln Tech and staying there for now about two decades?

SCOTT SHAW:

Sure. Well, I actually started off in investment banking. The organization I was with made an investment in Lincoln and I was looking for a change to get from being on the investing side to the operations side and Lincoln was having some financial problems, so my first role at Lincoln was actually as a CFO. So I came and joined the organization, helped kind of get their footing back on ground and then frankly just fell in love with the education space. I had gone to school, but never thought I'd be involved in a school, but it's certainly very rewarding to be able to really help people change their lives and get themselves established. And I stayed here, and 20 years later I am where I am.

SHIV GAGLANI:

As a fellow education entrepreneur, I couldn't agree more about how gratifying it can be to run an educational organization. So can you tell us a bit more about Lincoln Tech and what makes it different… like how do you differentiate yourself?

SCOTT SHAW:

We actually are about to enter our 75th year. The founder of the company originally started with training vets coming back from World War II to be automotive and HVAC mechanics and it continued to do that and expand that offering. But then around 2000, we expanded into the healthcare sector simply because we saw that there's a huge need with looking to the future and seeing that the population was going to be aging, that there would be greater and greater need for healthcare professionals. And so we started offering some medical assisting, dental assisting, some of the allied health curriculum. Then we were asked, frankly, by the state of New Jersey to take over a failing LPN program. And we took that over very successfully and grew that, and so now we produce 50% of all the LPNs in the state of New Jersey. And we also have the same program in Pennsylvania, Connecticut, and Rhode Island.

So now today, we have in total 22 campuses, but only nine of them have healthcare profession programs in them. They're mainly situated in the northeast since we started in New Jersey. We're kind of from Boston to Baltimore, but we do have a healthcare program down in Atlanta, and we're about to launch one in Indianapolis.

SHIV GAGLANI:

Congratulations, that's incredible scale. And I actually didn't know that about the history of Lincoln Tech training World War II vets when they returned, that's pretty inspiring. Now, you have a couple of health professional programs, allied health programs, medical assistant and LPN… was that the gamut or are there a few others you wanted to mention?

SCOTT SHAW:

We have some other forms of medical assisting and some of the office administrative jobs. We're looking at adding other programs. We're hoping to get to the stage where we can offer an RN program simply because all of our LPNs would love to become RNs. A lot of them come to us just to be LPNs so they can get through that program frankly a lot more quickly, which still gets them established. And a lot of our students are very anxious to get working faster rather than later and so the LPN appeals to them. We've looked at some other programs over the years -- surgical tech and some others -- but in the markets we serve we just didn't find it successful. So right now we're really focused on LPN, medical assisting, dental assisting. Those are really the core allied health and pre-licensure nursing programs that we do today.

SHIV GAGLANI:

And can you give us a sense of the scope or the size of your alumni pool as well as how many health professionals you train every year? I mean, that's a remarkable stat that half of New Jersey's LPNs are trained through Lincoln Tech, which is incredible.

SCOTT SHAW:

We don't have all the stats but in our 75 years, we estimate in total we have probably over 350,000 graduates out there. But since we started the healthcare program, about 20 years ago, we have far fewer, so many 60,000 in the healthcare profession.

SHIV GAGLANI:

That's incredible, and that speaks to the title of this podcast. We call it Raise the Line because we want to focus on how we can improve healthcare capacity, and clearly you've helped train 60,000 healthcare professionals. So, going into COVID, you have 22 campuses distributed across 14 different states. How has COVID affected Lincoln Tech's operations? Has it accelerated some of your transition to online learning or maybe you were already doing a lot of that before. I think our audience would love to hear those changes.

SCOTT SHAW:

Right now it feels good as we went through it, but when it just started we were all a bit in shock. We are known for being a hands-on training educational provider, and so to have that taken away from us and being forced to go 100% online for a period of time was quite a shock. But the good news to me was really the creativity and the adaptability of both the faculty and the students that we were able to really get up and running in about 10 days. We were fortunate because we did have all the building blocks in place already, all of our nurses already received laptops and many of our medical assistants already had laptops. We were using Canvas as our learning management system, and so we had something there to scale very quickly.

And we did have two small blended programs that we were operating. We had dipped our toe into it so we were familiar and had all the, I'll say the “infrastructure” to run online, but if I were to have said to the organization, "Next week we're going to be 100% online," we still would be fighting today like oh, that's crazy, we can't do it, blah, blah, blah. But the fact that we had to do it really forced a lot of change, and it's really I think opened all of our eyes to what can be done. So I'm really proud of the organization, how they responded. I'm really also very impressed by the students, because online learning is more challenging. Now, our online learning is different because there's lots of forms out there and we're basically most of it is live, similar to what we're doing today. So there are some asynchronous aspects to the learning, but with most of it we're trying to still keep the student-teacher relationship and try to keep people more engaged. And that's how we've been doing it.

We do have to get better because as I said, we weren't planning to do this and we were forced to do this. But it's turned out to be far better than I thought. We're also realizing a lot of students appreciate, frankly, the flexibility that online gives them. As we look to hopefully eventually have COVID behind us, whenever that is, we're going to continue to offer blended learning so that today the way that our programs are structured, we offered an accelerated curriculum. Students usually come to our campus four or five days a week but for four or five hours a day. And that's a pretty big commitment when you might have a job and you also might have a family to take care of.

So going forward we will offer blended, where I'm not sure if it'll be 25 or 30% blended, but that will enable students to come to campus maybe one or two days less, which cuts down on maybe childcare, gives them maybe an extra day to work, and just builds some greater flexibility. So while the switch to distance learning was traumatic at first, I think we're going to end up in a much better place when it's all said and done.

SHIV GAGLANI:

Yeah, I think the forcing function is something we've heard from a lot of different groups, not only educational providers like yourself, but healthcare organizations that were forced to do telehealth and it would've taken them a long time to change the behaviors or even know what they're capable of. I'm curious how this has affected your applications or enrollments, just because right now 11 million people in the U.S. are still unemployed. First of all, their jobs may not come back in retail and other sectors such as transportation. But even if they do, this has exposed that “hey, maybe these are not the most secure jobs long-term.” So I'd love to hear two things, one is what's the profile of someone who applies to become a medical assistant or an LPN -- they may be different, but are they working adults, like second career… anything you can provide there. And number two is how do you think COVID has impacted the interest in the health professional careers you guys offer?

SCOTT SHAW:

Sure. So in the healthcare sector the average age is around 26, so these are individuals who were probably working somewhere else and as you just described it, were probably doing something that was an entry level position but not something that's really an entry level career. They usually have a family of some kind, and so they are needing to support the family while also trying to change their lives with a new career. In the healthcare sector it is majority female in our programs, just as an aside. In the auto and skilled trades it's about 95% male and only 5% female. We're trying to get more females in that sector. They tend to be the best students, we just can't seem to attract enough. But on the healthcare side we're probably about 80% female and about 20% male. But again, they are adults.

Since the pandemic and actually prior to the pandemic, we've seen an increase in enrollment. But to your point, we're definitely hearing now with unemployment higher, more people are coming because they're looking for that job security. And they know that especially if you go in to become an LPN, any form of nursing, you can get a job anytime, anywhere in the United States. They're seeing that all of these people are employed during this pandemic, so that's also reassurance of this is a good field to go into.

And so while many people might have thought “boy, do I really want to be on the front line facing this horrific situation we're in”, instead of scaring people away we're definitely seeing that it's attracting people. Obviously, if you're going into healthcare you have a passion for people. And so they're definitely bringing more people to us that want to make a difference and feel like being part of the healthcare system is a great way for them to have not only a career, but also make a difference in the world.

SHIV GAGLANI:

Yeah, I couldn't agree more. I mean, we mostly are on the supplemental side where we have an audience of millions of current and future healthcare professionals -- mostly medical, RN, NP, PA, and dentistry, students. They use us as a supplement for their curriculum and test prep. But for end-to-end training like what you all offer, it's very interesting to me just because I think so many of these folks, as you mentioned, maybe they don't want to work at Amazon anymore in the warehouse, and instead want to go work in a skilled nursing facility.

What role do you all play in terms of the employment aspect? Like do you work directly with employers to place them and what are you hearing from the employers? Because during the middle of the pandemic there were people in healthcare losing their jobs just because medical assistants of surgical care centers-

SCOTT SHAW:

Were shut down, yep.

SHIV GAGLANI:

Were shut down temporarily, but they've come back.

SCOTT SHAW:

We do help with placement, surely, because at the end of the day our success is tied to our students' success. So we constantly focus on getting more students to graduate and getting more students to be placed.  Our placement rates is around the 70% level in the healthcare sector. It would be higher but for whatever reason, some students just don't want to go to work after they've gone to school. Don't know why, but that's their decision, not mine.

What we're hearing from employers is that there is still big demand. But there are a lot of changes and challenges right now. It's a bit bumpy from the standpoint that, as you mentioned, not all clinical sites are open, doctor’s offices have been shut down, some of those doctors then may have put their employees on furlough, or maybe even had to eliminate their jobs. But for the most part, the vast majority of our students, from what we hear, are staying employed and have jobs and opportunities going forward. I just think that's going to continue because the demand is out there. I mean, we can't stop the process of getting older and there's more and more of us like me getting more and more gray hair out there. We need good people to take care of us, so I think anyone going into healthcare has a great long-term future.

SHIV GAGLANI:

What I've been hearing more and more too is people maybe start as a medical assistant or they start as an LPN and then they view that as just the entry point to then continue educating themselves. You mentioned wanting to create an RN program as a result. Do you see that, do you see people who go through your program start as an MA and they come back to Lincoln Tech to get their LPN? Is that something that's fairly common?

SCOTT SHAW:

It's not fairly common that they'll come back to us if they're an MA to become an LPN. But I do know that from our surveys we've done, probably 99% of the LPNs all want to be RNs. Now as to whether or not they all can make it to be an RN, that's to be determined, but that's their goal. That's why we're really hopefully trying to get this RN program in New Jersey, because based on all of the statistics we look at, New Jersey has one of the third highest deficits of nurses in the country. We can help accelerate and bring more capacity in the students that can then transition from LPN to RN. I would bet that once we have an RN program, those that haven't already become RNs who are LPNs will definitely try to come back to us.

SHIV GAGLANI:

Got it, makes sense. One other thing, in terms of things that have changed because of COVID is the government, right? They've accelerated some of the things they've done and we've been talking to, for example, the Oregon State Board of Nursing and I know that a lot of these boards of nursing and health professional regulatory bodies have had to kind of waive requirements or make it possible for an RN to finish their clinical training while actually being on staff, graduating early. What are your thoughts on lasting changes that the regulatory boards may be making to make it easier for us all to raise the line and improve healthcare capacity?

SCOTT SHAW:

Well, I would say Oregon, if they're doing that, is the minority because I'm finding that the boards of nursing are very slow to react to the rapid change that we're all facing. And the biggest challenge we have, or our students have, is in the clinical sites. While things are open, some of the clinical sites have cut back on how many people they'll accept because they're obviously concerned about bringing in the virus into their environment. So that's impacting us. In certain states for a while a lot of the clinical sites were closed. We have gone back to the boards of nursing seeking to temporarily allow us to use simulation more, but there seems to be -- from what I understand from our nursing professionals a study that was done, I don't know how many years ago -- that kind of limits the simulation capabilities up to only 50%. I think that while I might understand that, in a period of time of greatest need of getting more people into the healthcare profession, to have a roadblock that's going to slow down the number of people getting into the healthcare profession doesn't seem to be the right decision.

So it would be nice if the boards of nursing were becoming more receptive to even more simulation, at least, on a temporary basis until things got back to normal so that more people could graduate and get into the workforce and help more people. Because with this bottleneck, there already was a shortage, it's going to create a greater shortage unless we can overcome this.

SHIV GAGLANI:

Especially because every year the simulations get more robust. Like one guest coming up on Raise the Line is someone who started a surgical training company that's completely VR. And it's remarkable the type of stuff that they've created. I'm sure when these rules and when that study was done a couple of years ago things may not have been as high fidelity as they are today.

SCOTT SHAW:

Yeah, so I'm hoping that they'll get there, but boards of nursing aren't known for rapid change.

SHIV GAGLANI:

Let's cross our fingers. Maybe there will be some national mandates or changes coming up. One other thing that we pay a lot of attention to at Osmosis is student debt. So the median student debt for a graduating med student is $200,000.  It’s very expensive to go into medicine. They're paid a lot but it takes a while to pay off that student debt. There are innovative programs like Income Share Agreements, or placements where the employer pays for the student to be placed. I'm curious how you guys view that as a way to innovate, or as an impediment for students to get into healthcare careers.

SCOTT SHAW:

I think debt across the board is an impediment for all.  Everyone going back to school should carefully look at that situation and make sure that they truly understand why they're going to school, why they're taking on the debt, and what are the true outcomes that they could expect once they get employed. For us, we're constantly looking at that. And frankly, as a for-profit school, there are a lot more rules and regulations on us than there are on traditional schools to ensure that that happens.

But for us, the average student leaves Lincoln with about $13,000 worth of debt. Certainly not a small number, but not anywhere near $30,000 that a traditional person leaves from a bachelor's program. Now granted, you're coming out with an LPN in that case, which isn't as high as let's say an RN, but you can be making $40-45,000 right off the bat. And so paying back a $13,000 loan is very doable and if you're a good negotiator, given the demand, you can probably get your new employer to kick in 1,000 or $2,000 signing bonus to help make that number even less.

SHIV GAGLANI:

Sounds like there could be some education around that, if not already, in terms of career placement and how to negotiate your first contract. So, I know we're coming up on time, but I had just a couple of more quick questions. The first is what are some lasting changes you think will have to happen to the U.S. healthcare system as a result of COVID?

SCOTT SHAW:

Well, I think that they're going to have to expand how people can get into it, first of all. So I think that there are certain changes taking place, like in the state of New Jersey, they're requiring that all nurses in hospitals be BSNs, which is great, I guess, because that's better quality from what their research tells them. That's also narrowing the number of people that could work in those institutions. And so I think that schools or hospitals are going to have to become a little more flexible in their thinking to also allow more…I'll say less expensive employees that can add a lot of value and provide a lot of great service to their constituents into the various organizations. So I think there will be constant change, just as PAs are becoming more popular, that's kind of an interim layer in the healthcare profession.

I think that boards of nursing hopefully will become a little more responsive, because when rapid change like this occurs they just need to be thinking a little more proactively of how they can ensure that the supply of people coming into the healthcare field remains constant. So I haven't seen anything as we just were talking earlier for that to happen, but I'm hopeful that maybe someday that will happen.

SHIV GAGLANI:

Yeah, those are important changes. Another question is what advice would you give to someone considering a career in healthcare? Obviously COVID has attracted many of them to healthcare careers, but it's also scared some people away, due to the risks inherent in being on the front lines. So, I would love to hear what advice you give your students.

SCOTT SHAW:

Sure. Well I think that most of the students coming to us really want to make a difference and healthcare is a way that an individual can make a difference in peoples' lives and in their local communities. And it's something that I think is well respected, I think that this whole COVID situation frankly has raised the profile of all healthcare workers or first line responders. I don't see why that will ever go away. So I think if you want to be in a career that's well respected with long-term job opportunities, there's really nothing better, frankly, than healthcare.

As far as specific advice, one of the things that we constantly hear from employers, and it’s something we're trying to incorporate into our curriculum but is a little more challenging, is it's just not enough to know the technical skills. Everyone's asking for soft skills, and that kind of runs the gamut of a lot of different things. But we hear everything from just having a more professional attitude and look, making sure that you show up on time and every day, making sure that you have everything as basic as good communication skills -- whether that's phone skills or now more and more people are texting -- but when you're interacting with patients, having unclear information go back and forth just adds a lot more anxiety and stress to the patient and to the situation. And so being able to communicate well, gain the patient's confidence, and demonstrate your competency and professionalism will go a long way to make you a successful healthcare provider.

SHIV GAGLANI:

That is very consistent with things we've heard and one reason we've also invested in not only soft skill training, but also selection, right? Because there are definitely people at the top of the funnel, maybe people who come from customer service careers at retail outlets, who could already have that inherent ability to communicate and relate to, quite frankly, very angry customers by the time they arrive at a retail desk.

SCOTT SHAW:

Yes, and we hear it across the board from all of the industries that we serve. So in this age of everybody having smartphones and instant communication, it seems like communication ends up being one of the top ones that everyone mentions as something that needs improving.

SHIV GAGLANI:

Well my last question for you is: is there anything else you'd like to be able to share with our audience about anything we didn't get a chance to discuss?

SCOTT SHAW:

I think that we touched on a lot of the key issues. Again, I think that the last thing which is also pretty common today that everyone talks about is, and this current situation just reemphasizes that, our education never stops. It's truly going to be lifelong learning. If you're not learning new things, not learning how to adapt, you'll hurt yourself in the long run. Because the world's very dynamic now and things are changing at a more rapid pace as well. And so you'll be very well suited if you constantly have that sense of curiosity and discipline to really learn new things and stay abreast of things. So instead of getting left behind, you're there at the forefront.

SHIV GAGLANI:

Very, very good advice, thank you for bringing that in. So with that, Scott, I'd like to really thank you for taking the time to be with us on Raise the Line as well as more importantly for the work that you've done to raise the line at Lincoln Tech and educate tens of thousands, and soon to be hundreds of thousands of future healthcare professionals.

SCOTT SHAW:

Great, thank you very much, appreciate the opportunity again.

SHIV GAGLANI:

And with that, I'm Shiv Gaglani, thank you to our audience for checking out today's show, and remember to do your part to flatten the curve and raise the line since we're all in this together. Take care.