Proceedings of a Workshop Series—in Brief

August 28, September 10, and October 15–16, 2025

Addressing Training Site and Slot Shortages Across the Health Professions
Proceedings of a Workshop Series—in Brief

The global shortage of high-quality clinical training opportunities is an urgent concern for health professions education, and it has far-reaching implications for the access to and quality of health care delivery (Williams et al., 2025). In the United States, clinical training sites and slots are not expanding in proportion with the growing number of health professional schools and students, resulting in heightened competition for placement slots and difficulty for students in completing required training (Kayingo et al., 2023). Burnout of clinicians and workforce attrition, due in part to increased productivity demands, exacerbates the problem and leads to limited preceptor capacity (Zolotor et al., 2025). To explore the growing challenge of insufficient experiential learning placements across all the health professions and highlight innovative solutions, the Global Forum on Innovation in Health Professional Education (IHPE) held a workshop series in late 2025 (see Box 1 for highlights from the workshop discussions). The series of workshops was planned by a committee who selected and invited speakers, moderators, and panelists to participate. In addition, the committee solicited abstracts that highlighted innovations or strategies for expanding high-quality clinical training placements. Several authors were selected from the list of submitted abstracts to discuss their work in video presentations and to provide insights as speakers during the final workshop sessions. Abstracts and videos are available on the event website.¹

The workshop series began with a session on August 28 that explored the perspectives of educators, students, and trainees in the health professions. On September 10, a second session was held to examine health systems, accreditation, and regulatory perspectives. The final workshop sessions were held on October 15–16 and featured speakers from across the health professions who shared examples of programs and innovations designed to improve the availability of quality clinical placements. Workshop attendees participated in a table activity in which they discussed approaches for creating a collaborative, interprofessional system for clinical learning. This Proceedings of a Workshop Series—in Brief summarizes the presentations and discussions throughout the workshop series.

EDUCATOR, STUDENT, AND TRAINEE PERSPECTIVES

On August 28, Jody Frost, an education consultant and IHPE forum co-chair, and workshop co-chair Carl Sheperis of Kutztown University of Pennsylvania welcomed participants to the first session in the series. Sheperis commented on the growing shortage of quality clinical training sites and placement slots, saying that it is one of the most pressing challenges in preparing the next generation of health professionals. There are not enough quality clinical and experiential learning opportunities, he said, and the shortage creates a bottleneck that strains the health care workforce pathway at a time when demand for providers is higher than ever. This challenge cuts across health professions, and this workshop session, he said, brings together diverse voices to share educational and trainee perspectives. Through these conversations, he added, “we can build the evidence base needed to expand high-quality clinical opportunities, strengthen the health care workforce, and better meet the needs of patients and communities.”

Educator Perspectives

Frost moderated a discussion among educators and asked them to begin by identifying a single challenge related to training placements that is unique to their profession:

• Alicia Ribar, University of Cincinnati: There are inconsistent policies for nursing education, both at the undergraduate pre-licensure level and at the graduate level, regarding the use of alternative placements for clinical education (e.g., rural sites and simulation).
• Stephanie Petrosky, Nova Southeastern University: Dietetics has recently transitioned to requiring a graduate degree for entry-level practice, and it has been a challenge to teach preceptors and training sites about new requirements for performance expectations.
• David Tolentino, Campbell University: The profession of osteopathic medicine struggles not only with having enough clinical experiences for trainees, but also with having enough high-quality clinical experiences.
• Melissa R. Held, University of Connecticut: In the medical profession, a lack of “carrots and sticks”

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makes it difficult to ensure the quality of the educational experience at clinical placements.

• Shanita Brown, East Carolina University: Like many other health professions, clinical education in counseling is challenging in part because there is not a history of paid internships.
• Zachary Brian, University of North Carolina (UNC) at Chapel Hill Adams School of Dentistry: The accrediting body in dentistry does not require students to complete community-based rotations, so there is a lot of variability across programs.
• Lisa Meyer, Saint Louis University: It is challenging to find a wide variety of settings for physical therapy (PT) clinical rotations.
• Gerald Kayingo, University of Maryland, Baltimore: The problem of a lack of clinical sites for physician assistants (PAs) has worsened as the number of PA programs has grown.

Frost noted that while the quality and quantity of clinical sites is an issue across all these health professions, there are unique challenges in each profession which require unique solutions. She then led the panelists in a roundtable discussion on topics that included consequences of inadequate clinical placements for learners and ideas on how to address the challenges.

Consequences for Students

Frost asked panelists to discuss the consequences for students when clinical placement options are limited or lower in quality. There is competition for training sites, Held remarked, particularly with increasing numbers of medical and other health professions schools. If a site does not provide a high-quality experience, the student and school often do not have other options and must simply find a way to continue at the site. Another issue, she said, is that the medical school accreditation bodies require that clinical sites be “relatively comparable” to one another. This can be very difficult to accomplish when some students have to be doubled up at sites due to the shortage; crowded sites mean less exposure to the cases and the experiences that the students need for graduation. Petrosky commented about nutrition and dietetics, saying that there is some flexibility in the types of settings and experiences considered acceptable placements. However, students often have to secure and manage their own placements, and they may need to piece together different experiences to obtain the required skills. This model places a large burden on students, she said. Tolentino mentioned the opinions of others who support paying preceptors. They believe that financial compensation could lead to higher-quality placements for students, he said, before adding his own view that payment alone would not improve quality. Tolentino encouraged institutions to offer faculty development opportunities to preceptors to help them provide higher-quality clinical experiences for students. Brian described a unique challenge related to site placements and student experience at UNC. All dentistry training sites are with organizations that serve vulnerable populations who have limited access to care; for many students, this is their first time serving this population. If a student has a poor experience at their site, he said, it can underscore and perpetuate misunderstandings about the underserved population.

Addressing the Challenges

Frost asked the panelists to discuss the strategies that their institutions have tried in order to secure more quality placement opportunities. Ribar began by noting that colleges of nursing are usually preparing two levels of nurses—pre-licensure “bedside” nurses and advanced practice nurses. This creates a challenge, she said, because the sites needed for pre-licensure students are significantly different from those for advanced practice nurses. To address this challenge, the University of Cincinnati has created a program in which pre-licensure and advanced practice learners are teamed together at a similar site; this triad model allows both levels of nursing students to learn from each other as well as from the preceptors. Tolentino commented on the triad model saying that it resembles models of interprofessional collaboration, which is a cornerstone of the clinical learning experience at Campbell University. Medical students at Campbell do rotations with learners from other medical schools as well as learners from PA programs and work with clinical faculty from multiple fields. Tolentino added that medical students can learn from all health professionals, including PAs, nurses, surgical assistants, and others. In response to a question from Frost, Tolentino clarified that the clinical supervisor for a medical stu-

dent must be a doctor due to accreditation standards, but the expectation is that the supervisor will communicate with the rest of the health care team about a student’s progress.

Dietetics also has interprofessional clinical experiences for students, Petrosky said. Due to a workforce shortage, health systems are in need of dietitians. Petrosky’s institution developed an academic–clinical partnership with a local health system in which students are recruited and hired to do rotations within the health care team. Once students graduate and are licensed, they can seamlessly transition to full-time work in the system where they trained. Brian provided information on placements for students at UNC dentistry, saying they are all in the nonprofit sector and there has been great value for both the sites and the students; many students have ended up working for their sites after graduation. Kayingo commented on the importance of emphasizing the value of being a placement site; rather than asking a site to “take” a student, educational institutions could propose a strong value proposition to preceptors and sites. Echoing what panelists said earlier about the importance of relationships, Brown noted that East Carolina University hired a clinical experiences coordinator to strengthen relationships between the school and the community. Alumni have been an important source of support and feedback for the program, and students have been encouraged to go out into the community and talk with people about their program and what they are looking for in a placement site. Brian added that his institution also hired a community outreach programs manager, who is tasked with executing the vision for community partnerships across the state. It is critical, he said, for institutions to make investments in the time and resources it takes to run these programs properly and effectively.

Systemic Solutions

Given that access to high-quality clinical placements is an issue across health professions, Frost said, what policy, funding, regulatory changes, or health professions collaboration could reduce competition and improve access? Brian led off the discussion by noting how accrediting bodies, which dictate the standards of clinical placements for many professions, are themselves limited by regulatory and legislative barriers. Even when those in a profession want to change the nature of clinical placements, changes may be difficult to achieve due to rules about scope of practice and supervision. He urged all those involved with clinical education to work toward breaking down these barriers in order to realize more interdisciplinary, whole-person health care. He also observed that students perform their work uncompensated. At a time when there are major workforce shortages and maldistribution of providers, students are bringing great value to clinical sites. Brian then encouraged “everyone” to speak with their legislators about using Medicaid funds to pay for these services. Kayingo added that for some specialties and in some areas, there are tax credits that are offered for precepting. This is a “great incentive,” he said, but the current restrictions make it “almost useless.” Kayingo suggested expanding tax credits beyond certain specialties and areas to give student learners a wider array of training opportunities. Held said that it is important to think beyond government funding for these programs due to the recent withholding of federal funds from research and academia. She expressed her hope that philanthropists will step into the void to support the education and training of future health professionals.

Ribar agreed about the importance of highlighting the great work that students are doing, particularly in rural and underserved communities. She added that in nursing specifically, there is a lack of harmonization among states regarding the use of simulation for clinical hours. Evidence exists for using simulation as an effective learning tool, she said, but many states still require all clinical hours be direct, in-person care. Brown and Meyer both expressed a desire to make clinical placements more manageable and equitable. Brown wanted to reduce competition for sites while Meyer suggested universities could collaborate and coordinate their requests for clinical placements so that sites are not “bombarded” with requests.

Frost asked panelists to talk about what it would take to implement these changes—how could health professions work together to actually change policy? Kayingo responded by saying that policy makers could “listen to data.” If health professions work together to gather data about the extent of the problem and present these data

collectively, he said, this could make a difference. Ribar added to Kayingo’s data comment by emphasizing the importance of collecting and presenting student impacts on patient outcomes. Individual professions do a good job of highlighting their contributions to health care, she said, but there is a gap in demonstrating the value of student learners across the health professions. Brian agreed with the value of speaking to legislators collectively and added that legislators are particularly receptive to data about how a program or initiative could save the state money. Rather than focusing on granular data about the impact of student learners on health care, he urged everyone involved with clinical education to “draw the thread” through to the fiscal impact at the state level.

Student and Trainee Perspectives

Breanne Jaqua, a National Academy of Medicine fellow in osteopathic medicine, moderated a discussion among students and recent graduates in the health professions. Jaqua commented on how the shortage of clinical training sites affects not just institutions and systems, but also individual students who are striving to develop the knowledge, skills, and confidence required to serve patients and communities. The students and graduates in this session shared their personal perspectives on what makes a placement high quality, the role of supervision and patient exposure in their development as professionals, and the equity of access to meaningful opportunities. They reflected on how the availability (or unavailability) of placements shaped their readiness for practice and offered ideas based on their own experiences for both peers and the broader health professions community. These insights, Jaqua said, can help constituents understand the challenges for students, and imagine how they could work together interprofessionally to resolve them. The panelists were

• Courtney Collier, a student at Freed–Hardeman University seeking a masters of clinical mental health counseling;
• Samuel Gowan, a second-year physician assistant student, Saint Louis University;
• Raashmi Krishnasamy, a third-year student at A.T. Still University School of Osteopathic Medicine in Arizona, currently doing rotations in Chicago;
• Emily Torres-Medaglia, recently graduated from Nova Southeastern University with a master of science in nutrition; and
• Nathaly Mendez, who will graduate with a bachelor of science in nursing (B.S.N.) in May 2026 from Ursuline College.

Role of Supervision and Patient Exposure

Jaqua asked panelists to give an example of a time when supervision or patient exposure made a difference to their growth as clinicians. Gowan led off by recounting a time early in his emergency department rotation when he was uneasy and lacked confidence in his skills to evaluate a patient with a possible stroke. Identifying this as a weakness allowed him to work with his preceptor to gain confidence and to gradually become more independent over time. He noted that his preceptor used a framework of graduated responsibility to prepare him to function as an independent PA practitioner. Gowan remarked on the effectiveness of this precepting structure. Torres-Medaglia had a similar observation about her experiences; conducting a nutrition-focused physical exam was “nerve-wracking” at first, she said, but performing exams daily with her preceptor and then on her own with the preceptor’s feedback has given her the confidence to practice independently. Collier joined the discussion by saying that a good supervisor can help a student develop not just clinical skills, but also skills for dealing with coworkers and stresses in the workplace. He recalled one supervisor who reframed a difficult interaction he had experienced, which set off a “light bulb moment” and helped him see workplace dynamics differently.

Several panelists said that not being able to get a placement in a specific area can have an impact on competencies, confidence, and future career plans. Mendez said that B.S.N. students are expected to choose a specialty in their senior year but may not be able to get a placement in that area. “Does the health care system expect new grads to just jump straight into the field?” she asked. Collier agreed, saying that a lack of adequate exposures during school can hinder the development of necessary skills and knowledge. In mental health, for example, students may not get sufficient training on or exposure to addiction, but they are likely to encounter addiction issues during practice. He noted that addiction tends to

be siloed in the mental health field and that those outside the silo can lack the knowledge and skills necessary for practice. Krishnasamy added that sometimes a student or trainee may have to think creatively about how to get exposure to a specific field. For example, Krishnasamy is interested in pediatrics or family medicine but is getting limited exposure to pediatrics in her county hospital rotation. She is now considering choosing an elective or other experience to get the needed exposure to pediatrics. Torres-Medaglia said that her program has been very supportive and finds sites for students that best match their interests and experience. This arrangement, she said, allowed her to focus on her coursework and to build confidence and skills in her chosen area.

Access to High-Quality Sites

Jaqua asked the students and trainees about whether people in their profession have equal access to high-quality clinical sites. Collier replied that access is not equal. The locations of sites and the availability of transportation are two major issues, he said; rural areas have very limited sites for mental health care, and transportation is difficult in both rural and urban settings. Jaqua emphasized that many students and trainees are living on loans with limited financial resources and that paying for transportation can be a major barrier. Krishnasamy described disparities in placement access between allopathic and osteopathic medical students. Allopathic programs are often affiliated with a health system that provides rotations for its students, she said, while osteopathic programs usually do not have these partnerships, and students may have to look harder for placements and may even have to pay fees for rotations. Gowan commented on how there is a similar issue among PA programs; some older programs have longstanding relationships with health systems, while newer programs do not. This can make it challenging for students to find and compete for placement sites. Mendez also spoke of competition for sites as a major challenge and said that some nursing students are unable to access in-person clinical experiences and get “stuck” doing only simulations, “which lacks the personal connections within the health care system.” Torres-Medaglia pointed to one reason for a lack of sites, which is preceptor burnout and lack of time. Potential preceptors are busy with their clinical work and may be unable or unwilling to take on the additional responsibilities of precepting, she said. Torres-Medaglia found it easier to find a placement at a smaller, community-based clinic, rather than looking only at large hospitals.

Summary

Jaqua offered her closing thoughts on the discussion. A high-quality clinical placement, she said, is not defined by just a single ingredient. It is a combination of factors, including equitable access, consistent experiences, environments designed for learning, and challenging and supportive preceptors. She offered numerous insights but pointed to one theme that “kept resurfacing,” she said, which is the role of collaboration. Tackling this challenge will require educators, students, health systems, policy makers, and others to work together. Jaqua closed by reminding the workshop participants that the quality and availability of clinical placements do not shape just the health professions education but also the future of health care delivery itself.

HEALTH SYSTEMS, ACCREDITATION, AND REGULATORY PERSPECTIVES

The second session in the workshop series was held on September 10, 2025. Cheryl Hoying, representing the National League for Nursing and co-chairing the workshop, welcomed participants and shared information gleaned from workshop registration. Registrants were asked about the biggest challenges in the area of clinical site placements; both academics and non-academics reported that “preceptor burnout” and “too many students” were top concerns, with “financial and policy constraints” closely behind. It appears that registrants, regardless of position, feel similarly about the challenges we are all facing, Hoying said. She added that this workshop was aimed at illuminating these shared challenges and charting a path forward.

Health Systems Perspectives

Reamer Bushardt of the Massachusetts General Hospital Institute of Health Professions moderated the first session, which focused on the perspectives of people working within health systems. Bushardt began by offering some data on the challenges involved with clinical education:

• In 2023, U.S. nursing schools turned away over 65,000 qualified applicants to their programs, in part due to limited clinical sites, faculty, and preceptors.

• The Association of American Medical Colleges projects a shortage of 86,000 physicians in the United States by 2036; limited capacity in both graduate medical education and residency slots is a major barrier to addressing this shortage.
• Students in nursing, social work counseling, rehabilitation, and other health professions often complete hundreds of unpaid experiential hours; this can create significant burdens for students and drive attrition, particularly for students from underrepresented communities.

These are complex, multifaceted challenges, Bushardt said, and different constituents see these challenges through different lenses. Educational institutions want enough high-quality sites to meet enrollment goals and accreditation standards. Health systems weigh the costs and productivity loss associated with clinical education against the value that clinical education creates for the future workforce. Students want the opportunity to be active contributors to health care teams and to build their professional identity, but they also may carry financial and emotional burdens of the placement. Finally, Bushardt said, policy leaders and funders want scalable, equitable, and sustainable solutions to these challenges. This session was designed to explore the perspectives and experiences of health systems and to begin to identify potential solutions.

Making the Case for Clinical Education

From an economic perspective, Bushardt asked, why would a health system want to train students? What is the business case for clinical education? Tricia Johnson, a health economist at Rush University, replied by offering three core reasons. First, some health systems have an explicit mission to train health professionals. Second, bringing in trainees can make the recruitment of employees easier; trainees are already pre-screened and familiar with the organization, so the costs of bringing them onboard as employees are likely to be lower. Employees who trained in the system may also have a greater commitment to the organization, Johnson said, resulting in better retention. Third, health systems take on trainees in order to keep the pathway of future health care workers moving. Whether trainees stay at their specific organization or not, all health systems benefit from a consistent pathway of prepared health professionals. Matt Calendrillo—owner of Live Every Day, a small business that employs and trains physical therapists—responded to why a health system would want to train students by saying that a well-placed clinical education program can reduce the costs of recruitment and retention as well as create a culture of teaching and learning. High-quality clinical education requires high-quality clinical instructors. At Live Every Day, Calendrillo developed a track for clinical instructors that allows preceptors to focus on clinical teaching and leadership. One challenge for clinical educators can be the ebb and flow of students, he said. To address this, Calendrillo keeps student learners in the workplace at all times. This allows clinical instructors to remain in this role for their entire career, rather than “taking that hat on and off.” Calendrillo added that students can learn in many different ways; they might absorb information best from peers, from individuals with a lot of lived experience, or from someone who is just ahead of them in their educational journey. A clinical instructor’s job is not just to teach the learners, but to facilitate learning opportunities among their trainees. Creating these “layers of learning” engages learners across the educational continuum and gives patients a whole team that is thinking, discussing, and reflecting on their care. Bushardt agreed with Calendrillo’s assessment of the benefits of clinical education and said that as expert clinicians gain more experience teaching, this can translate into better care for patients and families.

Overcoming the Challenges of Clinical Education

The schedules and needs of the educational system do not always line up with the schedules and needs of the health care system, Bushardt observed. He asked panelists how their organizations have managed logistical and scheduling challenges. Michele Scott of Cincinnati Children’s Hospital Medical Center responded that as the sole pediatric hospital in the area, Cincinnati Children’s receives a lot of requests for clinical time. The hospital works with academic partners to think beyond the traditional clinical rotation hours; students may train during night shifts, 12-hour shifts, weekends, or other times. Students and educators have been willing to look beyond the traditional hours in order to get a training slot, Scott said. Bushardt added that when he was a trainee, working in the hospital at night was an interesting and “totally

different” experience, and clinicians often had more time to spend with trainees during evening and night shifts.

Krystal Lighty of the University of Maryland Medical System answered the scheduling question by saying that as a health system with 11 hospitals and multiple health professions programs, the University of Maryland system had been competing against itself for many years. Each entity functioned in a silo; each academic institution communicated separately with each clinical institution about placement slots. A few years ago, she said, the University of Maryland created a coalition of clinical education coordinators for physical, occupational, and speech therapy. These coordinators meet bi-monthly and have open and honest conversations about where and how to place students in the clinic. This has been a journey, Lighty said, and it required building relationships and trust. Ultimately, it required a mutual understanding that everyone is “trying to move in the same direction.”

Disruptions to Clinical Education

The COVID-19 pandemic disrupted the way that care is delivered, Bushardt noted. He asked panelists how it may have changed the approach to experiential learning. Chaz Kohlrieser of Rising for Justice replied that the pandemic pushed more social workers into telehealth. This flexibility has allowed social workers to serve clients where they are and has also made it easier to incorporate student trainees. However, Kohlrieser said, a major barrier is state licensure rules. Without a social work interstate compact, site supervisors are restricted to supervising students in their own states; permitting telehealth supervision across state lines would allow many more students to get the supervision they need. Lighty offered insights from her experiences during and after COVID. Clinical instructors were facing major burnout, she said, so Lighty and her colleagues lightened their load by standardizing the onboarding process through online modules. In addition, they brought academic faculty members in to do some portion of the clinical teaching in order to alleviate the workload of the clinical instructors. Scott shared her organization’s approach to supplementing clinical instruction. At Cincinnati Children’s Hospital, nursing clinical experiences are done in a cohort of six to eight students. If the academic partner does not have a clinical faculty instructor available, Scott said, the hospital has current pediatric nurses who are available to serve as clinical instructors. There is a predetermined rate for these instructors, which is billed back to the colleges of nursing. She added that not all nurses want to serve as clinical instructors, while others have found a new passion for education and moved into working at a nursing school.

Policy Approaches for Supporting Clinical Education

Student trainees participate in the delivery of health care, Bushardt said, and preceptors take on an additional workload when supervising trainees. Some disciplines or specific training programs have funds to provide stipends to trainees, and some do not; some disciplines have traditions of compensating preceptors or health systems for experiential training, and others do not. Bushardt asked panelists about navigating these differences and invited them to share policy ideas that could help support and sustain the system of clinical education. Johnson commented on the fact that some trainees are paid and some are not. This happens both within and across disciplines, she pointed out, and creates a hierarchy of students that could create varying levels of debt and inequality among future health professionals. Deena McRae of the University of California Office of the President said that the primary goal of her office is to expand the state’s health care workforce to address doctor shortages and serve communities’ needs. With this goal in mind, her office has three areas of focus for policy change. The first is improving reimbursement rates for primary care and psychiatry so that safety net hospitals and rural regions are better supported and are more attractive places to work. The second area is creating financial incentives (e.g., loan repayment) to attract graduates and junior physicians to work with medically underserved and in rural areas. McRae underscored the importance of incentives for more senior, experienced faculty; a lack of experienced faculty in an area means fewer training spots for students. Finally, the third area of focus in McRae’s office is funding scholarships and financial aid for students so learners do not graduate with a high debt burden. High medical-school debt can influence specialty choice, McRae said, steering physicians away from lower-paying specialties such as family medicine and driving them toward higher-paying fields such as dermatology.

Addressing student debt could allow early-career physicians to choose any medical specialty and work in locations with the greatest need for doctors.

McRae also told participants about some specific initiatives currently happening in California. To address concerns about a dearth of clinicians in rural areas, there is a state-funded program to expand graduate medical education in these areas. She said that if individuals train and build community in an area, they are more likely to stay and set up a practice in that community. There is a program in the San Joaquin Valley that recruits students from area high schools and places them on an 8-year path to obtain a baccalaureate degree at UC Merced and Doctor of Medicine through the University of California, San Francisco School of Medicine. All clinical rotations are aimed at preparing physicians—from the Valley or with close ties to the Valley—to address health and health care needs of people in the San Joaquin Valley (UCSF, 2025).

Preceptor and Student Burnout

Several speakers had mentioned the issue of preceptor burnout, Bushardt noted, and he asked panelists to address this issue and share their insights. Yoon Suh Moh of Thomas Jefferson University brought up the issue of burnout as a problem among both preceptors and students in the field of counseling. The literature suggests that preceptors feel overwhelmed and unprepared for their role as supervisors, she said. Many preceptors have advanced degrees in their field (e.g., masters of social work), but they have not been specifically prepared to serve as an educator or supervisor. The key to addressing this challenge, Moh said, is collaboration between the site preceptors and the education programs. One of the accreditation bodies in counseling requires schools to offer ongoing training opportunities for site supervisors. At Thomas Jefferson University, she noted, the counseling school has a team of people with varying backgrounds who work together to build the infrastructure for supporting site supervisors. The university currently partners with about 80 site supervisors in the community and offers ongoing training and support to these individuals.

Closing Thoughts

To close the session, Bushardt asked panelists to choose one key message to share. The panelists offered the following thoughts:

• One way to incentivize preceptors to participate in clinical education is to give them continuing education credit for supervising students. (Lighty)
• If better data were available—both qualitative and quantitative—the challenges and opportunities in clinical education could be captured and analyzed. (Calendrillo)
• There is competition for clinical training experiences in practice areas with low reimbursement rates, and some schools are raising tuition to pay for these rotations. Unfortunately, this increases debt for students and makes it less likely that students will go into these practice areas after graduation. (McRae)
• Shifting the costs of clinical training to students is unacceptable and counterproductive. (Johnson, McRae, Moh)
• Developing systematic approaches could help administrators better understand and overcome challenges that cause and result from limited clinical education slots. (Moh)

Accreditation and Regulation Perspectives

Mark Merrick of the University of Toledo, a forum representative from the Commission on Accreditation of Athletic Training Education, moderated a workshop session focused on the perspectives of health professions accreditors and regulators. To open the session, Merrick asked each panelist to briefly respond to the problem statement that guided the workshop series: “There are not enough quality clinical placement sites and slots to accommodate the large number of students needing experiential learning for graduation. This creates a bottleneck for meeting the demands for more health and care providers.” The panelists’ responses included the following:

• The challenge that the health professions face is multi-pronged, said Marianne Biangone of the University of California, San Francisco, School of Nursing. Accreditation standards and regulations can limit innovation and may not reflect current practice. Furthermore, a lack of consistency across states means that health professionals may enter the workplace with different education and experience.

• In social work, accreditors have tried to create policies and standards that are not restrictive in terms of placement settings and sites, said Megan Fujita of Council on Social Work Education (CSWE). With a competency-based model, programs have autonomy to use different approaches, including simulation and employment-based field placements.
• Accreditors have an immense responsibility and are uniquely positioned to help mitigate the shortages in clinical learning sites through shaping expectations, fostering innovation, and creating systemic partnerships, said Dominique S. Hammonds of the Clinical Professional Counseling program at the University of Maryland Global Campus.
• The Liaison Committee on Medical Education (LCME) is working on a strategic visioning plan centered around 10 challenges, one of which is the competition for clinical training sites in undergraduate medical education, said the LCME’s Donna Russo.
• The rules put in place by boards of pharmacy have the primary goal of protecting public health, said Andrew Funk of the National Association of Boards of Pharmacy.
• Accreditors look at numerous characteristics of experiential learning sites, said Mary Romanello of the American Physical Therapy Association, including the credentials of clinical instructors, the opportunities afforded to learners, and the needs in the community.
• Clinical learning experiences in hospitals are limited, said Nancy Spector of the National Council of State Boards of Nursing (NCSBN). Mitigating the shortage of sites will require nursing and other health professions to expand beyond the hospital into other sites where learners can get clinical experience.

Standards and Flexibility

The first topic of discussion involved accreditation and regulatory standards as well as the flexibility of these standards. Merrick asked panelists to comment on any requirements in their field that might prohibit the use of innovative models for clinical education (e.g., a regulation that prohibits simulations). Hammonds replied that setting standards for clinical experiences requires balancing the needs of students with the protection of the public. If standards are too loose, there is a risk of endangering the public and eroding public perception of the health profession. If standards are too strict, they may limit flexibility and innovation in health professions programs. She further commented on the process of developing and adhering to new standards, saying that it is often a reactive process rather than a responsive process—new standards are released, and programs scramble to meet them. Instead, Hammonds suggested developing standards through a collaborative process in which the needs of the community and the unique contributions of health professions are taken into account. Fujita agreed with Hammonds about standards potentially stifling innovation, and said that one way that CSWE has encouraged innovation in the field is through a shift from input-based to outcomes-based accreditation. This allows students and programs to be flexible in clinical education, as long as students are assessed for competency before entering practice. CSWE has written parameters for some specific clinical experiences; for example, a student can do a field placement in his or her place of employment under certain conditions.

Several panelists addressed the issue of using simulations and other technologies to replace or supplement clinical experiences. Spector said that while requirements for nursing clinical hours vary among states, a majority of boards allow pre-licensure nursing programs to use simulation time to substitute for a percentage of clinical experiences. Russo noted how, in medical education, simulation is integrated into both pre clerkship education for training prior to patient exposure and clinical education, but it is not generally considered a substitute for direct patient interaction unless there are barriers to seeing certain clinical conditions during clerkships such as season or geography, in which case it may be used as an alternative clinical experience. Schools must monitor the number of alternative experiences that are used and address the issue if the number is too high, she said. Funk spoke about using technology to expand the number of pharmacy learners that can be accommodated in a community setting. He spoke about community pharmacies that are under tremendous pressure to safely and accurately dispense a large number of medications; this limits the time and energy that pharmacists have to precept learners. To balance

patient safety with access to clinical experiences, Funk suggested that technologies could be used both to alleviate workload and to facilitate the supervision of learners.

Noting that accrediting and regulatory bodies have a large number of requirements for clinical education, Merrick asked what the evidence is behind these requirements. Spector told workshop participants about the NCSBN’s efforts to develop evidence-based criteria for pre-licensure nursing programs. NCSBN conducted an integrative literature review, followed by national quantitative and qualitative studies, and a national Delphi study that included experts in education, practice, and regulation. A separate panel of experts reviewed all the data NCSBN had collected and established evidence-based quality indicators of prelicensure nursing education programs. She said that graduation or licensure pass rates are often used as indicators of quality but added that these are “lagging” indicators of problems in a program. Using NCSBN’s quality indicators allows a program to prevent poor outcomes instead of addressing them after they happen.

Interprofessional Competencies

Given the aim of interprofessional education, which is to learn how to collaborate with other professions, Merrick asked panelists about the possibility of developing a core set of standards that could be required across all the health professions. Fujita shared details about the Interprofessional Education Collaborative (IPEC) competencies. IPEC has created a defined set of core competencies to guide interprofessional education and team-based care across health professions; CSWE finds these competencies to be a great resource. Merrick noted that for standards to align across professions, multiple accreditors would need to be aligned. Another issue in collaborative care, Merrick said, is whether learners can be supervised by preceptors from a different health profession. Funk interjected that pharmacy learners have historically always been supervised by pharmacists. However, given the expansion of scope of pharmacy practice in many states, it may be appropriate for pharmacy learners to work under other health professionals such as physicians or nurse practitioners. At the same time, he said, pharmacy preceptors could bring enormous value to non-pharmacy learners. Merrick agreed, saying that clinical supervision would not have to be based on “historical turf” but could be structured around learning from health professionals doing similar work. Hammond added that counseling students are supervised by other types of clinicians because there aren’t sufficient counseling practitioners able and willing to serve as site supervisors. While this arrangement is based on need, she said, it has been beneficial for students to learn to work with a variety of different professionals.

Ideas for Improvement

To close the session, Merrick asked each panelist to identify one key idea for improving the system of clinical education. They offered the following comments:

• A clearer and more defensible understanding of the requirements that are in place for clinical education, both across health professions and across states, would improve the system. (Biangone)
• Outcomes-based accreditation standards protect the public’s health while allowing for innovation in education and training. (Fujita)
• Clinical education ought to be based not on “the way it’s always been” but instead on how the health professions can address the needs of the community. (Hammonds)
• Clinical experience is often measured in required time, but there may be better ways to assess readiness to enter practice, and it would be valuable determine if such better ways exist. (Romanello, Russo)
• Traditional direct care is essential to a learner’s clinical education experience, but there is a lack of research on best practices in traditional clinical experiences verses simulation. (Spector)

BRINGING IT ALL TOGETHER

The final workshop sessions were held on October 15–16, 2025, both in person and virtually. Zohray Talib of the California University of Science and Medicine, the IHPE Global Forum co-chair, welcomed participants to the workshop. Hoying joined Talib and commented on the previous sessions. The sessions in August and September showed that virtually all of the health professions are challenged by the problem of a lack of quality clinical placement slots for learners, she said. There are multiple

barriers to addressing this challenge, and some barriers are shared among professions while others are unique. Sheperis then spoke and reminded the audience of the problem statement that outlines a lack of quality clinical placements as a primary cause of bottlenecks for meeting the demand for more health and care providers. The purpose of the workshop is not just to identify barriers, he said, but to share ideas on designing potential pathways toward solutions. To this end, Bushardt introduced workshop participants to the Consolidated Framework for Implementation Research (CFIR) (Figure 1), which is widely used in implementation science; it helps researchers and practitioners systematically identify, organize, and understand factors (barriers and facilitators) influencing the adoption and success of interventions, programs, or innovations in real-world settings, structured around five key domains: Innovation, Outer Setting, Inner Setting, Individuals, and Process (Reardon et al., 2025).

The first thing to mention, he said, is how complicated and messy this topic is, and how many variables and factors and people are involved. Bushardt then described CFIR as a possible organizing framework that could help the workshop participants think through practical interventions and solutions from within and across health professions, based on their own situational context. “As we move from identifying challenges to prototyping solutions,” Bushardt said, the framework can facilitate a systematic approach to thinking through the environments, people, and processes that are involved. “Only when all of those things are considered and addressed,” he added, “do we get both successful and sustainable solutions.” Bushardt briefly explained the model: the outer dark blue circle represents the health system, the inner blue circle is the educational system, and the white circle represents the individuals within these systems—preceptors, faculty, trainees, clients, students, and others.

In this section of the agenda, workshop participants discussed overcoming the “problem” at each level of the

model and identified the barriers and facilitators to clinical education. Bushardt moderated with assistance from Merrick and Sicoutris (outer health system), Frost (inner educational system), and Jaqua (individuals). Within each level, invited speakers provided examples of barriers and solutions from their work (Boxes 2, 3 and 4). These speakers were drawn from participant-submitted innovations captured in the book of abstracts.²

Outer Health System

From the health system perspective, one major challenge to clinical education is the lack of financial renumeration for the supervision of learners, said Corinna Sicoutris of the Hospital of the University of Pennsylvania. Sicoutris and her colleagues analyzed the cost of hosting acute care learners in their hospital over the time period of 1-year and found that it equated to about 11 full-time employees’ worth of effort, and nearly $2 million in salary support. The system of clinical education is complicated, sometimes creating conflict where educational and clinical missions meet. One solution, she said, is to view clinical education as an investment, to create mutually beneficial partnerships between the two systems, and to acknowledge the costs and burdens on each. Bushardt added that it is important that the relationship between the two systems is not merely transactional, but that it is based on shared values and a shared commitment to workforce development.

Another systems-level barrier related to clinical education, Merrick said, is rigid accreditation rules. Rules including hours-based requirements, prohibitions on tools like simulation and telehealth, and supervisory requirements all create structural barriers to expanding clinical learning opportunities. To complicate the problem further, some professions have different rules in different states. This fragmentation makes it challenging for both students and health professions programs to plan and participate in clinical experiences, he said.

Bushardt asked Sicoutris and Merrick to identify some specific approaches to addressing these system-level barriers. Merrick said he has seen many creative solutions for compensating preceptors for their time, including giving preceptors faculty appointments. Regarding strict accreditation rules, Merrick spoke of a situation in which accreditation rules were so rigid that a second accreditor stepped into the space to compete because it better met the needs of the profession. Merrick noted that while every profession struggles with the “clinical placement puzzle,” there is too little discussion about solutions across the health professions. At the University of Toledo, he said, an office of experiential learning manages the logistics across all 21 of the programs that do clinical placements instead of 21 “one-off solutions.” In addition to collaboration across professions, Bushardt reflected that communication between the health system and education system could be improved. Is the education system preparing students adequately for their clinical placements? Does the curriculum reflect the realities of modern practice? The best and most sustainable models, from his experiences, are co-created by both systems. Merrick added that there is also a gap in determining the “formula” for developing competency—is it hours, entrustable activities, milestones? Each profession takes a different approach, which makes it difficult to design system-level solutions to ensure student competence. Examples of barriers and facilitators from a systems level were shared by two speakers (Box 2).

Inner Educational System

The August 28 pre-workshop session revealed that the educational system encounters a number of challenges related to clinical education, Frost said. Educational programs compete with one another for clinical placements, and the competition is fiercer in fields that are growing rapidly. Difficulty finding quality sites and preceptors sometimes leads to schools paying for slots, thus increasing tuition costs and exacerbating students’ debt load. The clinical placement process is fragmented, with individual programs each coordinating the logistics of placements rather than working together for efficiency. Frost asked three of the presenters to share the approaches that they or their institutions have taken to address these challenges. The presenters, Ann Gaba, Rachel Pittman, and Tara Mansour (Box 3), agreed that making precepting easier or more rewarding for preceptors could help increase the number of clinical placement slots for students. Incentives for preceptors might include continuing education credits (Gaba), professional development opportunities (Pittman), training

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about supervision and mentoring (Pittman), and making precepting more flexible and less burdensome through telesupervision (Mansour).

Individuals

Jaqua opened the session by saying that the large systems-level challenges related to clinical education are personal for the individuals involved. They are not abstract barriers but rather daily realties expressed through fatigue, inequity, and constrained opportunities. Preceptors and clinical faculty are the backbone of experiential learning, Jaqua said, but they face a number of barriers that make precepting challenging. Some clinicians are under pressure to meet patient quotas or productivity benchmarks; adding student precepting to this workload may feel like an added responsibility rather than an integrated part of professional practice. Clinical faculty may not have any formal training in teaching or assessment, and yet they are expected to serve as educators. This lack of preparation can make precepting stressful, can discourage continued participation, and may lower the quality of the learning environment for students. Unlike research or administrative leadership, precepting is rarely recognized as a valued contribution towards career advancement, which may discourage participation. These factors, taken together, can produce burnout in preceptors and further reduce the number of willing preceptors. The student perspective is equally important, Jaqua said. Student barriers include variable and inequitable access to quality clinical experiences, the financial strain of working unpaid hours while covering the costs of housing and travel, and the psychological toll of relocation and social disconnection. For students with fewer financial resources, these challenges not just are hardships, but may be exclusionary barriers. The shortage of clinical placements is a story of individuals; it is a preceptor who wants to teach but cannot afford

the time and a student who must choose between completing rotation and paying rent. Sustainable solutions to the shortage of clinical placements, Jaqua said, must begin with supporting the individuals at the heart of the system through structures that value their time, effort, and humanity. Examples of barriers and facilitators from an individual level were explored with two presenters, Corbyn Martz and Sindy Louisma (Box 4).

MODELS OF PROGRESS: QUALITY CLINICAL PLACEMENTS ACROSS HEALTH PROFESSIONS

Julieanne Sees of the American Osteopathic Association (AOA) and CVS Health gave the keynote talk, which covered a variety of topics, including clinical education in osteopathic medicine and training programs at CVS Health. Following her description of osteopathic medicine’s significant role in addressing workforce shortages in primary care and rural health care, Sees went on to describe CVS Health as one of the largest providers of care in the United States. The company has a number of training programs, particularly in the areas of pharmacy, but also in nursing, physician assistants, and behavioral health. It does not offer clinical rotations for physicians, she said, but it can provide clinicians insights into the business side of health care.

Sees next described how CVS Health programs, such as the General Management Corporate Internship Program (GMCIP), could be used as a model for developing opportunities for clinical training in industry settings. The

GMCIP is a 10-week internship program in which participants gain work experience in a key business area and have opportunities for mentorship and networking. It is open to college students who are between their junior and senior years who have many different backgrounds. These students are placed in a variety of business units across CVS Health, spanning from Healthcare Delivery (like Signify Health and Oak Street Health) to Pharmacy and Consumer Wellness (like CVS Pharmacy and CVS Specialty), to Healthcare Benefits at Aetna and pharmacy services at CVS Caremark. After graduation, participants in the GMCIP are invited to apply to the General Management Development Program, a 3-year program with three rotations. The three rotations build in intensity; participants are first placed in an area that is closely aligned with their strengths, then to one where they have a gap in experience, then to a “stretch rotation” where they demonstrate their ability to perform at a higher level. As a business model, Sees said, programs like this represent an investment in future employees and leaders.

A recent college graduate who participated in the GMCIP, Olivia St. Marie, briefly talked about her experience. One of the biggest values was the mentorship and networking opportunities, she said. Interns are assigned a mentor months before they start the program in order to prepare and ask questions, and they meet with their mentor weekly during the internship. Another beneficial aspect was having multiple managers throughout the internship

and getting to experience different parts of the business and different leadership styles, St. Maria said. Sees commented on clinical rotations in the health professions, saying that they often do not have this depth of purposeful mentorship, and she suggested that this type of investment is critical to preparing the future health care workforce. She further remarked that CVS Health is a unique model of placement for learning about the business side in the health care industry. It may not be the medical side, she noted, but that is the point. The internship is an opportunity to learn about how a successful business implements its strategy of “building a world of health around every encounter and every customer.”

PATHWAYS TO SOLUTIONS

For the final workshop session, workshop participants formed breakout groups to engage in a table activity. Sheperis introduced the activity and gave some remarks to set the stage. Change is difficult, he said, but implementation science provides a guiding framework for thinking through barriers and facilitators. On the topic of clinical education, it is critically important that implementation be approached through an interprofessional, collaborative lens. Rather than having a mindset of trying to get other people to change, Sheperis said, it is essential to get others on board by convincing them of the necessity of change and to work together to identify problems and co-create solutions.

This workshop is based around the problem statement that there are not enough clinical placements for the students who need them, Sheperis said. Rather than competing for these limited spots, the challenge in this exercise is to find ways to work interprofessionally to create a system that will accommodate all students in the health professions and ensure a well-trained workforce pathway. Workshop participants were then asked to divide into small groups. The groups were told to imagine they were deans starting a new school of health professional education that includes interprofessional experiential learning. To create the school, said Sheperis, the deans would have to better understand each profession’s requirements within the clinical learning environment and what each health profession’s students are expected to be doing during their experiential learning. Workshop participants were instructed to create a system that is collaborative rather than competitive using the full CFIR model (Figure 1) as a guide. Sheperis then introduced the “RE-AIM” framework for groups to use to test the innovation and implementation process created by their breakout group. The RE-AIM framework comprises five parts (Glasgow et al., 2019):

• Reach: Who will be part of the innovation?
• Effectiveness: What are the most important outcomes you expect to see?
• Adoption: Where will initiative be conducted?
• Implementation: How will the initiative be delivered, including adjustments and adaptations?
• Maintenance: What will happen over the long-term?

Report-Backs

After participants met in their breakout groups, a representative from each group gave a brief report on that group’s discussions. One of the groups’ representatives, Kylie Dotson-Blake of the National Board for Certified Counselors, noted that capacity studies could help institutions determine their ability for taking on learners. She mused that a formula for “total learner capacity” could be developed so that systems are better able to assess how many students organizations are able to engage and what that would look like. Bushardt added to the research suggestion by saying that the “dosage” of clinical learning would also be a valuable measure. In other words, how much clinical experience is necessary for a learner to reach competence? Clinical activities could be redistributed if a learner no longer needs reinforcement of the particular experience, thus freeing up clinical time.

Sheperis, who moderated the report-backs, observed that the innovations explored by each of the groups fell into four broad categories: coordinating schedules, grouping learners, innovating clinical experience design, and making better use of simulation.

Coordinating Scheduling

Dotson-Blake said that her group had discussed the idea of coordinating clinical education slots and schedules at a higher level, rather than each program individually negotiating place and time—an idea that was also considered by others groups. She also said that experiential learning centers on campuses are a great way to coor-

dinate scheduling and to lighten the administrative load for preceptors and programs. Expanding available clinical hours would also be helpful, she suggested; while regular daytime hours align well with faculty and university schedules, expanding the schedule to other hours could allow students to get different types of experiences and could also make it easier for nontraditional students to get their clinical hours. Bushardt agreed that coordinated, more flexible scheduling would be more efficient and could benefit both students and preceptors. Merrick then said that the office of experiential learning at his institution coordinates all the logistics of placements across 21 programs. This arrangement frees up the faculty to play “matchmaker” to find appropriate slots for students, while the office handles contracts, evaluations, and other administrative tasks. Another approach, Merrick said, would be for programs in the same field to create consortiums that would navigate the clinical education system. Instead of having programs compete for space, he said, the programs could use a structured system to ensure that everyone gets what they need. Jaqua agreed with the need for a centralized scheduling that distributes rotations and opportunities equally. Dotson-Blake said that one way to improve the logistics of clinical education would be to involve health administration students in these types of efforts. Engaging these learners early on will help to build a health care culture that is more proactive and collaborative and in which leaders are better informed about the needs of students, educational programs, preceptors, clinical training sites, and others with clinical education interests and responsibilities.

Grouping Learners

The breakout groups explored the idea of grouping learners both within professions and across professions, with Dotson-Blake suggesting that the “triad model” used at University of Cincinnati nursing be expanded to other professions. Learners of different levels, she said, could be grouped together with one preceptor. Bushardt noted that dyads of students from the same or different professions could be placed together within a rotation, both in order to support each other and to decrease burden on the preceptor. Bushardt’s group also discussed “near-peer” teaching in which students in one level are entrusted to support the education and training of more novice learners. Jaqua mentioned a promising program from Western University of California; the school has a required rotation where students from different professions are sent as a group to learn about interprofessional team-based care in rural and underserved populations. She commented that students find great value in being able to learn from and about other health professions and to collaborate on care. An important feature of this rotation is that the leadership of the care team rotates each day so that students get to practice leadership and team dynamics in real time. Stacy Pommer of the U.S. Department of Veterans Affairs commented on how mentors can be incredibly important in the growth of a health professional, adding that both intraprofessional education and interprofessional teams give an opportunity to build mentorship relationships.

Innovating Clinical Experience Designs

Discussions in the breakout groups explored re-reimagining the design of clinical rotations in terms of location, objective, or format, which led Bushardt to suggest several potential options for less traditional rotations. These rotations included hospital-at-home programs, telehealth, school-based clinics, and industry collaborations. He also proposed designing rotations with different goals in mind, such as the productivity and well-being of those involved. For example, rather than a trainee following a provider through the entire day, the trainee could spend part of the day in supervised clinical care but dive deeper into a condition or issue encountered with subsequent self-directed research and study. This would allow for deep learning with less burden on the clinician—said another way, consider the quality over quantity of experiential learning. Merrick described another way to redesign clinical education, which would be around the patients’ needs. Clinical training is traditionally designed around professions—the specific skills and tasks of doctors, nurses, physical therapists, and so on. Instead, Merrick said, training could be reframed to focus on what the patient needs and structured to pull multiple disciplines together in a partnership to meet these needs. Several speakers acknowledged that particular challenges exist within finance (Pommer), institutional policies (Jaqua), and accreditation requirements (Doherty) but are not insurmountable. Bushardt added that the traditional

system of clinical education is “entrenched” among faculty and that innovating in this space would require getting their buy-in.

Using Simulation

Simulation was a frequent topic of conversation among the breakout groups. Pommer sharing her thoughts on the topic first. Simulation can be very helpful for preparing students for clinical work, she said, both in the early years of their education and when they are doing clinical rotations. Haru Okuda, the forum representative from the Society for Simulation in Healthcare, agreed with Pommer and added that because clinical time is limited, it is critical that students are prepared to maximize the time that they do get. By using simulations, students can get exposure, experience, and competency before they are placed in the clinical environment; this makes the best use of both learners’ and preceptors’ time. Merrick said that simulation can also be used to give students experiences that are not available in the clinic. For example, at the University of Toledo there are plenty of medical–surgical rotations but not enough obstetrics rotations. Using simulation can help fill this gap. Merrick noted that, in an ideal system, all students would get the clinical experiences they needed rather than replacing some with simulation. However, he said, the system is not ideal, and the use of simulation is a pragmatic solution to a real-life challenge.

Closing

To close the workshop, Hoying and Sheperis thanked the staff, planning committee, speakers, and participants and gave a challenge to participants. Participants were asked to reflect on what they had heard and to consider what they could take back from the workshop, what they learned about problem solving, and what innovation could realistically be adapted in their institution within the next 12 months.

REFERENCES

Glasgow, R. E., S. M. Harden, B. Gaglio, B. Rabin, M. L. Smith, G. C. Porter, M. G. Ory, and P. A. Estabrooks. 2019. RE-AIM planning and evaluation framework: Adapting to new science and practice with a 20-year review. Frontiers in Public Health 7(64):1-9.

Kayingo, G., K. L. Gordes, S. Fleming, and J. F. Cawley. 2023. Thinking outside the box: Advancing clinical education in an era of preceptor shortage. The Journal of Physician Assistant Education: The Official Journal of the Physician Assistant Education Association 34(2):135–141. https://doi.org/10.1097/JPA.0000000000000500.

Reardon, C. M., L. J. Damschroder, L. E. Ashcraft, C. Kerins, R. L. Bachrach, A. L. Nevedal, A. M. Domlyn, J. Dodge, M. Chinman, and S. Rogal. 2025. The Consolidated Framework for Implementation Research (CFIR) user guide: A five-step guide for conducting implementation research using the framework. Implementation Science 20(1):1-13.

UCSF (University of California, San Francisco). 2025. San Joaquin Valley PRIME+. https://meded.ucsf.edu/san-joaquin-valley-prime-plus (accessed December 31, 2025).

Williams, M., S. Kohli, and P. Leventis. 2025. How to harness education fellows to optimise clinical placement capacity. The Clinical Teacher 22(2):e70061.

DISCLAIMER This Proceedings of a Workshop—in Brief was prepared by Patricia Cuff and Erin Hammers Forstag as a factual summary of what occurred at the workshop. The statements made are those of the rapporteurs or individual workshop participants and do not necessarily represent the views of all workshop participants; the planning committee; or the National Academies of Sciences, Engineering, and Medicine.

PLANNING COMMITTEE Cheryl Hoying (Co-Chair), National League for Nursing Board of Governors; Carl Sheperis (Co-Chair), Kutztown University of Pennsylvania; James Ballard, University of Kentucky; Kylie Dotson-Blake, National Board for Certified Counselors and Affiliates; Elizabeth Gatewood, University of California San Francisco; Gerald Kayingo, University of Maryland, Baltimore; Lyuba Konopasek, Intealth; Senthil Kumar Rajasekaran, Wayne State University School of Medicine; Lisa Meyer, Saint Louis University; Stephanie Petrosky, Nova Southeastern University, Florida; Stacy D. Pommer, U.S. Department of Veterans Affairs; Monica Sampson, American Speech–Language–Hearing Association. The National Academies’ planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

REVIEWERS To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by Marianne Biangone, University of California, San Francisco; Mary Beth Bigley, National Organization of Nurse Practitioner Faculties; Lynette Hamlin, Daniel K. Inouye Graduate School of Nursing; Tricia Johnson, Rush University; and Kelly Meyers, SUNY Upstate Medical University, Syracuse, NY. Kirsten Sampson-Snyder, National Academies of Sciences, Engineering, and Medicine, served as the review coordinator.

SPONSORS This workshop series was supported by the Global Forum on Innovation in Health Professional Education. The global forum is supported by contracts with the Academic Collaboration for Integrative Health; Academy of Nutrition and Dietetics; Accreditation Council for Graduate Medical Education; American Association of Colleges of Osteopathic Medicine; American Board of Family Medicine; American Council of Academic Physical Therapy; American Dental Education Association; American Medical Association; American Nurses Credentialing Center; American Physical Therapy Association; American Speech–Language–Hearing Association; Association of American Medical Colleges; Association of Schools and Colleges of Optometry; Athletic Training Strategic Alliance; Council on Social Work Education; Indiana University of Pennsylvania; Intealth; Kutztown University of Pennsylvania; MGH Institute of Health Professions; National Academies of Practice; National Board of Certified Counselors, Inc., and Affiliates; National Board of Medical Examiners; National League for Nursing; Physician Assistant Education Association; Society for Simulation in Health Care; Southern California University of Health Sciences; Texas Tech University Health Sciences Center; Uniformed Services University; University of California, San Francisco; University of Utah School of Nursing. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

STAFF Patricia Cuff, Senior Program Officer; Erika Chow, Research Associate; and Breanne Jaqua, NAM Fellow in Osteopathic Medicine.

SUGGESTED CITATION National Academies of Sciences, Engineering, and Medicine. 2026. Addressing Training Site and Slot Shortages Across the Health Professions: Proceedings of a Workshop Series—in Brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/29362.

For additional information regarding the workshop, visit https://www.nationalacademies.org/projects/HMD-BGH-24-12/event/45379.

Copyright 2026 by the National Academy of Sciences. All rights reserved.