Abstract
Introduction
High school healthcare pathway programs play an important role in shaping the future healthcare workforce by providing students with opportunities to envision themselves in the field and offering tools to support their progression into the profession. Since the repealing of affirmative action, barriers to admission for applicants of underrepresented backgrounds have been rising. There is a growing need to support students on their path into a healthcare career. This study aimed to develop a map of high school pathway programs across the United States to identify common program features and document promising practices in program operation.
Methods
This sequential mixed methods study first used environmental scan procedures to evaluate U.S. programs (n = 90) across structural frameworks, curriculum development, length, cost, and other defining features. After the environmental scan was completed, interviews with purposefully selected program directors (n = 6) were conducted on Zoom, lasting 45-60 minutes following a standardized protocol developed from the results of the environmental scan. Interviews were transcribed and an iterative coding procedure using inductive descriptive coding, and a secondary coding review was done prior to development of themes.
Results
Among the 90 external programs identified, summer-only programming was the most common structure (52.2%), while only 11.1% were clearly multi-year. Hands-on activities were the most frequently documented program component (85.6%), followed by exposure to multiple health professions (77.8%) and mentoring (61.1%). Academic support was documented in approximately half of programs (46.7%), while shadowing (31.1%), research (30.0%), and service (12.2%) were less common. Most programs used an application-based entry process (78.9%), and no participant fee was reported for 57.8%. Formal academic credit or a degree pathway was uncommon (13.3%). Across programs, three themes were identified: long-term mentorship, life-skill development, and academic support. These themes were embedded within broader, cross-cutting practices, including hands-on experiences that made health careers tangible, exposure to multiple professions and potential career pathways, and relationships with near peers, professionals, alumni, and program staff that helped students envision and navigate those pathways. Programs operationalized these elements differently according to their populations, local workforce needs, institutional contexts, and available resources. Directors also described challenges maintaining longitudinal connections and measuring student outcomes after program completion.
Conclusion
Ultimately, this study differentiated the key aspects between a “healthcare experience” program and a true “pathway” program. The environmental scan and director interviews suggest that healthcare pathway programs share common goals but use different structures and strategies to achieve them. Understanding the framework of these programs helps program directors develop their structure and better support their students along the path to entering the healthcare field.