Association for Public Policy Analysis & Management

Traditional measures of career progress, based largely on linear career pathways models, use job title, wage and educational attainment to indicate advancement. Workforce development systems are designed around this conceptualization. As such, their focus is on entry into the first job or training program, and retention or advancement within the first few months, with the assumption that participants will continue to advance on their own after this initial entry period.

Based on this conceptualization of career progress, early findings from the Health Profession Opportunity Grants (HPOG) national evaluation show that entry-level healthcare workers often struggle to advance, remaining in entry-level positions such as Certified Nursing Assistant (CNA) working in home care, with low wages and little job security.

The Institute on Assets and Social Policy (IASP) at Brandeis University, in partnership with a workforce development agency in Connecticut, is using new and existing HPOG data to reconceptualize career progress and develop new methodologies for measuring and analyzing advancement. We use data from interviews with 60 low-income healthcare workers to identify their own interpretations of their career progress and priorities for advancement. These findings inform a broader understanding of career progress, incorporating characteristics of job quality beyond wage and job title, including workplace institutional characteristics and structural barriers. We map these concepts onto administrative data to examine the shape of career progress for entry-level healthcare workers, assess the impact of existing programming, and identify leverage points for intervention.

We find that participants can make strategic “micro-advancements,” which do not meet the traditional markers of career progress, to move forward in their careers. Examples of these moves include:

• Moving from a per diem CNA job in home care to a CNA job at a nursing home, making the same or even lower wage but with guaranteed hours and benefits (a move that appears lateral or downward by traditional markers of career progress).
• Moving from a fulltime day shift to a fulltime night shift in order to gain income through a shift differential and have more time with family (appears lateral).
• Moving from a CNA job in home care to a housekeeping job in a hospital, with guaranteed hours, benefits and union membership (appears downward).

This new understanding and method of measuring career progress has important implications for workforce development programming and administrative data collection. By instructing participants in strategic micro-advancement, programs can give entry-level workers the tools that they need to navigate toward a job with the qualities and security that meet their needs.

[1] In the HPOG 1.0 sample, only one in ten participants enrolled in a second training program following completion of their first training program (Werner, Alan, Pamela Loprest, Deena Schwartz, Robin Koralek, and Nathan Sick (2018). Final Report: National Implementation Evaluation of the First Round Health Profession Opportunity Grants (HPOG 1.0), OPRE Report # 2018-09. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.).