Anne Arundel Community College (AACC) and the University of Maryland Baltimore Washington Medical Center (BWMC) have a strong collaborative partnership dedicated to advancing the region’s healthcare workforce. Grounded in a shared commitment to education, workforce readiness, and community health, this relationship has evolved into a strategic model for building career pathways that strengthen talent pipelines and support long-term organizational growth. 

BWMC provides essential clinical placements for AACC’s Registered Nursing (RN) and Practical Nursing (PN) students, giving learners direct exposure to real-world practice. Beyond nursing education, the partners engage in broader workforce initiatives through the Anne Arundel County Workforce Development Healthcare Industry Collaborative. AACC also delivers contract training tailored to BWMC’s needs and offers grant-funded Adult Basic Education and English Basic Skills, along with tuition-based Certified Nursing Assistant (CNA) programming on the BWMC campus. Locating high-quality instruction on site and aligning it with employer demand removes barriers for working adults and community members, creating seamless education‑to‑employment pathways. By working in concert, AACC and BWMC demonstrate how higher education and healthcare providers can codesign solutions that prepare individuals for meaningful careers while strengthening the health and economic vitality of the communities they serve.

Need

Maryland, like much of the United States, faces persistent shortages in critical healthcare roles (National Institute for Health Care Management, 2025). The need is especially acute for RNs; licensed practical nurses (LPNs); certified nursing assistants (CNAs); and allied health professionals across respiratory care, therapy, pharmacy, and behavioral health (Health Resources & Services Administration, 2025; National Institute for Health Care Management, 2025). Statewide shortages are projected to continue through 2035, increasing pressure on employers and education providers to expand capacity without compromising quality (Burton, 2025; Health Resources & Services Administration, 2025).

Multiple forces drive these gaps. The COVID‑19 pandemic accelerated retirements and turnover in 2020-2022, while vacancy rates climbed and burnout intensified (National Institute for Health Care Management, 2025). At the same time, nursing education programs face capacity constraints due to faculty shortages and limited clinical placements, slowing the flow of new graduates (Burton, 2025). Demographic trends compound the issue as Maryland’s growing and aging population elevates demand for both acute and long‑term care services, stretching an already thin workforce (Health Resources & Services Administration, 2025).

Problems/Issues

Working adults seeking to advance their education often encounter structural barriers that make traditional college participation difficult. Rotating shifts, overtime demands, transportation limitations, family responsibilities, and financial strain can impede enrollment or completion. Capacity limitations within high-demand healthcare programs further compound the challenge. Additionally, competitive admissions processes, limited clinical placements, and capped enrollment can delay entry into programs such as nursing and allied health. For many incumbent workers, these systemic barriers restrict pathways for advancement and affect long-term career mobility. Healthcare organizations also experience persistent workforce challenges, including high turnover, extended onboarding timelines, and the need for ongoing upskilling to meet evolving clinical and technological standards. The result is a gap between aspiration and access, particularly for incumbent workers who are already contributing to the healthcare workforce but lack streamlined pathways for advancement (National Institute for Health Care Management, 2025).

Without accessible educational pathways, talented employees may find limited opportunities to grow within an organization. This can lead to stagnation, reduced engagement, or eventual departure (National Institute for Health Care Management, 2025). Regional healthcare workforce shortages have placed additional pressure on community colleges to expand capacity and respond quickly to employer needs. As healthcare systems grow and patient demand increases, colleges are called upon to produce more credentialed professionals, often with limited physical space, faculty availability, and clinical placement opportunities. The dual expectation to maintain high academic standards while rapidly scaling enrollment creates operational strain (Burton, 2025). Meeting employer demand requires innovative models that move beyond traditional campus-based instruction and leverage partnerships to expand access without compromising quality. 

BWMC also faces growing pressure to strengthen and modernize its workforce. Rapid changes in healthcare delivery, technology integration, and patient care standards require continuous upskilling (National Institute for Health Care Management, 2025). Supporting career advancement for existing employees is not only a workforce development priority but also a strategic imperative. 

A Collaborative Solution: Designing a School-at-Work Model

To address these interconnected workforce challenges, AACC, BWMC, and the Anne Arundel Workforce Development Corporation (AAWDC) developed a multi-institutional collaboration designed to remove barriers, accelerate credential attainment, and strengthen the regional healthcare talent pipeline. Rather than relying on traditional campus-based delivery, the partners cocreated a scalable school-at-work model that integrates academic instruction directly into the healthcare work environment. Each organization plays a distinct and complementary role in ensuring program quality, accessibility, and sustainability.

AACC leads curriculum development, faculty recruitment, and academic oversight to ensure that programs meet industry requirements. The college adapts coursework into hybrid and accelerated formats specifically designed for working adults. By blending online learning with structured in-person instruction and compressing course timelines where appropriate, AACC maintains academic rigor and clinical competency while increasing flexibility. 

BWMC provides the physical infrastructure that makes the school-at-work model possible. Dedicated on-site classroom and laboratory space allows employees to attend class during or adjacent to their work shifts, significantly reducing transportation and scheduling barriers. The medical center also plays a key role in employee vetting and candidate selection, identifying motivated staff members who are ready for advancement. Tuition funding and scheduling flexibility further reinforce BWMC’s commitment to employee growth and retention.

AAWDC provided critical start-up funding for the program, covering eligible tuition, fees, and books to reduce financial obstacles for participants. BWMC continued this support through a tuition assistance program. In addition, the corporation provided student career coaching and supportive services, helping participants navigate academic expectations, balance work and study, and plan for long-term advancement.

Implementation: From Concept to First Cohort 

The school‑at‑work model moved from concept to execution over a multi‑year timeline that emphasized careful planning, cross‑institution coordination, and continuous problem‑solving. From initial discussions in 2021 through the launch of the first cohort in 2024, each phase centered on accessibility, quality, and alignment with workforce needs.

A critical early milestone was identifying and preparing clinical, laboratory, and classroom spaces at BWMC. BWMC converted appropriate areas into fully functional learning environments: Laboratories were equipped with the necessary medical equipment and simulation resources, while classrooms were configured to support hybrid instruction, and all spaces were scoped to comply with safety protocols and industry standards. In tandem with space preparation, AACC completed faculty onboarding, course scheduling, and instructional design. Faculty adapted curricula for accelerated and hybrid delivery, calibrating the balance between online content and hands‑on laboratory experiences. Close collaboration with BWMC leadership ensured that course objectives aligned with clinical competencies, workplace expectations, and patient‑care standards.

Recruitment strategies targeted multiple audiences to ensure strong cohorts. Priority went to BWMC employees seeking advancement, supplemented by AAWDC referrals and qualified community applicants. This mix broadened access, met workforce demand, and built diverse peer learning communities that mirrored the realities of modern care teams. By 2024, after planning, space conversion, curriculum adaptation, and recruitment, the partners launched the first cohort, demonstrating the feasibility of fully integrated worksite‑based education. The phased approach enabled the institutions to anticipate challenges, test solutions, and uphold both operational and academic standards.

A notable implementation innovation involved tuition funding. Initially, BWMC partnered with AAWDC to cover tuition, fees, and books. As BWMC assumed responsibility for these expenses, the hospital revised its tuition reimbursement model to allow upfront payment of employee tuition. This change removed administrative hurdles and financial strain for staff, who no longer needed to provide upfront costs or manage reimbursement paperwork. Another implementation innovation was delivering AACC’s Human Biology 1 and 2 on the BWMC campus. By combining online learning with on‑site laboratories, employees can complete core science requirements more efficiently and with greater continuity. Together with streamlined third‑party billing and funding, these steps strengthen the model’s sustainability and learner experience.

Results and Early Impact

Early outcomes show strong participation and completion rates across multiple program pathways. The first LPN cohort, launched in December 2024, graduated 9 of 12 BWMC employees, resulting in a 75 percent completion rate. The second cohort, completed in February 2025, graduated 8 of 14 participants, with an additional four on track to graduate in May 2026, bringing the projected completion rate to 85 percent. The CNA program has also seen meaningful early impact. To date, 30 students have successfully completed CNA training in the college’s on-site CNA laboratory at BWMC. This integrated training model has supported both incumbent workforce advancement and new workforce entry. Additionally, accelerated, hybrid-format biology prerequisite cohorts have enrolled between seven and eight participants per session. These smaller cohorts provide targeted academic preparation while offering flexible access for working adult learners pursuing nursing pathways. 

Lessons Learned 

It is essential to have continuing collaboration among multiple AACC departments to ensure seamless student experiences. From enrollment and tuition management to academic advising and instructional delivery, alignment across departments minimizes administrative barriers and supports student persistence.

This experience also underscores the need for careful space and equipment planning when offering instruction at off-site locations. Establishing high-quality laboratory experiences outside of the college campus requires detailed logistical coordination, including equipment transport or duplication, compliance considerations, technology access, and scheduling alignment with employer partners. Proactive planning in these areas ensures that instructional quality remains consistent regardless of location. 

Another key lesson is the value of strong partnerships in funding and supporting adult learners. Employer investment, whether through tuition assistance, flexible scheduling, or shared facility use, significantly enhances access and completion outcomes. Collaborative financial and structural support reduces barriers for working adults and strengthens overall program sustainability. 

Recommendations for Other Institutions

Institutions seeking to replicate this approach should begin with employer partnerships grounded in shared goals and mutual investment. Success depends on employers who are ready to co-invest through financial support, dedicated learning space, equipment, and employee release time. Designing academic structures that meet the realities of working adults is also essential to success. Hybrid and accelerated formats can lower barriers related to scheduling and transportation while still maintaining rigor. Programs that intentionally integrate online instruction with condensed timelines and employer‑based laboratories are more accessible for adult learners and more responsive to talent needs. Finally, establishing clear divisions of responsibility among the college, employer, and any workforce agencies strengthens effectiveness. Explicit roles in recruitment, funding, student support, compliance, and logistics prevent duplication of effort and reduce confusion for participants. Formal agreements and standing communication routines help maintain coordination and accountability as the model scales.

Impact and Broader Significance 

One of the most significant outcomes is expanded access for adult learners. Hybrid and accelerated formats, coupled with workplace-based laboratories, reduce common barriers such as transportation challenges, schedule conflicts, and time away from work. The structure enables incumbent employees to advance without stepping away from their roles and opens doors for community members entering healthcare careers.

Participant feedback underscores the value of the design. Learners report high satisfaction with the balance of online and hands‑on instruction and appreciate the convenience and quality of the on‑site lab experience. Learning in a familiar clinical environment enhances confidence and supports immediate application of skills.

The initiative has also deepened institutional collaboration. Through shared resources, close coordination, and aligned workforce goals, the relationship between AACC and BWMC has moved beyond a traditional training arrangement to a strategic partnership focused on long‑term workforce development. Notably, this marked the first time AACC had delivered both a PN program and a CNA program entirely off‑site at BWMC, a milestone that required extensive planning and compliance work.

Next Steps 

Building on early success, the partnership is focused on thoughtful expansion and continuous improvement. A primary priority is scaling future LPN and CNA cohorts to meet continuing workforce demand. By refining recruitment, onboarding, and instructional processes, the program aims to increase capacity while maintaining strong completion rates and instructional quality. 

Careful vetting and preparation of BWMC employee‑students will remain central. Clear program expectations, early academic support, and proactive coaching will help incoming cohorts succeed in accelerated and hybrid formats. Ongoing review of student outcomes, employer feedback, and regional workforce trends will guide data‑informed adjustments.

Given the model’s demonstrated results, the partners will also explore expansion beyond the current portfolio. By applying lessons learned and preserving strong collaboration, the initiative is positioned to broaden its impact and continue strengthening the healthcare talent pipeline in the years ahead.

References

Burton, L. (2025). Nursing shortage fact sheet: What to know for 2026. https://www.registerednursing.org/articles/nursing-shortage-fact-sheet

Health Resources & Services Administration. (2025). Health workforce projections. https://bhw.hrsa.gov/data-research/projecting-health-workforce-supply-demand?_hsenc=p2ANqtz-8WRaWebePghOdOkyjXuSWnNFuLHyqOcgc4MthbvRiQSOR5HdvDvppaZKsb4M_kGRAD9fQ0&utm_
campaign=The%20Compass%202022&utm_medium=email&utm_source=hs_email

National Institute for Health Care Management. (2025). Addressing health care workforce shortages. https://nihcm.org/publications/addressing-health-care-workforce-shortages  

Elizabeth Appel is Dean, Health Sciences, at Anne Arundel Community College in Arnold, Maryland.

Opinions expressed in Leadership Abstracts are those of the author(s) and do not necessarily reflect those of the League for Innovation in the Community College.