Guest Columns

Increasing quality of the AIT experience

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Jennifer Johs-Artisensi
Jennifer Johs-Artisensi

Nursing home quality reflects to a significant degree, its leadership – the expertise and commitment of the administrators in charge of leading person-centered organizations. The “Administrator-in-Training” (AIT) or “practicum” experience serves as an essential educational component, facilitating the transition from student to leader, and research has suggested that this AIT experience is critical to the effective development of health care administrator competencies.   

A recent research study, funded by the Foundation of the National Association of Long Term Care Administrator Boards (NAB Foundation) and Commonwealth Fund, has found that the quality of the AIT or practicum experience is heavily determined by the environment in which the trainee learns, most notably the experience of the trainee's preceptor and the “spirit of learning” embodied by the practicum site. Key characteristics of training sites offering the highest quality experiential learning that best prepared future leaders included the following:

  • The individual serving as the preceptor makes a significant difference in the student's learning experience. The number of years the preceptor has been with their organization, the number of students he or she has mentored, how involved they are in their profession, and their level of education are all significant factors towards the student's success.
  • A positive learning environment – an atmosphere that communicates the student is wanted, accepted, and encouraged to engage with the work of the organization, encourages a climate of learning. In addition, stability of department head teams and the level of organizational support for employees and trainees to continue their own professional development were also important factors. Conversely, instability among staff or leadership teams served as distractions to the preceptor and inhibited student development.
  • Organizations, that emphasize the advancement of culture change, have high customer satisfaction, and participate in the Advancing Excellence in America's Nursing Homes Campaign also better poised students for future success.
  • Finally, students who were best prepared to lead long-term care organizations of their own, obtained their education and training at sites where a variety of services, such as skilled nursing, assisted living, dementia care, senior housing, and other community based services were provided.

We hope the findings of this white paper will facilitate a dialogue and subsequent actions by state licensing boards, academic programs, and corporate AIT directors, to advance a more useful, systematic approach to site selections and future student trainee placement. It is imperative we develop high-impact practices to support the education and training of a new generation of leaders in our field, and this project has yielded several that could be leveraged to further improve administrator education and training to enhance quality care. There is ample opportunity for academic programs, professional associations, state boards, and the providers to work together to develop core competency criteria and models or standardized tools to help advance quality clinical training experiences for future long-term care administrators. Some areas ripe for collaboration might include development of:

  • In/exclusion criteria for site and preceptor selection
  • Strategies to help cultivate an organizations' learning environment
  • Preceptor training, development, or certification programs

The complete white paper can be found on the NAB Web site at

Jennifer Johs-Artisensi, Ph.D., MPH, is the Education Committee Chair for NAB, and an Associate Professor and Program Director for the Health Administration Program at the University of Wisconsin – Eau Claire, a program with over 200 undergraduate future senior care leaders. The Foundation of the National Association of Long Term Care Administrator Boards (the “NAB Foundation”) is a nonprofit organization established to promote and enhance the profession of long term care administration to and on behalf of the organization's members and to promote quality care and public protection for the disabled and frail elderly populations. 


Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.