Stackable and Micro-Credentials: Alternative Pathways for Building Expertise in the Health Information Profession

The pandemic has caused all industries, particularly healthcare, to take a step back and revisit how service is delivered. In addition, consumers are assessing how they use these services and professionals are reassessing their theoretical knowledge, technical abilities, and competencies to be able to perform the services.

Employers require workers to maintain a level of proficiency or acquire advanced knowledge and skills to retain their employment. Professional associations encourage their members to stay informed and current on trends and changes in the industry by requiring credentialed members to provide evidence of continuous learning to reinforce knowledge and retain certifications or credentials they have earned.

Adults understand that to be competitive in the market they need to maintain and update their skills. To meet these requirements, individuals attend webinars, workshops, or conferences, among other activities. Evidence of ongoing training generally results in a certificate or continuing education units (CEUs). However, obtaining CEUs offers limited certainty that professionals have retained or reached adequate levels of competence. Additionally, some of these methods no longer result in career advancement, salary increases, or meet the demands of a changing workforce.

The traditional methods of enrolling in two- or four-year accredited institutions continues to hold value and serve as effective methods for learning about a discipline. However, there has been a steady decline in enrollment in these institutions. In part, students are dropping out or stopping studies due to the cost of education, family obligations, or employment needs, and also because of an increased desire to obtain knowledge quicker and to have a more diverse portfolio.

The unpredictability that the pandemic has brought to the job market has caused a shift in the focus of the savviest job seekers from earning a degree to gaining competencies that will lead to versatility in earning income. Professionals are seeking to extend their scope of practice and hold multiple certifications to ensure employability. Historically, employers hired individuals based on education and experience in an area that was commensurate with the tasks required to perform the job.

A Changing Workplace Allows New Ways to Attain Skills

Research dubbed “degree inflation” as “the practice of seeking a candidate with a four-year college degree for a position currently held by someone with a high school diploma or an associate degree.” The research revealed that although new hires with a bachelor’s degree were preferred or required, persons who were already employed were performing the tasks but did not hold a bachelor’s degree. These hiring practices were harming the middle-class job seeker because they may have possessed the experience and ability, but were overlooked because they did not hold a degree.

Several key recommendations came from this study. First, employers should reexamine requirements for employment and focus on the competency needed to perform the task rather than a degree, and match the skills needed to the appropriate level of career preparation to create additional pathways for hiring for non-degree holders. Secondly, there may be some challenges in making a shift from traditional methods to more flexible approaches in meeting career and education goals. But these barriers can be overcome by the industry, institutions of higher learning, and policymakers coming together to de-institutionalize the education process to allow more flexibility in creating alternative pathways to train the workforce.

The employment market has caused individuals to become more agile in their career aspirations. There is a shift from employees staying in one job for a decade or longer to changing jobs in fewer than five years. We’ve also seen the emergence of “gig” work in healthcare, where skilled workers augment their income with a side hustle. Gig workers, also known as freelancers or independent contractors, work on short-term projects for multiple organizations. The gig worker who is self-employed has more control over what they do and when they work.

In healthcare, technology has increased opportunities for many health information professionals to pursue contract work as tumor registrars, data analysts, privacy or compliance specialists, coders, transcriptionists, health informatics specialists or release of information technicians for multiple facilities. Employers are looking for employees to have advanced knowledge and competencies in areas that historically were not required to perform daily tasks, such as data analytics.

Health information professionals need to be agile and flexible to keep up with the pace of this everchanging landscape. Over the last decade, alternative approaches for evidence of advanced learning and professional development have emerged, by way of stackable and micro-credentials.

Understanding Stackable and Micro-Credentials

The US Department of Labor (DOL) defines the term stackable credentials as “part of a sequence of credentials accumulated over time to build up an individual's qualification to help them move along a career pathway or up a career ladder to potentially different and higher-paying jobs.” Credentials are considered stackable when they are part of a collection of degrees, credentials, certificates, or micro-credentials accrued over time to exhibit advanced knowledge and skills that help individuals navigate and move forward professionally.

The most commonly cited framework for stackable credentials are vertical, horizontal, and value-added. Vertical stacking is the most common method by stacking degrees in a discipline that build on each other, such as an academic track that starts at the associate degree level, progresses to bachelor’s, master’s and ultimately a doctoral degree. Horizontal stacking is generally not sequential and less focused on the degree but geared towards earning competencies in related fields that lead to advanced skills for a particular role in the industry. Finally, value-added stacking is a combination of vertical and horizontal. Individuals may hold a two- or four-year degree but earn additional credentials or certifications completed in a shorter timeframe that leads to career advancement.

Health information professionals are increasingly taking advantage of this combination, by earning multiple credentials that compliment and increase their skillsets from what they may have earned through the attainment of their associate’s, bachelor’s, or master’s degrees. Currently, there is no one agreed upon definition for micro-credentials. However, researchers created a definition that is based on a framework developed by the International Standard Classification of Education (ISCED). ISCED established a globally recognized classification system used for organizing education programs.

The framework is periodically reviewed and revised by the UNESCO Institute for Statistics. ISCED defines three main types of education:

• Formal: education that is institutionalized, intentional and planned through public organizations and recognized private bodies, and – in their totality – constitute the formal education system of a country.
• Non-formal: education that is institutionalized, intentional and planned by an education provider. The defining characteristic of non-formal education is that it is an addition, alternative and/or complement to formal education within the process of lifelong learning of individuals.
• Informal: forms of learning that are intentional or deliberate but are not institutionalized.

Researchers proposed the following definition for micro-credentials, guided by the types of education defined by ISCED:

“A micro-credential is a certification of assessed learning that is additional, alternate, complementary to or a component part of a formal qualification.”

Stackable and micro-credentials enable students to earn credit and learn skills that can be stacked to lead towards specialized certifications and academic degrees and adult learners to build their skills quicker that can lead to professional credentials, career advancement, and economic mobility.

Unconventional Methods Provide New Opportunities

In 2019, the Rand Corporation and the Ohio Department of Higher Education collaborated to examine the effectiveness of stackable credential channels awarded in healthcare, information technology, and manufacturing and engineering technology. Data analysis covered a time span between 2005 and 2019. A few of the most prevalent findings from the study included persons earning a postsecondary degree had a 16 percent increase in earnings and those stacking multiple credentials on average saw a 37 percent increase; about $9,000 annually. Highest earning gains were seen when individuals incrementally stacked healthcare certificates in the same field of study. Additionally, women who held certificates had greater gains in income than men.

These findings are comparable with results from the Center for Analysis of Postsecondary Education and Employment (CAPSEE) exploration of a comparison of earnings for community college completers, certificate holders and students who have accumulative academic experiences. The results indicated a positive, incremental value to attending community college. For the sample population, the more credits taken the higher their earnings, even though students did not earn a degree.

Stackable and micro-credentials offer a more flexible, accessible, and shorter pathway to bridge skill gaps, earn college credits, and encourage lifelong learning to meet workforce development needs. These unconventional methods promote benefits for students and professionals by building skills to enable the laborer to gain expertise in different domains and allow colleges to provide students incremental milestones along the pathway to degree attainment.

Mona Calhoun is the chairperson for the Health Information Management Program at Coppin State University in Baltimore. She is also the president/chair-elect for AHIMA.