For university leaders charged with preparing the next generation of health care providers, one question is becoming urgent: Are our graduates ready for what employers expect on day one?
Alyssa Englert, a physical therapist and site coordinator of clinical education at ProRehab, a Confluent Health partner clinic, works directly with students and recent graduates entering clinical settings.
She sees the best of what higher education provides and the areas where curriculum still falls short.
"We're producing bright students with strong foundations," Englert said. "But real-world success depends on more than technical knowledge. It's about communication, adaptability and clinical judgment, things that are harder to teach in a classroom."
For provosts, deans and program directors, this signals a clear opportunity: Reframe the curriculum to reflect clinical realities and workforce demands.
Build Communication Skills into Clinical Education
Englert emphasizes that while diagnostic knowledge and treatment planning are essential, soft skills often determine success in the clinic.
"What really accelerates a graduate's growth is the ability to problem-solve with patients, navigate tough conversations and motivate them," she said.
Most students know to avoid jargon, but few have been taught how to explain complex conditions in plain language. Communication training needs to move beyond best-practice reminders and become a structured part of clinical education.
Prepare Students for Chronic and Long-Term Patient Needs
Englert also points to gaps in care continuity. Students may be well-prepared to treat post-operative patients in early stages of recovery. but lack strategies for the latter half.
"They do great with a knee replacement in week one," she said. "But when the patient is halfway to their goals, they often get stuck."
Chronic pain presents an even greater challenge. Englert believes it should be treated as a specialty area, requiring earlier exposure in the curriculum and more consistent clinical integration.
Teach Interprofessional Collaboration in Health Care Programs
At ProRehab, students work directly with occupational therapists and orthopedic physicians, a level of interprofessional collaboration that mirrors modern health care systems.
" Many students feel nervous about communicating with the providers who refer patients to them, until they’ve had real-world experience," she said.
Yet many programs still treat collaboration as a theoretical concept rather than a practical skill. Leaders should prioritize team-based simulations, interprofessional labs and documentation exercises that reflect how care is actually delivered.
Train Students to Manage Patient Expectations and Constraints
Englert notes a shift in patient expectations, driven by rising costs and limited access to one-on-one provider time.
"We have patients who say, 'I'd love to come to therapy twice a week, but I can't afford it,'" she said. "And students need to know how to respond."
This is not just a communication issue. It's a clinical planning and ethical decision-making skill. Programs must prepare students to balance advocacy for best practices with respect for patient limitations.
Prepare Students for EMRs and Telehealth in Clinical Practice
One of the biggest surprises for students entering practice? Documentation systems.
"They understand SOAP notes conceptually," Englert said. "But they've never used an actual electronic medical record."
The result: time lost, stress elevated and slower onboarding. While full EMR access may not be possible in the classroom, simulation tools or platform-agnostic templates could give students a major head start.
Telehealth exposure remains limited in some regions, but the modality is growing, and programs that prepare students for virtual care now will position them ahead of the curve.
Rethink the Therapist's Role in Health Care
If given the chance to build a new course from scratch, Englert would focus on shifting the public's understanding of therapy from reactive to preventive.
"We already have direct access in every state," she said. "But what if people came to their physical therapist for a yearly movement screen, the way they see their primary care physician for a physical?"
That kind of innovation could help address long-term cost pressures and improve patient outcomes, and institutions that lead on this front could shape the future of care delivery.
Recommendations for Academic Leaders
To close the readiness gap, health care programs must move beyond technical competence and address the full spectrum of clinical preparedness.
That includes:
- Build communication into curriculum design. Move beyond "don't use jargon" and teach how to explain diagnoses with clarity and empathy.
- Integrate chronic care early. Ensure students are prepared for long-term care planning and chronic condition management.
- Simulate interdisciplinary care. Use cases, labs or role-play to teach provider collaboration and communication with referring physicians.
- Offer EMR documentation training. Even basic familiarity with common structures can shorten ramp-up time in clinical rotations.
- Equip students for real-world patient constraints. Train them to adapt plans when cost or access becomes a barrier without compromising outcomes.
- Explore new models of preventive care. Encourage innovation in how therapy is positioned in the broader care continuum.
"Professionalism and communication aren't extras," Englert said. "They're essential parts of being a good clinician."
Higher education has a vital role to play, not just in educating future providers, but in shaping the kind of care those providers will provide.