In the midst of the COVID-19 pandemic, higher, health, and medical education environments have gone from previously packed lecture halls to now empty seats. How must institutions of academic medicine and advanced learning pivot, transform, and adapt in order to ready for and survive the uncertain future? We keep hearing "new normal," but It is not that it is a new normal, but a pathway toward the future that we are seeing more clearly and visibly. We just have to adapt and change more quickly, which will require a new way of thinking in order to navigate the future.

1. HindsightT h e F u t u r e o f H i g h e r E d u c a t i o n
PHOTO ©️ UNT HEALTH SCIENCE CENTER
ELIZABETH BUNTING, MS, PA-C, DFAAPA

2. MS, PA-C, DFAAPA
Elizabeth
Bunting
Physician Assistant Studies:
Department Chair and Associate Clinical
Professor of Practice
University of Tennessee
Physician Assistant Studies:
Associate Clinical Professor; Director of
Admissions; Clinical Coordinator
Chancellor Appointment:
Faculty Leadership Fellow
East Carolina University
Practice clinically across disciplines of family and
internal medicine, pediatrics, women’s health, and
allergy. Distinguished Fellow of the American
Academy of PAs (DFAAPA).
Physician Assistant (PA)Questions?
liz@lizbunting.com
Calling Today From:
Chattanooga, TN
Who Am I?
2©️ E M B | U N T H S C
Mom, Wife

3. In the midst of the COVID-19 pandemic, we have gone
from previously packed lecture halls to now empty seats.
What is the new normal? And how must institutions of
advanced learning pivot, transform, and adapt in order to
ready for and survive the uncertain future?
Hindsight 2020: The Future of Higher Education
?
3©️ E M B | U N T H S C

4. 4©️ E M B | U N T H S C
"My parents were devastated.” “[They] didn't get to finish high school, so for them,
seeing their daughter graduating college was just beyond their dreams.” 1
– Monica Ferrufino, 2020 Graduate of California State University
"I have been waiting for this day since I was little.” 1
– Sandra Mendez, 2020 Graduate of Trinity Washington University
Harsh Reality
The class of 2020 has become the class of COVID-19, “celebrating”
virtually without a full regalia⏤without full pomp and circumstance.
CAP AND GONE?
Imagine if we never
had a commencement
ceremony...
1 NPR, “No Caps, No Gowns: For Many In The Class Of 2020, Commencement Is Called Off.” (April 1, 2020)
4©️ E M B | U N T H S C

5. We
HINDSIGHT
Coming
What is now a harsh present-day reality for students, faculty, and institutions themselves has
for years been a smoldering fire—and the challenges aren’t going away.
5©️ E M B | U N T H S C
‘20

6. 20??
“I think it's an open question whether or not technology will further
stratify higher education. Anyone who tells you these days they
know the impact that online learning is going to have on the future
of higher education is blowing smoke.” “We're still figuring out how
to use it in parallel with other forms of education.” 2
SCRATCHING THE SURFACE
Moving beyond
chalk and talk toward
online learning.
⏤ Dr. Lawrence Bacow, President of Harvard University
2 The Editorial. “Lawrence S. Bacow #36” (March 5, 2014)
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7. 20??
“Tough times call for hard choices. Furthermore, boards need to act
before they face existential threats. Unfortunately, these choices
often require institutions to depart, sometimes radically, from
treasured traditions that lie at the core of institutional identity.” 3
SCRATCHING THE SURFACE
The weather
forecast isn’t
always sunny.
⏤ Dr. Lawrence Bacow, President of Harvard University
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3 Ithaka S+R. “Double Trouble” (September 15, 2015)

8. 20??
"People are questioning the value of a diploma. They are
questioning the value of these institutions to society. They are
questioning whether or not colleges and universities actually
contribute to the American dream. That’s scary. We need to change
that conversation." “…the current narrative about higher education
in the U.S. is one that we have to work really hard to change.” 4
SCRATCHING THE SURFACE
Higher education
being challenged and
called into doubt.
4 Barnes & Noble College NEXT. “Is College Worth It? College Presidents Talk About the Value of Higher Ed” (July 17, 2018)
⏤ Dr. Lawrence Bacow, President of Harvard University
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9. 20??
“[Universities] are, in fact, quite durable and can adapt, in some
cases quite quickly, especially when they face existential threats.
[They] change and adapt, and they change and adapt quite a lot,
only on a time constant that’s much longer than many other
institutions in our society. …colleges and universities are far more
adaptable and durable than some may give them credit for being.” 5
SCRATCHING THE SURFACE
Universities must
respond to changing
priorities of today.
5 Brookings. “The future of higher education: A conversation with Lawrence Bacow, President of Harvard University ” (March 1, 2019)
Photo: Stephanie Mitchell / Harvard Staff Photographer
⏤ Dr. Lawrence Bacow, President of Harvard University
9©️ E M B | U N T H S C

10. THESE ALL HAPPENED IN THE PAST
We saw the
“essential threats”
smoldering, but
our vision of it
was burry.
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ADAPTING TO CHANGING PRIORITIES (2019) (2018) DEFINING VALUE
(2015) CHALLENGING THE NORMSMOVING ONLINE (2014)

11. AND THEN IT HAPPENED
Those existential threats
became a reality.
“The crisis facing institutions of
higher learning may well spark
needed innovation more broadly.
But the ones that survive and
thrive in the post-pandemic era
will be those who learn how to
make do with less.” 6
Financial Uncertainty
“Right now, video-conferencing
apps are throwing universities a
lifeline. However, lecturers are still
struggling to maintain the same
depth of engagement with
students they could have in a
classroom setting.” 7
Curriculum Delivery
“Population declines are expected
to reduce enrollment, even as
skyrocketing tuition and student
debt have led to questions about
whether a college education is
worth the cost.” 8
Future Enrollment
DR. BACOW AND SPOUSE RECOVERING FROM COVID-19 (MARCH 2020)
Photo: Lane Turner / Globe Staff
2020
11©️ E M B | U N T H S C
⏤ The New York Times
April 15, 2020
⏤ Bloomberg
May 11, 2020
⏤ World Economic Forum
May 12, 2020

12. #02
CURRICULUM DELIVERY
#03
FUTURE ENROLLMENT
#01
FINANCIAL UNCERTAINTY
WHAT’S THE SOLUTION TO HIGHER EDUCATION’S MOST PRESSING CHALLENGES?
No one person has the right answer.
The puzzle will take a collaborative effort to solve.
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13. Partnerships
Risk Management
Efficiency
Community
CARES Act distribution to sector.9
$12.5 billion
Conservative sector loss estimate due to COVID-19.12
$45+ billion
FINANCIAL UNCERTAINTY
“Colleges are stressed both
on the revenue side and on
the expenditure side.”11
4 in 10 parents say the
COVID-19 crisis may prompt
their children to delay going
to college.10
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The COVID-19 pandemic didn’t create financial
uncertainty—it already existed. Since roughly the recession,
states have put less money into higher education, leading
to an increased reliance on tuition during a time that
enrollment has also decreased over 11% (2011-present).11
9 NPR. “Can Colleges Survive Coronavirus? ‘The Math Is Not Pretty’’” (April 20, 2020)
10 CNBC. “College enrollment likely to drop as schools consider staying closed until 2021” (April 27, 2020)
11 NPR. “Fewer Students Are Going To College. Here's Why That Matters” (December 16, 2019)
12 The Wall Street Journal. “Coronavirus Pushes Colleges to the Breaking Point, Forcing ‘Hard Choices’ About Education” (April 30, 2020)

14. Reducing Redundancy
Efficiency through modular learning, within increased
opportunities for IPE and parallel teaching.
Greater Focus on Student & Wellness Needs
Learning isn’t one-side-fits all—consumer experience
must finally meet student experience.14
Culture Shift
Universities will have to be sensitive to societal ‘norms’
about college, while slowly shifting the delivery model.
Scenario Planning & Teaching Methodologies
Changing circumstances will require us to adapt how
we operate in-person, remotely, or in a hybrid model.
“Zoom university is not
worth 50k a year. I didn't
pay to attend zoom.”13
The species that survives is the one that is able to adapt to and to
adjust best to the changing environment. “COVID-19 can and will
act as a catalyst for necessary innovation”15 and those who adapt
their teaching philosophy, methodology, infrastructure and
experience will be the most poised to thrive in the ‘new normal.’
14©️ E M B | U N T H S C
CURRICULUM DELIVERY
13 U.S. News & World Report. “Why Students Are Seeking Refunds During COVID-19” (April 22, 2020)
14 KPMG. “COVID-19: Hoe the coronavirus could transform higher education” (April 8, 2020)
15 Huron Consulting Group. “From Pandemic to Transformation: Higher Education Leadership During COVID -19” (2020)

15. “For the first time,
we’ll see a sustained
drop in applications.”16
Admissions was already going to be more competitive
moving forward following the National Association of College
Admissions Counseling’s deal with the Justice Department.17
Following COVID-19, the stakes are even higher.
Expand the recruiting focus to include returning
adults seeking to enhance their skills.
Micro-Credentials
Reach prospective students earlier with
accelerated learning, partnerships, and training.
Pipeline Programs
Make education more affordable for students
by bringing down non-academic costs.
Reducing Costs
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FUTURE ENROLLMENT
16 Business Insider. “The pandemic will reshape the future of higher education—and many universities may not make it” (April 3, 2020)
17 USA Today. “Coronavirus could change where students go to college, if they go at all” (April 14, 2020)

16. UNIFY AND ALIGN ALL STAKEHOLDER GROUPS
We must mitigate risks and transform together in
order to thrive in a ‘new normal’ environment.
Have a direct interest in sustaining and
protecting the investment and value of the
qualifications they will or have achieved, and
must be involved as a key beneficiary.18
Students, Parents, Alumni:
Operate parallel to faculty, but now must more
consciously balance the need to maintain the
academic reputation and quality of the
institution—seemlessly.18
Administrators & Trustees:
Underpin much of the value and purpose of
Universities, and must be intimately involved
with process development, implementation,
and ongoing performance.18
Academic Faculty:
Increasingly hold a substantial amount of
political power and influence over the shape
and priorities of the system, and are vital to
scaling system activities.18
Community, Partners, Government:
B U I L D
TRUST
16©️ E M B | U N T H S C
18 Springer. “Shaping the University of the Future” (2018)
Photo: UNT Health Science Center

17. LEARNING FROM OTHER SECTORS
The ‘new normal’ will
require new thinking
to navigate the future.
Transparent collaboration, iterative
development, continuous feedback—
planning, testing, integration.
Agile Development
Empathy and understanding of end users—iterative
process of developing new ideas, challenging
assumptions, and redefining problems.
Design Thinking
17©️ E M B | U N T H S C
Higher education’s shift toward digital transformation—and
simultaneous shifts in shifts in workforce, culture, and
business model—will accelerate faster in the wake of the
COVID-19 pandemic. And to survive, ‘waterfall planning’
methods will no longer suffice—leaving educational
institutions to adapt to a ‘new normal’ by benchmarking
against successes and methodologies from other sectors of
the economy in order to both survive and thrive.

18. What Is The New FOR HEALTH & MEDICAL EDUCATION
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19. AVOIDING GHOSTS
It’s not a new
normal, but a
more clear and
visible future.
Much like a game of Pac-Man, we now must mitigate
both visible and not yet visible threats in order to thrive,
while simultaneously focusing on the low-hanging fruit
that will allow us to survive.
19©️ E M B | U N T H S C
DISK ERROR

20. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
20©️ E M B | U N T H S C
TRUST&TRANSPARENCY

21. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
21©️ E M B | U N T H S C
TRUST&TRANSPARENCY

22. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
22©️ E M B | U N T H S C
TRUST&TRANSPARENCY

23. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
23©️ E M B | U N T H S C
TRUST&TRANSPARENCY

24. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
24©️ E M B | U N T H S C
TRUST&TRANSPARENCY

25. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
25©️ E M B | U N T H S C
TRUST&TRANSPARENCY

26. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
26©️ E M B | U N T H S C
TRUST&TRANSPARENCY

27. CATCHING LOW-HANGING FRUIT
MedEd
Pac-Man
WELLNESS
INTERPROFESSIONAL EDUCATION
INNOVATIVE LEARNING
INTERPERSONAL SKILLS & PROFESSIONALISM
ACCREDITATION
GENERATIONAL APPROACH
EQUITY & INCLUSION
Photo: UNT Health Science Center
27©️ E M B | U N T H S C
TRUST&TRANSPARENCY

28. EQUITY & INCLUSION
Embracing our
differences so we can
make a difference.
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Embody the promise of equal
opportunity by finding creative ways to
decrease the divide between low- and
high-income students.
Narrow the Divide
Ensure that the diversity of student
enrollment mirrors that of the region
and community, while reflecting the
values of the institution.
Decrease the Disparities
Proactively plan for ways to
mitigate the challenges that
present during uncertain fiscal
times to ensure the needs of
disadvantaged students are
continually met, and that equal
opportunity can be provided to all.
Remove the Barriers

29. Integrate Mindfulness-Based
Stress Reduction (MBSR)20
throughout curriculums, while
encouraging regular journaling
and Narrative Medicine to
develop self awareness
“muscles” to debrief past
traumatic experiences in both
training and clinical practice.
Help students create and maintain psychological school / work / life
boundaries—such as developing a weekly life schedule to invest
and prioritize time outside of clinical practice.19
Coping & Maintenance
WELLNESS
Taking care of ourselves, so
we can take care of others.
Create and set a precedent for students to share their experiences,
thoughts, and feelings with peers to both learn and help each other
through the highs and lows of clinical practice and life.
Self-Reflection & Peer Groups
Help students brainstorm, prioritize, and create an action plan to
align their clinical practice experience / structure with their career
vision (ideal patient / procedure mix).
Peer Mentorship
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19 MedPageToday. “Self-Care is a 'Necessity' for Doctors” (April, 15, 2019)
20 Journal of Psychosomatic Research. “Mindfulness-based stress reduction for healthy individuals: A meta-analysis” (January 23, 2015)

30. INTERPROFESSIONAL EDUCATION
Working together to
achieve shared goals
and discover new ideas.
Breaking down the discipline silos
across the continuum of care to
establish and maintain a climate
of mutual respect, dignity, vision,
diversity, inclusion, ethical
integrity, and trust.
Building Relationships
Communicating across the care
continuum in a responsive and
responsible manner to best meet
the health maintenance and
treatment needs of individual
patients and populations.
Collaboration
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Understanding your own role, and
the roles of other clinicians, so
that the needs of the patients and
populations can be appropriately
assessed and addressed across
the care continuum.
Knowledge
Photo: UNT Health Science Center

31. The rapidly changing healthcare landscape will require an innovative
mindset to prepare students for tomorrow’s medical environment. By
improving education through innovation that represents the unique
needs of each learner, we develop more inquisitive leaders—those
that strive to create solutions for a healthier community. And thus,
creating a team of clinicians and practitioners that are committed to
excellence and unafraid to challenge conventional wisdom.
INNOVATIVE LEARNING
Evolving teaching
and learning to
encourage growth.
Advancing transformative educational experiences
with interdisciplinary teaching and learning will in
turn advance tomorrow’s healthcare delivery.
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DIVERSE TALENTS & WAYS OF LEARNING
HIGH EXPECTATIONS
CONTACT IN AND OUT OF CLASS
PROMPT FEEDBACK
ACTIVE LEARNING
RECIPROCITY AND COOPERATION
TIME ON TASK
Framework Adaptation: Chickering and Gamson’s (1987) “Seven Principles of Good Practice in Education“

32. Classroom
Setting
Create & Sustain Relationships
Develop active listening skills and nonverbal
techniques to elicit thorough, accurate medical history
and provide the best therapeutic care, while
collaborating with various healthcare team members
across the continuum to build patient-clinician trust.21
Work Effectively as a Team Member
Develop an understanding of the clinicians’ role within
the healthcare team, while fostering effective and
respectful communication skills necessary to maintain
and improve the health and wellness of patients with
fewer errors and ultimately higher quality.21
INTERPERSONAL SKILLS & PROFESSIONALISM
Building trust by
honoring our word
through action and
communication.
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EVALUATE & REFINE IRRESPECTIVE OF MODALITY
Virtual
Setting
Clinical
Setting
21 Competency adaptation from the “ACMGE Core Competency of Interpersonal and Communication Skills” (December 22, 2016)
Photos: UNT Health Science Center

33. ACCREDITATION
Navigating change
proactively to move
us forward.
The administrative burden for accreditation is
growing, but we must find creative ways to use data
continually to improve organizational systems and
processes to not only enhance student learning, but
also improve patient quality outcomes.
Don’t Just Check The Box
When done right, the results of accreditation bolster
the reputation of the institution, thereby potentially
attracting better students, faculty, and more funding
to expand the frontiers of scientific discovery.
Focus on The Advantage
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Photo: UNT Health Science Center
Prediction: Accrediting bodies for healthcare professions will
increasingly position themselves to be the foundational structure
in an outcomes-focused medical environment—grounded in both
educational outcomes and how it translates to patient care.
State of Accelerated Change

34. The ’typical’ student attending college is no longer typical—
something both higher education institutions and educators
must embrace and champion. A better understanding of
generational diversity will enable us to enhance the student
learning experience by fostering collaborative relationships
that value each other’s personal differences, backgrounds,
challenges, and needs—inspiring a new generation of
healthcare professionals that promotes and scales diversity
of thought, ideas, and people.
GENERATIONAL APPROACH
Turning generational
differences into new
opportunities.
BABY BOOMERS
XENNIALSMILLENNIALS
GEN Z
GEN X
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INCLUSIVITY
Self-Directed
Learners
Informal
Learners
Transformational
Learners
Social
Learners
Jack-of-All Trades
Learners

35. One University. Shared Values. Limitless Future.
This ‘new normal’… It’s
healthcare professionals
visionary moment.
35©️ E M B | U N T H S C
Photos: UNT Health Science Center

36. 2020H I N D S I G H T
Thank you!
I welcome your
questions.
Feel free to email me at:
liz@lizbunting.com
Have Other Questions?
I look forward to the opportunity to work with many of you in
attendance today to collaboratively design innovative approaches
for the changing priorities and challenges facing health and medical
education today, while developing mitigation strategies for those
existential threats that may present themselves in the future.
Photo: UNT Health Science Center
36©️ E M B | U N T H S C

37. HINDSIGHT 2020: THE FUTURE OF HIGHER EDUCATION
Cited Reference
Sources.
1 NPR, “No Caps, No Gowns: For Many In The Class Of 2020,
Commencement Is Called Off.” (April 1, 2020)
2 The Editorial. “Lawrence S. Bacow #36” (March 5, 2014)
3 Ithaka S+R. “Double Trouble” (September 15, 2015)
4 Barnes & Noble College NEXT. “Is College Worth It? College
Presidents Talk About the Value of Higher Ed” (July 17, 2018)
5 Brookings. “The future of higher education: A conversation with
Lawrence Bacow, President of Harvard University” (March 1, 2019)
6 Bloomberg Opinion. “The Crisis on Campus Is Here To Stay” (May 11,
2020)
7 World Economic Forum. “How COVID-19 is driving a long-overdue
revolution in education” (May 12, 2020)
8 The New York Times. “After Coronavirus, Colleges Worry: Will
Students Come Back?” (April 15, 2020)
9 NPR. “Can Colleges Survive Coronavirus? ‘The Math Is Not Pretty’’”
(April 20, 2020)
10 CNBC. “College enrollment likely to drop as schools consider staying
closed until 2021” (April 27, 2020)
37©️ E M B | U N T H S C

38. HINDSIGHT 2020: THE FUTURE OF HIGHER EDUCATION
Cited Reference
Sources.
38©️ E M B | U N T H S C
Photo: UNT Health Science Center
11 NPR. “Fewer Students Are Going To College. Here's Why That
Matters” (December 16, 2019)
12 The Wall Street Journal. “Coronavirus Pushes Colleges to the
Breaking Point, Forcing ‘Hard Choices’ About Education” (April 30,
2020)
13 U.S. News & World Report. “Why Students Are Seeking Refunds
During COVID-19” (April 22, 2020)
14 KPMG. “COVID-19: Hoe the coronavirus could transform higher
education” (April 8, 2020)
15 Huron Consulting Group. “From Pandemic to Transformation: Higher
Education Leadership During COVID-19” (2020)
16 Business Insider. “The pandemic will reshape the future of higher
education—and many universities may not make it” (April 3, 2020)
17 USA Today. “Coronavirus could change where students go to college,
if they go at all” (April 14, 2020)
18 Springer. “Shaping the University of the Future” (2018)
19 MedPageToday. “Self-Care is a 'Necessity' for Doctors” (April, 15,
2019)

39. HINDSIGHT 2020: THE FUTURE OF HIGHER EDUCATION
Cited Reference
Sources.
39©️ E M B | U N T H S C
20 Journal of Psychosomatic Research. “Mindfulness-based stress
reduction for healthy individuals: A meta-analysis” (January 23, 2015)
21 Competency adaptation from the “ACMGE Core Competency of
Interpersonal and Communication Skills” (December 22, 2016)

40. HINDSIGHT 2020: THE FUTURE OF HIGHER EDUCATION
Un-Cited
Sources.
40©️ E M B | U N T H S C
Slide 11: The Harvard Gazette. “‘I thought: This is going to be interesting’”
(April 6, 2020)
Slide 29: Medscape Today. “Can’t We Do Better to Support Minorities in
Medicine?” (May 15, 2020)
Slide 29: Forbes. “Redesigning College Admissions: COVID-19, Access and
Equity” (March 22, 2020)
Slide 30: Medium. “Let Clinicians Be Clinicians” (February 3, 2019)
Slide 30: Modern Healthcare. “Finally, an Answer to the Physician Burnout
Epidemic” (May 1, 2019)
Slide 32: Chickering and Gamson’s (1987) “Seven Principles of Good
Practice in Education“
Slide 32: MedPage Today. “Medical Schools Grapple With Challenges for
the Coming Year” (May 9, 2020)