Thinking Through Transfer: Examining How Community College Students Make Transfer Decisions

Objective: For many students, community college is a convenient first step toward a bachelor’s degree. Yet, although more than 80% of those who enroll in community colleges intend to transfer to a 4-year institution, fewer than 35% do so within 6 years. Quantitative data reveal the presence of a transfer gap and there is extensive research on college choice for high school students, but little qualitative research has been done to examine the transfer process for community college students to identify what drives their decisions. Method: In this article, we draw on interviews with 58 community college students in Texas to examine how they made transfer decisions. Results: We find that their decision-making and transfer pathways were complex and nonlinear in ways that were particular to the uncertainty of the community college context. For a subset of students, we identify minor hurdles that could derail their decision-making, lengthen their timelines to transfer, or lead to a failure to transfer. Contribution: By illuminating student pathways to transfer using qualitative research, our work identifies potential areas where policy and practice could strengthen transfer to improve student outcomes.

Primary to comprehensive stroke center transfers: Appropriateness, not futility

Background and purpose Ischemic stroke patients must be transferred to comprehensive stroke centers for endovascular treatment, but this transfer can be interpreted post hoc as “futile” if patients do not ultimately undergo the procedure or have a poor outcome. We posit that transfer decisions must instead be evaluated in terms of appropriateness at the time of decision-making. Methods We propose a classification schema for Appropriateness of Transfer for Endovascular Thrombectomy based on patient, logistic, and center characteristics. Results The classification outline characteristics of patients that are 1. Appropriate for transfer for endovascular treatment; 2. Inappropriate for transfer; and 3. Appropriate for transfer for higher level of care. Conclusions Appropriate transfer decisions for endovascular treatment are significant for patient outcomes. A more nuanced understanding of transfer decision-making and a classification for such transfers can help minimize inappropriate transfers in acute stroke.