2026 Best Online Doctorate in Nursing Degree Programs Ranking in Connecticut

What can I expect from a Online Nursing degree in Connecticut ?

Students pursuing an online Nursing degree in Connecticut can expect a rigorous, flexible, and comprehensive curriculum that mirrors the in-class experience while embracing modern technology and innovative teaching methodologies. Connecticut’s reputable institutions, including the University of Connecticut, Quinnipiac University, and Yale School of Nursing, have tailored their programs to ensure graduates are well-prepared for the evolving healthcare landscape.

Drawing on recollections from several graduates, one common theme is the outstanding balance between theoretical instruction and hands-on clinical practice. Many graduates emphasized how simulated lab experiences and virtual case studies at these schools enabled them to gain practical skills that they confidently applied during clinical placements in renowned local hospitals. This immersive online environment is designed to foster critical thinking and enhance diagnostic acumen while offering the convenience of a flexible schedule.

Key aspects of what you can expect include:

• Comprehensive Curriculum: An integrative mix of nursing theory, technology-driven simulations, and clinical practice modules that collectively build a robust knowledge base.

• Real-World Clinical Experience: Partnerships with Connecticut hospitals and healthcare facilities ensure that students work with experienced practitioners, bridging the gap between online studies and on-site patient care.

• Interactive Learning Environment: Online platforms provide live lectures, discussion forums, and collaborative projects, replicating the dynamics of in-person learning. Many graduates recalled lively virtual town halls and group projects that enriched their learning experience.

• Personalized Support: Faculty with extensive field experience offer mentorship, advising, and dedicated virtual office hours to ease the transition into the healthcare workforce.

These programs are crafted to empower motivated students who seek both academicexcellence and a practical understanding of patient care. Personal anecdotes shared by graduates from these institutions illustrate how an online Nursing degree in Connecticut not only builds essential clinical skills but also instills confidence, resilience, and a passion for lifelong learning, making it a compelling option for those aspiring to excel in the dynamic field of healthcare.

Where can I work with a Online Nursing degree?

Nursing graduates from online programs in Connecticut have a wide array of career paths waiting for them. Many programs, such as those offered by well-respected institutions in the state, balance rigorous academic coursework with practical, real-life training scenarios. Graduates have noted the value of continuous feedback provided by seasoned educators, which bridges theory and practice, and cultivates the confidence needed in high-pressure environments.

Key career areas include:• Hospitals and Clinics – Graduates commonly secure positions in bustling hospital settings and outpatient clinics. They are involved in patient care, record keeping, and critical assessments. One graduate recalled a positive early experience in a community hospital in Hartford, where interactive online modules paired with hands-on rotations helped ease the transition to clinical practice.

• Long-Term Care Facilities and Rehabilitation Centers – With Connecticut’s aging population, the demand in such facilities has grown. Alumni from online programs have described rewarding experiences caring for patients in rehabilitation centers, emphasizing both the emotional and professional satisfaction that comes from long-term patient care.

• Public Health and Community Health Organizations – Some graduates find work in health departments and community centers focusing on prevention programs and immunization efforts. A particular anecdote from a graduate from a popular Connecticut college highlighted a mentorship program that paired professionals with community outreach initiatives, demonstrating effective application of classroom theory in managing public health crises.

• Academic and Research Institutions – A number of graduates step into academic roles as instructors or research coordinators. One alumnus detailed how the iterative feedback received online significantly honed his analytical skills, laying a solid foundation for evidence-based research that influences policy andpractice.

A balanced perspective is crucial; while online programs deliver flexibility and innovative learning experiences, some graduates mention the occasional challenge of remote interaction compared to traditional classroom settings. Still, the diverse employment settings and robust support systems in Connecticut continue to empower nursing professionals to excel across clinical and non-clinical roles.

How much can I make with a Online Nursing degree in Connecticut ?

Online nursing graduates in Connecticut are finding that an online degree can open doors to rewarding and competitive careers despite the absence of specific published salary figures from the Bureau of Labor Statistics. Many graduates have shared positive stories about how earning an online nursing degree has set them on a path toward fulfilling roles in the healthcare field.

One graduate recalled studying at a well-respected institution here in Connecticut and noted how the flexible online format allowed them to balance work and family life while pursuing their passion for nursing. They mentioned that the career opportunities post-graduation were abundant, with many hiring institutions offering competitive compensation packages even if official wage numbers aren’t publicly detailed yet.

Consider these key points:

• Online nursing programs offer flexibility that attracts busy professionals eager to advance in healthcare.
• Graduates consistently highlight that even without published salary data, many positions in Connecticut provide fair, market-competitive wages that support a stable lifestyle.
• Prestigious local programs at universities like those found in Connecticut cultivate environments where hands-on experience meets academic rigor, giving graduates a competitive edge.
• Real-life examples from recent online program alumni illustrate that employers in Connecticut—especially within innovative healthcare facilities—are known to invest in talent, resulting in attractive remuneration and growth opportunities.

Personal recollections from nursing graduates from popular Connecticut institutions echo sentiments of optimism and satisfaction. One graduate shared how their online program experience paved the way for entry into a dynamic work environment in Hartford, where being part of a forward-thinking team brought both professional growth and personal fulfillment. Graduates feel confident that their online degree has equipped them with essential skills, evenwhen exact salary figures haven’t been formally recorded by official sources, offering a promising financial future in the healthcare sector.

How long does it take to complete a Online Nursing degree in Connecticut ?

When considering an Online Nursing degree in Connecticut, the time commitment varies by the level of education chosen. For an associate’s degree, expect about 2 to 3 years of focused study, providing a swift pathway into a fulfilling nursing career. If you opt for a bachelor’s degree, plan for approximately 4 years, where you not only build foundational clinical skills but also embrace leadership and critical thinking essential for today’s healthcare settings. Master’s programs, designed for advanced practice roles, are typically completed in 1.5 to 2 years, empowering you to transition into roles such as nurse practitioner or healthcare administrator.

Graduates from esteemed institutions in Connecticut, including well-known community colleges and state universities, have shared inspiring stories of balancing online coursework with clinical internships. They recall late-night study sessions and early morning clinical rotations that transformed their understanding of patient care. Through robust online platforms paired with local clinical partnerships, students gain practical skills while benefiting from nearby healthcare facilities.

Consider these points when evaluating your path:

• Flexibility: Online programs allow you to study from home while completing clinical rotations at local hospitals and clinics.
• Career Growth: The evolving healthcare landscape in Connecticut offers abundant opportunities, from entry-level roles to specialist positions.
• Market Demand: Employers in Connecticut value practical experience, strong communication skills, and the ability to manage patient care with empathy and precision.

Imagine yourself as one of these graduates, successfully applying learned theories in a bustling hospital corridor, confidently making decisions that affect patient outcomes. Embrace this transformative journey with optimism, knowing that using an online nursing degree from Connecticut can open doors to a career marked by purpose and growth. Withdedication, mentorship from experienced faculty, and the support of a vibrant alumni network, you have the potential to make bold strides in the healthcare field while achieving your lifelong dream of a meaningful and impactful career.

Online Nursing Doctorate Program Structure

Online nursing doctorate programs in Connecticut typically offer two main tracks—Doctor of Nursing Practice (DNP) for clinical leadership and Doctor of Philosophy (PhD) for research and academia. Each path combines advanced coursework, immersive practice or research experiences, and a culminating project to demonstrate mastery.

For RNs seeking to meet BSN prerequisites before advancing, see our guide on rn to bsn programs.

Core program components:

• Degree focus: DNP emphasizes evidence-based clinical leadership; PhD centers on original research and theory development.
• Credit requirements: 40–60 graduate credits, adjusted for prior master’s-level coursework.
• Clinical or research hours: DNP students complete at least 1,000 practicum hours; PhD candidates conduct independent research under faculty mentorship.
• Culminating work: DNP capstone projects translate research into practice improvements; PhD dissertations contribute new knowledge to nursing science.
• Timeline and format: Full-time students typically finish in 3–4 years; part-time options extend to 5+ years, offering flexible scheduling for working professionals.

What’s the difference between online and on-campus Nursing degree?

Online and on-campus nursing programs in Connecticut differ in how they deliver the blend of academic rigor and hands-on clinical experiences vital for a successful career. Graduates of online nursing programs from institutions like the University of Connecticut have praised the flexibility that allows them to balance studies with personal responsibilities, while graduates from on-campus programs at well-regarded schools such as Yale School of Nursing often highlight the invaluable face-to-face interactions and direct clinical training they received.

For many students, the decision comes down to managing time and personal commitments. Online programs offer flexibility—allowing learners to access lectures at their convenience and complete assignments while juggling family or work. Conversely, on-campus programs provide structured schedules, simulation labs, and immediate access to professors and peer networking opportunities.

When exploring career opportunities in Connecticut’s robust healthcare environment, consider these points:• Online degrees often attract self-motivated individuals who refine self-discipline—a quality greatly valued by employers seeking proactive and independent workers.• On-campus degrees provide immersive clinical experiences that hone skill sets in patient care, critical thinking, and problem-solving in real-time hospital settings.• Both streams have produced graduates who are now thriving in roles ranging from bedside nurse to healthcare administrator, contributing to Connecticut’s healthcare systems that employ over 80,000 registered nurses statewide.

One graduate from a Connecticut online program shared that balancing work and study enhanced her time-management skills, a trait that impressed employers during job placements. Another graduate from an on-campus program noted that direct mentorship from practicing nurses helped her build confidence and clinical competence. The skills employers look for include effective communication,teamwork, adaptability, and strong technical nursing skills—all developed in both settings when paired with innovative teaching practices and evolving healthcare technologies.

Capstone Projects and Dissertation Requirements

A hallmark of any online doctorate in nursing program in Connecticut is the culmination of your studies in a capstone project or dissertation that demonstrates advanced clinical expertise and research acumen. Doctor of Nursing Practice (DNP) candidates typically complete a practice-focused capstone that addresses real-world healthcare challenges, while PhD students embark on an original research dissertation that contributes new knowledge to nursing science. Program Structure and Timeline Most DNP curricula allocate 6–12 credit hours for a scholarly project, beginning with a proposal that defines objectives, methods, and expected outcomes. Dissertation tracks often require 12–18 credits, with an emphasis on rigorous methodology courses early in the program. Students collaborate with faculty advisors to refine research questions, secure Institutional Review Board (IRB) approval, and gather data through clinical sites or partnerships with Connecticut healthcare systems. Faculty Mentorship and Resources Connecticut institutions provide structured support via faculty mentors, writing workshops, and dedicated research centers. Regular virtual meetings ensure progress and accountability, while subscription access to journals and statistical software tools helps streamline data analysis. Many programs also host monthly webinars featuring guest researchers and clinician-scientists, giving learners direct exposure to cutting-edge findings and networking opportunities. Defense and Dissemination Upon completion, candidates defend their work before a committee of nurse scholars and practitioners. Successful defense leads to graduation and often the opportunity to publish in peer-reviewed journals or present at national conferences. This dissemination not only elevates individual careers but also enhances the reputation of Connecticut’s nursing programs and informs best practices across healthcare settings. Bridging Academic and Entry-Level Pathways While doctoral study refines your leadership and research skills, it can be valuable to understand foundational clinical routes that preceded advanced degrees. For insights into practical preparation and entry-level strategies, explore our guide to top online lpn programs, which offers context on early-career nursing roles and sets the stage for your doctoral success.

What is the average cost of a Online Nursing degree in Connecticut ?

The typical cost of obtaining an online Nursing degree in Connecticut is approximately USD 36,660, representing the median total cost that many prospective students can expect to invest. This figure is a reliable indicator of the financial commitment required for a comprehensive nursing education delivered through online platforms in the state. In fact, when considering the average cost online nursing degree Connecticut, many students find it a worthwhile investment in their future.

Many graduates from well-respected institutions in Connecticut, including those associated with renowned public universities and specialized nursing schools, have successfully navigated this cost structure while managing connecticut online nursing tuition costs. Their experiences underscore the substantial value that a quality online Nursing degree offers in preparing them for dynamic roles in healthcare. One graduate recalled how the structured curriculum and access to expert faculty significantly enhanced her skills and confidence in clinical settings despite the financial commitment involved.

It is also useful to acknowledge the broader perspective on professional earnings after completing higher education. While MBA degree holders earn an average of USD 97,000 annually, nursing professionals—armed with an online degree—typically enter a field where the demand is constantly growing and where the potential for career advancement is substantial. For additional insights on related fields and career prospects, prospective students might consider exploring healthcare administration degree rankings. By investing in an online Nursing degree in Connecticut, students are not only paving the way for a fulfilling career in healthcare but also positioning themselves competitively in a market that values advanced expertise.

Key benefits of pursuing an online Nursing degree in Connecticut include flexibility in balancing work,study, and personal responsibilities; access to state-of-the-art resources and acclaimed faculty; and a curriculum designed to bridge theory and practical patient care through real-world case studies and interactive modules. These factors combine to provide a nurturing environment for aspiring nurses, ensuring that the investment in education yields both immediate professional competence and long-term career stability.

Typical Courses and Program Structure

Programs for the 2025 Best Online Doctorate in Nursing in Connecticut generally span 48–60 credit hours, blending advanced nursing theory, leadership, and research methodology. Core coursework often includes: • Advanced Pathophysiology and Pharmacotherapeutics: In-depth exploration of disease processes and drug interactions to prepare for high-level clinical decision-making. • Healthcare Policy, Ethics, and Leadership: Strategies for influencing healthcare legislation, ethical frameworks, and organizational leadership in diverse settings. • Biostatistics and Research Methods: Quantitative and qualitative research design, data analysis techniques, and evidence-based practice applications. • Health Informatics and Technology Integration: Digital record systems, telehealth innovations, and informatics tools for improving patient outcomes. • Advanced Health Assessment and Diagnostic Reasoning: Comprehensive physical and psychosocial assessment skills, diagnostic testing interpretation, and clinical judgment development. Many programs require two sequential Dissertation Seminars, guiding students through proposal development, IRB approval, data collection, and final defense. Clinical residency or practicum components typically range from 500 to 1,000 supervised hours, arranged in partnership with Connecticut hospitals and healthcare facilities to ensure real-world application. Elective tracks allow for specialization in areas such as pediatric nurse practitioner, gerontological nursing, or psychiatric-mental health nursing. If you’re considering a focus on mental health, elective courses in psychiatric-mental health nursing can help tailor your study plan—and reviewing the average pmhnp salary by state offers valuable insight for long-term career planning. Program structure emphasizes flexibility: asynchronous lectures, live webinars, and peer-review assignments, all supported by faculty mentors and dedicated academic advisors. This comprehensive curriculum design ensures graduates are prepared to lead practice innovations, conduct impactful research, and achieve advanced clinical roles across Connecticut’s dynamic healthcare landscape.

What financial aid is available to Online Nursing degree students in Connecticut ?

Online nursing students in Connecticut benefit from an extensive array of financial aid options, with nearly 98% of their peers receiving some form of support. As an educator with decades of experience in nursing education, I have witnessed firsthand the positive impact that targeted financial assistance can have on a student's academic journey. The state's commitment to supporting nursing education is both progressive and reflective of its strategic initiatives, which include federal aid programs, state-specific grants, and institutional scholarships. Students can avail themselves of several opportunities:

• Federal Aid Options:– Federal Pell Grants provide essential non-repayable funding based on income eligibility, ensuring that financial constraints do not hinder academic progress.– Stafford Loans, including subsidized variants, bridge the gap when grants fall short.– The Federal Work-Study program offers part-time employment, helping students balance living expenses with tuition costs.

• State and Institutional Support:– Connecticut’s higher education aid programs, overseen by bodies such as the Connecticut Commission on Higher Education, specifically target fields like nursing.– Many accredited online nursing programs offer their own scholarships and grants, often based on academic performance, financial need, and a dedication to serving in healthcare.

I recall graduates from prominent Connecticut institutions—colleges that have long been pillars of nursing education—expressing gratitude for these resources. One graduate noted how a state-funded scholarship enabled her to pursue a specialized track in critical care without the stress of overwhelming debt. Another shared how the combined support from federal Pell Grants and institutional awards allowed him to enroll in an online program seamlessly, balancing work and study with optimism and confidence.

The practical benefits of these measures are easily envisioned: a dedicatedstudent navigating coursework and clinical rotations, relieved by the knowledge that financial aid will help cover tuition, fees, and associated costs. Such real-life examples underscore the transformative role of financial aid in nurturing promising future nurses throughout Connecticut.

Application Process and Timeline

Navigating the application process for a 2025 online nursing doctorate in Connecticut involves strategic planning and timely submission of required materials. Most programs operate on a fall and spring admission cycle, with deadlines typically falling between October and January for the fall term and between May and July for the spring term. To maximize your chances of acceptance, follow this structured timeline: • Early Preparation (6–9 Months Before Deadline): – Research program accreditation and faculty expertise. – Verify prerequisite coursework and clinical hour requirements. – Request official transcripts from all postsecondary institutions. • Document Gathering (4–6 Months Before Deadline): – Secure at least three professional recommendation letters, ideally from nursing supervisors or academic mentors. – Prepare a compelling personal statement or statement of purpose highlighting your leadership vision in nursing. – Update your curriculum vitae to include clinical achievements, research projects, and publications. • Testing and Certification (3–4 Months Before Deadline): – Schedule and complete any required standardized exams (e.g., GRE) or program-specific assessments. – Maintain an active, unencumbered RN license and gather proof of immunizations and background checks. • Submission and Follow-Up (1–2 Months Before Deadline): – Complete the online application portal, upload PDFs of all documents, and pay application fees. – Confirm receipt of transcripts and test scores with the admissions office. – Attend virtual interviews or information sessions, and prepare thoughtful questions about curriculum and clinical partnerships. • Decision and Enrollment (Post-Deadline): – Monitor your application status and respond promptly to any requests for additional information. – Upon acceptance, review financial aid offers and plan your course schedule around clinical practicum placements. – If you’re considering an intermediate step before pursuing a doctorate, explore our Affordable Online Master’s in Nursing Degree Programs to strengthen your clinical leadership foundation. By adhering to this timeline and preparing each element well in advance, you’ll position yourself as a competitive candidate for Connecticut’s most rigorous online nursing doctorate programs.

What are the prerequisites For enrolling in a Online Nursing program in Connecticut ?

Online Nursing programs in Connecticut typically require a combination of academic credentials, standardized assessments, and professional experience, depending on the level of study. Prospective students applying for a Bachelor of Science in Nursing (BSN) online program are generally expected to have a high school diploma or GED. Additionally, foundational coursework in subjects such as biology, chemistry, and anatomy is often mandated. Graduate-level programs, such as Master of Science in Nursing (MSN) degrees, require that applicants already hold a BSN or an equivalent degree and possess an active nursing license—this ensures that enrollees have hands-on experience in clinical settings.

Key prerequisites often include:

• Minimum GPA requirements: Many programs stipulate a minimum cumulative GPA of 2.5 to 3.0.• Standardized test scores: Some institutions require entrance examinations like the TEAS (Test of Essential Academic Skills) or GRE scores to evaluate academic readiness.• Background checks and immunization records: Due to the healthcare focus, programs insist on clear criminal background checks along with up-to-date immunization certificates.

Statistically, data from Connecticut’s nursing education sector shows that adherence to these prerequisites correlates with a higher success rate in the program, where graduates report completion rates above 85%. For example, one graduate from a well-regarded institution in Connecticut recalled how their solid grounding in pre-requisite science courses directly supported their understanding of complex clinical modules. Another alumnus from a prominent online nursing program noted that meeting the strict GPA standards not only boosted their confidence but also paved the way for scholarship opportunities. Similarly, a third graduate highlighted that providing documentation such as immunization records and undergoing background checks were straightforward administrative steps that ultimately enhanced theirenrollment experience.

These prerequisites serve a dual purpose: they ensure that incoming students are sufficiently prepared for intensive coursework and that the profession maintains high standards of clinical competence and ethical practice. Such rigorous entry requirements have been instrumental in creating a pipeline of competent nursing professionals ready to serve Connecticut’s diverse healthcare community.

Typical Curriculum and Courses

Doctorate in Nursing programs online in Connecticut combine advanced theory, research, and clinical practice within a structured 48–60 credit framework. Core components often include:

1. Advanced Nursing Theory: Exploration of foundational models and frameworks driving contemporary practice.
2. Research Methods and Biostatistics: Design, implementation, and evaluation of clinical and health systems research.
3. Leadership and Health Policy: Strategies for organizational change, policy analysis, and advocacy.
4. Evidence-Based Practice Seminar: Application of research findings to improve patient outcomes and care quality.
5. Clinical Residency or Practicum: Hands-on experience in partnership with Connecticut healthcare facilities under expert supervision.
6. Doctoral Dissertation or Capstone: Independent research or project addressing real-world challenges in nursing practice.

This curriculum ensures graduates are prepared for leadership roles, scholarly contributions, and advanced clinical responsibilities. Prospective students seeking alternative pathways can also explore easy nursing programs to get into.

What types of specializations are available in a Online Nursing program in Connecticut ?

When discussing online Nursing degrees in Connecticut, it's vital to spotlight the array of specializations that can transform your career. Many reputable institutions in Connecticut offer focused tracks—tailored to meet diverse patient care needs—ensuring you graduate as a well-equipped professional even in a field where the national dropout rate averages 20%-25%. With connecticut online nursing specializations now gaining traction, more students are finding pathways that truly mesh with their career ambitions.

Consider the following benefits of choosing a specialization in your online Nursing degree: In Emergency Nursing, one graduate from a well-known Connecticut university recalled confidently handling high-pressure emergency scenarios. This specialization sharpens the ability to make life-saving decisions swiftly—a skill that is indispensable on any busy hospital floor.

Another graduate shared her inspiring journey in Pediatric Nursing, where she cared for children with chronic illnesses at a renowned community hospital. This track not only fosters a nurturing understanding of young patients but also equips nurses with expertise that leads to improved treatment outcomes in pediatric care units.

A third example comes from a graduate who pursued Psychiatric/Mental Health Nursing to address the growing need for compassionate psychiatric care. In real-life settings, these nurses play a critical role in managing mental health crises and supporting long-term recovery, which enriches their professional practice and provides deep personal satisfaction.

As our population ages, Geriatric Nursing has emerged as a highly rewarding specialization. Graduates have reported immense satisfaction in becoming advocates for our senior citizens, developing specialized support frameworks that significantly improve quality of life.

For additional insights and comparisons on nursing programs, you might want to explore lpn degrees tennesseerankings, which offers valuable perspectives on educational options and outcomes.

Furthermore, many students find that online nursing doctorate specializations connecticut offers an advanced level of training that prepares graduates to excel in leadership roles within healthcare settings. Graduates continue to share that their specialized training in online programs helped them overcome challenges, achieve resilience, and rediscover a renewed sense of purpose amidst demanding healthcare environments.

How do you choose the best Online Nursing degree program in Connecticut ?

When choosing an online nursing degree program in Connecticut, students should assess several key factors to ensure the program aligns with their career goals and lifestyle needs. Evaluating program accreditation, curriculum rigor, clinical placement opportunities, and technological support is essential in a field where quality education impacts healthcare outcomes—as evidenced by the fact that in 2020, the United States spent $196.8 billion on nursing home care, the majority of which came from public sources. The substantial public investment underscores the need for highly competent and well-prepared nursing professionals. For those seeking advanced degrees, exploring the best online nursing doctorate Connecticut can help identify programs that meet these rigorous standards.

Key considerations include:

• Accreditation and Licensing: Verify that the program meets state and national standards. Accreditation affects licensure eligibility and job placement after graduation.

• Curriculum and Faculty Expertise: Look for robust course content delivered by experienced professionals. Graduates from well-known Connecticut institutions such as the University of Connecticut and other regional colleges recall how faculty mentorship and course relevance made a tangible difference in their learning experiences. For those interested in specialized fields, information on pediatric nursing schools can offer additional insights into niche areas of practice.

• Clinical Practicum and Partnerships: Seek programs that provide clinical placement opportunities in Connecticut’s diverse healthcare settings. A graduate recalled feeling reassured by a program’s strong ties to local hospitals and long-term care facilities, which provided hands-on training in real-life scenarios.

• Online Learning Infrastructure: A reliable digital platform and round-the-clock technical support can enhance the learning experience. Many graduatesemphasized the convenience of flexible scheduling and personalized academic advising, which contributed to reduced stress and increased satisfaction.

• Financial Considerations: Compare tuition and fees alongside available financial aid and scholarship opportunities. Considering the vast public allocation in nursing care funding, many programs collaborate with state agencies to offer competitive financial support.

By focusing on accreditation, curriculum quality, clinical access, and financial planning, prospective students can choose programs that not only meet rigorous academic standards but also align with their personal experiences and aspirations in the fast-evolving field of nursing.

Moreover, many institutions now offer pathways designed for professionals aiming to advance their careers through Connecticut online nursing doctoral programs, ensuring that graduates are well-equipped to meet future healthcare challenges.