Adult nonlicensed students can experience diminished engagement and increased absenteeism while attempting to complete medical assistant programs. The purpose of this qualitative, multisite narrative case study was to explore the perceptions, meanings, and interpretations of instructors and students. The theoretical foundation focused on the characteristics influencing adult student absenteeism and diminished engagement. Content analysis by interpretation was performed after conducting one-on-one interviews with 4 vocational instructors and 3 students. Data were then coded and categorized. Results indicated that teachers allow students to make up missed classes, but this repeated behavior does not adequately prepare the student for the workforce; students forgo inquiry for a counselor due to personal embarrassment and unknowingly dismiss available resources, students comprehension of materials due to learning at different pace and social awkwardness negatively impact outcomes, and students often find it difficult to cultivate relationships due to poorly developed interpersonal skills. These findings were used to create a modular professional development program for vocational school personnel and instructors. These modules provide a conduit for enabling social change by providing academic leaders reference materials that positively influence student outcomes in order to deliver the patient care required in today's ambulatory care settings across the United States. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]