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It can be difficult to persuade students to take the time for an internship or job-shadowing day, especially those in Advanced Placement classes, and increasingly, many don't want to work for free, said Cara Kirby, the senior career-experience specialist for the Fairfax County district in Virginia. "They are scared to miss one day of school, even though the opportunity could change their lives. It's a challenge," she said.

Polishing Up Students

The more successful internship programs make workplace expectations clear to students.

"You have to work with students to [help them] understand there is an appropriate dress, way to act, and address people," said Mr. McPherson of the Trezevant center.

In Fairfax County's hospitality program, Pat Edwards teaches juniors and seniors the basics of the industry in the classroom before they spend two days a week in an internship at local businesses. She explains the etiquette of the workplace, but students don't always catch on right away.

One of her seniors, Jermane Whyte, was in an all-day orientation at the Ritz Carlton, Tysons Corner this past fall when he pulled out his cellphone during some down time to text his father. He also missed about a quarter of his internship days the first semester because of conflicts with college interviews and other activities.

The hotel supervisor called Ms. Edwards, who then talked with her student to reinforce the rules. Looking back, Mr. Whyte, 17, said he recognizes his mistakes and is more aware now of his conduct. He continues to intern at the Ritz and has enjoyed rotating among various positions, from the front desk to security. "I had no prior work experience," he said. "This has opened my eyes to work life and team building."

Talking It Over

What's missing from many work experiences in high school is time to reflect, said Mr. Miller. To get the most out of an internship, students should talk about what they enjoyed, what they didn't, and how that translates into their next move, he said.

At Children's Hospital of Colorado, Stacey Whiteside holds weekly group debriefing sessions for interns. "They may see something hard emotionally or physically, and this is where they need to be talking about it. And they are assigned a mentor on the unit," said Ms. Whiteside, who coordinates the hospital's high school internship program aimed at underrepresented minority students.

More than 200 students in Denver apply for the 25 positions in the hospital's two-year, paid Medical Career Collaborative, which includes training, monthly field trips, and internships. At the end of the program, students give a formal presentation to a group of about 70 hospital staff and family members about their experience. "Many families are blown away by seeing their student in a professional role," said Ms. Whiteside. "They have not seen that side of them, and it helps the families buy into college."

Former hospital intern Chisom Agbim is a second-year medical student at the University of Colorado. In 2006, she worked alongside a nurse in the emergency room at Children's Hospital and says it solidified her career choice. "It was exciting to be able to see what was going on ... to see how the whole team works," said Ms. Agbim, who noted that the experience gave her a different impression than what she had imagined from watching episodes of the drama "ER" on television. "I had a more realistic sense of what patients are like and what physicians can do."

Now 23, Ms. Agbim says she understands it was rare to get a hands-on opportunity in medicine as a high school student, while she knew of others who just volunteered and got stuck shelving books.

Clarifying Responsibilities

To help students, mentors, and employers understand their responsibility in an internship, Ms. Jenkins of Maine has all parties sign a contract. "It makes it clear who is accountable for what," she said.

Once, Ms. Kirby of Fairfax sent three students to a job site and the chief executive officer asked them to sweep. "They were furious," she recounts. After later talking with the CEO, she learned he had started at the company by sweeping and was trying to convey that to the students. "Even if it is not ideal, you still have to be respectful," said Ms. Kirby.

In Lincoln, Neb., all students at Northeast High School take a career course that includes job-shadowing, and next fall, it will be expanded from one quarter to a semester of instruction. "Every student is required to do job-shadowing. It's the only way for students to make a good decision and be confident in their career decision," said Ruth Lohmeyer, a counselor and the counseling team leader, recently named 2013 School Counselor of the Year by the ASCA.

The district has increased its emphasis on working with the business community, and Ms. Lohmeyer has found employers receptive. "People like to talk about their occupations," she said. The push to make business connections is also fueled by efforts to stem the brain drain from Nebraska and keep graduates working in the area.

As a teenager in Pennsylvania, Meagan Phelan toured a manufacturing plant, bank, and hospital as part of her mother's goal to introduce her to a variety of careers. "It created in me this curiosity," said Ms. Phelan. Learning how various professionals arrived at their jobs was liberating for her because she realized there were many paths to take with a degree.

After studying biology and Spanish in college, she went on to get a master's in science writing and now works as a writer for a firm in Boston, as well as a columnist for the website Prepped & Polished. "Everyone is working hard to get good grades in high school and studying for the SAT," she said. "But not everyone is interning, and so many get to college undecided."

Special coverage on the alignment between K-12 schools and postsecondary education is supported in part by a grant from the Lumina Foundation, at www.luminafoundation.org.