MPH education for the 21st century: motivation, rationale, and key principles for the new Columbia public health curriculum

Engaging Public Health Alumni in the Tracking of Career Trends: Results From a Large-Scale Experiment on Survey Fielding Mode

OBJECTIVE

We sought to understand the relative impact of fielding mode on response rate among public health alumni.

METHODS

As part of the 2021 Career Trends Survey of alumni from the University of Minnesota School of Public Health, we designed a fielding mode experiment to ascertain whether a paper survey, a postcard with a custom survey link ("postcard push-to-web"), a mobile telephone call or text (mobile), or an email invitation would garner the highest response rates. Invitations were randomly assigned from available contact information.

RESULTS

Of 8531 alumni invited, 1671 alumni (19.6%) completed the survey. Among the initial fielding modes, the paper survey had the highest response rate (28%), followed by mobile (19%), email (10%), and postcard push-to-web (10%). More robust recent engagement with alumni relations, paper survey invitation or mode switch, and recent graduation were all significantly associated with a higher likelihood of response.

CONCLUSIONS

Paper and mobile invitations had the highest response rates to our survey among public health alumni. Findings from this fielding mode experiment are relevant to schools and programs of public health seeking to capture similar information among their alumni, especially given current trends in investment in the public health workforce.

Job preferences of master of public health students in China: a discrete choice experiment

BACKGROUND

The shortage of public health personnel and the uneven distribution between urban and rural areas are thorny issues in China. Master of public health (MPH) is an integral part of public health human resources in the future, and it is of far-reaching significance to discuss their work preferences. The present study wants to investigate the job preference of MPH, understand the relative importance of different job attributes, and then put forward targeted incentive measures.

METHODS

Discrete choice experiment (DCE) was used to evaluate the job preference of MPHs in two medical colleges in Liaoning Province. Attributes include employment location, bianzhi, working environment, career development prospects, work value and monthly income. Thirty-six choice sets were developed using a fractional factorial design. Mixed logit models were used to analysis the DCE data.

RESULTS

The final sample comprised 327 MPHs. All the attributes and levels included in the study are statistically significant. Monthly income is the most important factor for MPHs. For non-economic factors, they value career development prospects most, followed by the employment location. Respondents' preferences are heterogeneous and influenced by individual characteristics. Subgroup analysis showed that respondents from different family backgrounds have different job preferences. Policy simulation suggested that respondents were most sensitive to a salary increase, and the combination of several non-economic factors can also achieve the same effect.

CONCLUSIONS

Economic factors and non-economic factors significantly affect the job preference of MPHs. To alleviate the shortage and uneven distribution of public health personnel, more effective policy intervention should comprehensively consider the incentive measures of the work itself and pay attention to the individual characteristics and family backgrounds of the target object.

FORWARD: Building a Model to Hold Schools of Public Health Accountable for Antiracism Work

Schools of public health have increasingly adopted programs, praxis, and competencies for antiracist work. Fighting Oppression, Racism and White Supremacy through Action, Research and Discourse (FORWARD) was founded to accelerate antiracist work at the Columbia University Mailman School of Public Health in New York City. Seven action corps reporting to an accountability cabinet were established with 183 participants. FORWARD achieved progress across five core pillars. We describe how an iterative, dynamic structure and explicit framework for accountability can guide future antiracism work. (Am J Public Health. 2023;113(10):1086-1088. https://doi.org/10.2105/AJPH.2023.307356).

Levers of Change: How to Help Build the Public Health Workforce of the Future

CONTEXT

Public health leaders are working to rebuild the US public health workforce. Master of Public Health (MPH) programs have a stake in this, given their role in educating and training public health practitioners. Over the last 10 years, MPH programs have implemented changes to program structure, content, and approach, but workforce gaps persist.

OBJECTIVE

This study sought to explore the factors that inform and influence MPH program design and changes they make in order to elucidate how MPH programs may be further engaged to help address current and future public health workforce needs.

DESIGN

Sequential mixed-methods study.

SETTING

US MPH programs accredited by the Council on Education for Public Health (CEPH), and applicants approved to seek accreditation.

PARTICIPANTS

In total, 115 representatives representing at least 43% of the 215 accredited/applicant MPH programs in the United States.

MAIN OUTCOME MEASURES

Factors that inform and influence programmatic and curricular changes within MPH programs.

RESULTS

The shifts that MPH programs have made to program focus and the approaches used to support student competence development are influenced by individual, programmatic, institutional, and national factors, including faculty and staff background, access to resources, program team/faculty culture, access to resources, program placement, university priorities, and national policies. Most influential in catalyzing changes made by MPH programs between 2015 and 2020 were CEPH MPH accreditation standards, feedback from interested parties, learning best practices, university initiatives, and access to resources including funding and faculty. Identified factors served as facilitators and/or as barriers, depending on the context.

CONCLUSIONS

There are multiple levers at different levels that may be utilized by national public health leaders, university administrators, and program constituents to effect change within MPH programs, helping them to be even better positioned to help address public health workforce needs of today and tomorrow.

Increasing student engagement with course content in graduate public health education: A pilot randomized trial of behavioral nudges

Digital advances in the learning space have changed the contours of student engagement as well as how it is measured. Learning management systems and other learning technologies now provide information about student behaviors with course materials in the form of learning analytics. In the context of a large, integrated and interdisciplinary Core curriculum course in a graduate school of public health, this study undertook a pilot randomized controlled trial testing the effect of providing a "behavioral nudge" in the form of digital images containing specific information derived from learning analytics about past student behaviors and performance. The study found that student engagement varied significantly from week to week, but nudges linking coursework completion to assessment grade performance did not significantly change student engagement. While the a priori hypotheses of this pilot trial were not upheld, this study yielded significant findings that can guide future efforts to increase student engagement. Future work should include a robust qualitative assessment of student motivations, testing of nudges that tap into these motivations and a richer examination of student learning behaviors over time using stochastic analyses of data from the learning management system.

Master's Degrees Among Academic Plastic Surgeons and Plastic Surgery Residents: What Are the Trends?

BACKGROUND

As more plastic surgery clinicians pursue advanced degrees and strive to become stronger physician-scientists, an objective understanding of how such degrees influence careers becomes important. We hypothesized that having a master's degree is associated with higher scholarly activity, research funding, academic progression, and leadership appointments.

METHODS

Accreditation Council for Graduate Medical Education-accredited integrated plastic surgery residency program Web sites were queried to create a data set of current academic plastic surgeons (APSs) and plastic surgery residents (PSRs). Scholarly metrics such as publications, citations, and H-indices were extracted from the Scopus database. National Institutes of Health and Plastic Surgery Foundation funding information was collected through their respective Web sites.

RESULTS

Our cohort comprised 799 APSs and 922 PSRs, of whom 8% and 7.4%, respectively, had at least one master's degree. Academic plastic surgeons with master's of public health degrees had a significantly higher median number of publications and citations than APSs without a master's of public health. There was no association between any master's degree and academic rank or being a department chairman or program director. Academic plastic surgeons with master of science degrees were more likely to receive National Institutes of Health grants. Among PSRs, master's of science graduates had a higher median number of publications. Other master's degrees did not significantly influence scholarly productivity or funding.

CONCLUSIONS

Certain master's degrees had an impact on scholarly productivity, with no significant effect on academic rank or leadership positions. The value of master's degrees in programs focusing on healthcare management, leadership skills, and business acumen likely extends beyond the scope of this study.

Columbia University Master of Public Health Core Curriculum: Implementation, Student Experience, and Learning Outcomes, 2013-2018

OBJECTIVES

Public health education must respond to 21st-century public health challenges in an ever-evolving landscape. We describe implementation and educational outcomes of the Columbia University Master of Public Health (MPH) Core (hereinafter, Core) curriculum since its inception.

METHODS

This retrospective evaluation combined 6 years (2013-2018) of student survey data collected from students (N = 1902) on the structure and delivery of the Core curriculum to quantify implementation, student experience, and learning outcomes, both during study (Core Evaluation Survey [CES]) and after graduation (Graduate Exit Survey [GES]). We used χ² tests and analysis of variance to compare outcomes across years, and we used McNemar tests to compare differences in outcomes from the same students at different time points.

RESULTS

Of 1902 respondents to the CES, 1795 (94.4%) completed the Core curriculum. During the study period, 81.7% of students were able to integrate concepts across Core curriculum modules with ease; postgraduation, a similar proportion of respondents were able to apply Core curriculum content to departmental and certificate coursework and applied field experiences. On-time graduation rates were high (range, 85%-93%).

CONCLUSIONS

The high percentage of students who reported their ability to integrate concepts and who completed the Core during the study period likely reflected changes to teaching team structures, training, attention to inclusion and equity, and collaboration to implement active learning strategies. The Core curriculum meets its intended goals by providing critical learning abilities to support ongoing interdisciplinary work.

Motivating people to sustain healthy lifestyles using persuasive technology: A pilot study of Korean Americans with prediabetes and type 2 diabetes

OBJECTIVE

To test the efficacy of a hybrid model of the self-help intervention program (hSHIP), which combines a mobile version of SHIP (mSHIP) and personal coaching, to address unique cultural and motivational factors for optimal self-management of type 2 diabetes and prediabetes among Korean Americans (KAs).

METHODS

A single-group feasibility study design was used. The hSHIP utilizes texts and motivational counseling based on well-tested intervention content for KAs. To facilitate the dissemination of hSHIP, we developed a web application adopting the principles of persuasive technology to motivate behavior changes.

RESULTS

Feasibility assessment found that hSHIP was well accepted by both participants and community health workers who delivered the intervention. An average of 1.3% A1C reduction (from 7.8% to 6.5%) was achieved by KAs with diabetes (n = 165), 51.5% of whom lowered their A1C below 6.5% in 6-months. No one with prediabetes (n = 50) progressed to diabetes. Other clinical outcomes (e.g., weight, depression, and blood pressure) also improved significantly; 41.2% were able to reduce or discontinue antidiabetic drugs.

CONCLUSION

The feasibility and initial efficacy of hSHIP were demonstrated.

PRACTICE IMPLICATION

This hybrid diabetes self-management model is a viable tool for traditionally underserved groups with diabetes or prediabetes.

A scoping review to understand "leadership" in interprofessional education and practice

This scoping study examined how "leadership" is referred to and used in interprofessional education and practice. A total of 114 refereed articles were reviewed to determine how leadership is defined, conceptualised, and theorised. The review also examined what capabilities were identified for effective interprofessional leadership. The majority of papers were empirical studies undertaken by researchers based in North America. The majority of articles did not refer to a specific leadership approach, nor did they define, describe, or theorise leadership. Moreover, "leadership" capabilities were rarely identified. Articles generally focused on health practitioners and educators or students as leaders with little exploration of leadership at higher levels (e.g. executive, accrediting bodies, government). This review indicates the need for a more critical examination of interprofessional leadership and the capabilities required to lead the changes required in both education and practice settings. The goal of this article is to stimulate discussion and more sophisticated, shared understandings of interprofessional leadership for the professions. Recommendations for future research are required in both education and practice settings.

Columbia Public Health Core Curriculum: Short-Term Impact

We evaluated a transformed core curriculum for the Columbia University, Mailman School of Public Health (New York, New York) master of public health (MPH) degree. The curriculum, launched in 2012, aims to teach public health as it is practiced: in interdisciplinary teams, drawing on expertise from multiple domains to address complex health challenges. We collected evaluation data starting when the first class of students entered the program and ending with their graduation in May 2014. Students reported being very satisfied with and challenged by the rigorous curriculum and felt prepared to integrate concepts across varied domains and disciplines to solve public health problems. This novel interdisciplinary program could serve as a prototype for other schools that wish to reinvigorate MPH training.

Using consensus methods to develop a country-specific Master of Public Health curriculum for the Republic of Maldives

BACKGROUND

Over the last four decades, the health status of Maldivian people improved considerably, as reflected in child and maternal mortality indicators and the eradication or control of many communicable diseases. However, changing disease patterns are now undermining these successes, so the local public health practitioners need new skills to perform effectively in this changing environment. To address these needs, in 2013 the Faculty of Health Sciences of the Maldives National University developed the country's first Master of Public Health (MPH) program.

METHODS

The process commenced with a wide scoping exercise and an analysis of the curricular structure of MPH programs of high-ranking universities. Thereafter, a stakeholder consultation using consensus methods reached agreement on overall course structure and the competencies required for local MPH graduates. Subsequently, a working group developed course descriptors and identified local public health research priorities, which could be addressed by MPH students.

RESULTS

Ten semistructured interviews explored specific training needs of prospective MPH students, key public health competencies required by local employers and preferred MPH training models. The recommendations informed a nominal group meeting, where participants agreed on MPH core competencies, overall curricular structure and core subjects. The 17 public health electives put forward by the group were prioritized using an online Delphi process. Participants ranked them by their propensity to address local public health needs and the locally available teaching expertise. The first student cohort commenced their MPH studies in January 2014.

CONCLUSION

Consensus methods allowed a broad stakeholder engagement with public health curriculum development and the creation of a country-specific curriculum, informed by local realities and needs.

Developing the new Columbia core curriculum: a case study in managing radical curriculum change

Curricular change is essential for maintaining vibrant, timely, and relevant educational programming. However, major renewal of a long-standing curriculum at an established university presents many challenges for leaders, faculty, staff, and students. We present a case study of a dramatic curriculum renewal of one of the nation's largest Master of Public Health degree programs: Columbia University's Mailman School of Public Health. We discuss context, motivation for change, the administrative structure established to support the process, data sources to inform our steps, the project timeline, methods for engaging the school community, and the extensive planning that was devoted to evaluation and communication efforts. We highlight key features that we believe are essential for successful curricular change.

A case-based, problem-based learning approach to prepare master of public health candidates for the complexities of global health

Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013-2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health-Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned.

The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development

The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

Public health education in South Asia: a basis for structuring a master degree course

Countries in South Asian Association for Regional Cooperation (SAARC) lack enough public health workforces to address their poor public health situation. Recently, there have been efforts to develop capacity building in public health in these countries by producing competent public health workforce through public health institutes and schools. Considering the wide nature of public health, the public health education and curricula should be linked with skills, knowledge, and competencies needed for public health practice and professionalism. The 3 domains of public health practice and the 10 essential public health services provide an operational framework to explore this link between public health practice and public health education. This framework incorporates five core areas of public health education. A master degree course in public health can be structured by incorporating these core areas as basic and reinforcing one of these areas as an elective followed by a dissertation work.

MPH education for the 21st century: design of Columbia University's new public health curriculum

Because public health challenges are changing rapidly, over the past 3 years, we have turned a critical eye to the master of public health program at the Columbia University Mailman School of Public Health. Under a process dubbed "curriculum renewal," we engaged more than 170 faculty, staff, and students (and hundreds of alumni and employers of our graduates) in an initiative to develop a completely new design for master of public health education that launched in fall 2012. We have described its design and structure and presented some preliminary evaluation data.