Guidelines for public health practitioners serving as student preceptors

Student fieldwork and service learning are valuable strategies for developing the skills of future public health professionals. Practitioners who serve as preceptors to students often receive little preparation for guiding and evaluating students. Findings from a review of fieldwork and service learning literature and a program evaluation of an undergraduate public health program at a large southern public university were used to construct guidelines for the practitioners supervising students in the field. These guidelines should aid practitioners in their role as preceptors of public health students. The guidelines address assessing student competencies, developing student competencies, writing learning objectives, evaluating students, maximizing the student precept or relationship, and managing problems.     

Challenges of preparing allied health professionals for interdisciplinary practice in rural areas

Meeting the health needs of individuals in rural communities involves addressing the challenges of complex multifaceted health problems, limited local health resources and services, isolation, and distance. Interdisciplinary collaboration can create solutions to health care problems that transcend conventional, discipline-specific methods, procedures, and techniques. This paper reports on the four-pronged approach of the Western Maryland Area Health Education Center used to prepare allied health students to be interdisciplinary team members in rural areas. It describes the development of four interdisciplinary instructional team member training venues (in-class instruction, Web-based modules, service-learning programs, and faculty development workshops) that integrate opportunities to develop and practice interdisciplinary health promotion skills in rural communities. Challenges to implementing the model are described, including developing faculty and student training participation, integrating training venues into existing programs at participating institutions, and designing a unified program evaluation.     

Using Polvika's model to create a service-learning partnership

Collaboration can maximize limited resources of universities, school systems, and public health departments by offering learning from experience. Polvika's theoretical model and principles from Community-Campus Partnerships for Health guided development of a service-learning partnership among a university, a county health department, and an alternative school in a large public school district. Of three commonly identified patterns of service-learning, this partnership demonstrated the pattern that equally emphasizes service to a community or agency, and mutual learning by all participants. All organizations in the partnership share a common goal to optimize the health of children in schools, and to provide quality learning for professional students. The partnership is in its fourth year. Formal interagency agreements now exist among all partners. Individuals continue to demonstrate flexibility and mutual awareness of strengths and limitations of respective organizations. Public school students receive more services, many high-risk children achieve better learning outcomes, school nurses offer expanded services in many schools with the help of nursing students, and undergraduate and graduate nursing students gain meaningful learning experiences. Some nursing students state that school nursing has become a career goal. The partnership continues to evolve to meet changing needs of the partners. Members remain satisfied with the collaboration.     

Patient-centred medicine through student-centred teaching: a student perspective on the key impacts of community- based learning in undergraduate medical education

CONTEXT: The UK General Medical Council has proposed that increased use of community settings is essential to enhancement of medical education. However, such curriculum developments have been directed by educationalists and clinical faculty; there is to date little to show whether student perspectives accord with such expectations. AIM: To examine student views on whether community-based learning during a UK undergraduate medical education course results in new learning in the areas expected, and to elucidate any process factors which enhance attainment of learning objectives. METHOD: Nominal group technique, to develop consensus on important learning outcomes and process factors, and questionnaire survey, developed from the views of the nominal groups. RESULTS: 89 students participated (response rate 70% for the nominal groups, and 88% for questionnaire). Students perceived increased learning in many of the areas expected. In particular, students reported significant learning from: witnessing the impact of a longer term and more personal relationship with patients; the visible impact of social environment on health; the importance of dealing with people rather than diseases, and the use of the whole team for care. In addition, they emphasized that tutor, staff and patient enthusiasm for student presence and learning greatly enhanced the student learning experience. CONCLUSIONS: Community settings appear to achieve the expected attitudinal adaptation of students. The role of the committed tutor and team is seen as pivotal to learning. The conclusions support an increased emphasis in contemporary medical education and related research activity on the key impact of relationships in the learning environment.     

Using Service-Learning to Teach Mental Health and Research Skills

ABSTRACT

This paper describes how an occupational therapy program used service-learning to integrate the learning objectives for mental health and research curriculum content. The service-learning program assisted participants diagnosed with mental illness to achieve success in higher education and/or related goals and served as a clinical program within a research curriculum for entry-level graduate occupational therapy students. The occupational therapy students served as mentors for the participants. The purpose of the program for the occupational therapy students was to teach research skills, clinical skills, and increase comfort in working with the mental health population. Seventy-eight occupational therapy students participated in the program over four academic years. A case example of a student/participant mentoring relationship is provided. Results indicated that the occupational therapy students gained comfort with the population and competence in their clinical and research skills.     

Junior Doctors of Health©: an interprofessional service-learning project addressing childhood obesity and encouraging health care career choices

While much literature describes programmatic success of clinical service-learning opportunities, this initiative integrates student learning across a comprehensive discipline set (Dental Medicine, Graduate Studies, Health Administration, Medicine, Nursing, Occupational Therapy, Pharmacy, Physical Therapy, and Physician Assistant), providing preventive health education and role modeling to low-income elementary-school children. Junior Doctors of Health? (JDOH), a health education curriculum taught by Medical University of South Carolina students, addresses childhood obesity and encourages child interest in health professional (HP) and biomedical science (BS) careers. Of the 78 surveyed HP/BS students, over 80% agreed JDOH was worthwhile for their professional development, increased their appreciation and ability as an interprofessional team member, improved their understanding and interest in underserved communities, and provided them with valuable childhood-obesity prevention information. With the increased need for childhood-obesity prevention and team building among students of various health and science professions, recommendations are offered to others interested in creating or collaborating to build similar service-learning initiatives.     

Planning professional education at schools of public health.

OBJECTIVES. Professional education in public health should equip graduates with adequate knowledge and skills to manage diverse and complex problems. How best to address this challenge is widely debated. We describe the Harvard School of Public Health's self-evaluation and development of a practice-oriented program. METHODS. As part of Harvard's schoolwide review of the master of public health (MPH), self-administered questionnaires were distributed to all MPH students, 1987 to 1989, and international and US alumni, 1979 to 1986. Extensive discussions were conducted with relevant student and faculty groups. RESULTS. Survey results provided a basis for educational policy and curricular changes that culminated in a revised MPH that targets key areas of public health practice. Examples from the Harvard experience are provided. CONCLUSIONS. Information derived from student and alumni surveys can be highly effective in the process of guiding curricular change at schools of public health. This should be coupled with a strategic approach to gain faculty support for proposed innovations. Ongoing monitoring and modification of the new curriculum is essential.     

Undergraduate public health at 4-year institutions: it's here to stay

Undergraduate public health education at 4-year institutions, those with and without graduate public health education, has grown rapidly during the first decade of the 21st century since the IOM recommended that "all undergraduates have access to education in public health." Much of this growth has been guided by the Educated Citizen and Public Health initiative, a collaboration of arts and sciences and public health educators that encourages introductory course work in public health, epidemiology, and global health plus undergraduate minors and majors in public health. The Educated Citizen and Public Health model, as opposed to existing professional models, envisions core public health education based on the Association of American Colleges and Universities' Liberal Education and America's Promise essential learning outcomes that encourage experiential learning, evidence-based thinking, a global and community focus, plus integration and synthesis. Public health education in this model provides solid generalist grounding for graduate education in public health as well as a range of graduate disciplines from the health professions to international affairs and from law to business. In addition, it helps ensure a broad range of college graduates who understand and support public health approaches. The Healthy People 2020 objective to increase the proportion of 4-year colleges and universities that offer minor or major in public health should help propel additional growth, especially in 4-year colleges without graduate public health education. Integrative curricula designed as part of the reform of undergraduate education provide opportunities to make evidence-based public health approaches available to a large number of undergraduates.     

A rural service-learning model for health administration education

Service learning for students in the health professions can best be described as an educational methodology based on the collaboration between an academic discipline and a community agency to link student learning with community-based service. This paper describes a service-learning model in rural and medically underserved communities used in a master in health administration program in a rural Southern state. It presents the process, components, outcomes, and challenges. Over the past five years, 56 students completed 116 experiences involving internships, field projects, or special projects in rural and medically underserved communities. A total of 27 percent of our graduates who completed rural and medically underserved experiences accepted job positions in rural health care entities. Strategies utilized by this rural service-learning model include interdisciplinary team training, partnerships among rural and medically underserved community health care entities and academic institutions, faculty-preceptor retreats, and involvement in local community initiatives. These experiences prepare future health administrators to contribute in a meaningful way toward building an effective rural health care delivery system.     

Service Learning: Meaningful,Community-Centered Professional Skill Development for Occupational Therapy Students

The profession of Occupational Therapy advocates for new and emerging areas of practice that more fully embrace our moral responsibility to address significant social injustices that exist in our communities (Kronenberg, Algado, & Pollard, 2005). The service-learning pedagogy is impacted by the philosophical and theoretical influences of John Dewey, the mission and purpose of American higher education including Boyer's (1994) call for an engaged citizenry, and the social vision of occupational therapy. The pedagogy of service learning provides a natural context for students to experience community practice while contributing to reducing existing social injustices. This paper provides an overview of service learning (SL) as a philosophical and pedagogical approach in occupational therapy education, key processes in developing successful service learning experiences and community partnerships to support service learning. Characteristics of effective service learning, assessment of community and institutional outcomes of service learning and the scholarship of service learning are also discussed. Most importantly, strategies for developing service learning scholarship, an important but frequently neglected requisite to validate any educational practice, are delineated. The authors conclude that service learning provides educators with an opportunity to provide students with experiences in natural, community contexts while developing life-long commitment to civic engagement and social responsibility.     

Blogging as a Tool to Promote Reflection among Dietetic and Physical Therapy Students during a Multidisciplinary International Service-Learning Experience

Service-learning is a guided, structured learning experience that engages students in service to a community for the mutual benefit of the student and community. There is a growing trend in healthcare to include international service-learning experiences in the training curriculum to promote cultural competence. A critical element of service-learning is reflection. There have been many research studies examining how best to support and facilitate the reflective thinking process in students. The purpose of this study was to assess the development of reflective thinking among graduate allied health students during an interdisciplinary international service-learning experience using a web-based collaborative blog. Twelve graduate students-six dietetic interns and six physical therapy doctoral students-traveled to Belize for 6 days to provide primary healthcare screenings and intervention to a community. Group blogging was found to be an effective tool to promote reflection in allied health student and short duration service-learning experience developed reflective thinking.     

Undergraduate public health education: past, present, and future

The IOM's 2003 report Who Will Keep the Public Healthy? recommended that “…all undergraduates should have access to education in public health.” They justified their recommendations stating that “public health is an essential part of the training of citizens.” The IOM recommendations have catalyzed a movement linking undergraduate public health education with arts and sciences' Liberal Education and America's Promise (LEAP), an initiative designed to produce an educated citizenry. Schools and programs in public health rapidly adopted the IOM recommendations and efforts to reach the other 1900 4-year colleges and universities are now underway.     

Faculty Behavior and Other Key Factors in Student Adjustment to Medical School

Physicians today need a number of non-cognitive attributes and skills in order to be maximally effective. However, these attributes and skills, such as caring and respect for others, self-awareness, and communication skills, are not always addressed in medical education. Many would-be physicians find that medical school is a grueling experience characterized by chronic stress, the need to recognize one's strengths and limitations, and dissonance between their own values and beliefs and those of the school. The faculty and administrators at one medical school developed a special extra-curricular program to render their undergraduate program more humanistic in supporting student socialization and adjustment. The program featured intentionally structured,faculty-facilitated small groups of first-year students.This study used focus group interviews to explore student perceptions of the effectiveness of the Personal, Professional, and Leadership Development Program and thereby to gain insight into the phenomena that affect the development of medical students as future health care providers. Findings showed that students described social support and academic support from peers and faculty as contributing to their adjustment. The most compelling factor in student adjustment was faculty behavior and attitudes. Implications for adult learning and humanistic education practices are described.This revised version was published online in October 2005 with corrections to the Cover Date.     

Healthy People 2020 and Education for Health: What Are the Objectives?

The Education for Health framework is designed as an educational roadmap for Healthy People 2020. It aims to connect the educational phases and suggests overall educational strategies needed to educate health professionals and the public to achieve a healthier America. The framework seeks to develop a seamless approach to prevention and population health education from Pre-K through graduate school. The framework is built on national movements in health literacy, undergraduate public health education and evidence-based thinking. It envisions a coordinated set of learning objectives divided into Pre-K through Grade 12, 2-year and 4-year colleges, and graduate education in the health professions as well as for health education for the community-at-large. The Healthy People Curriculum Task Force, a consortium of eight health professions education associations, has developed the framework and connected the framework with new and revised educational objectives of Healthy People 2020. The Task Force envisions a decade-long process to define and implement specific learning outcomes that can be integrated across the educational continuum. Interprofessional prevention education, in which health professionals learn and practice together, is seen by the Task Force as a key method for implementation. Understanding the roles played by a range of clinical health professions is also essential to communication and understanding. Healthy People 2020 and its new and revised educational objectives provide a vehicle for promoting the discussion and experimentation that will be needed to achieve an integrated and seamless approach to education for health for the American public as well as for health professionals.     

The identification of best practices in teaching quality competencies for preparing future health care leaders

The mandate for quality in all aspects of clinical practice, service delivery, and management practice has never been greater. The Institute of Medicine's (IOM) landmark work To Err is Human heightened the urgency of this serious issue. In a follow-up report, the IOM's Crossing the Quality Chasm called for radical change to achieve numerous quality objectives throughout the continuum of the healthcare system including the preparation of future healthcare leaders. This study was conducted to assess how effectively healthcare management education faculty are meeting the challenge of integrating quality improvement into their curricula and how faculty perceived their quality expertise. Another goal was to identify the student learning assessment strategies, teaching methods, content, and resources utilized by faculty to achieve this integration and to suggest a framework for "best practices" in teaching quality competencies citing the literature. The study's findings raise a number of important issues with respect to the ways in which QI is conceptualized and integrated into curricula and concludes that there is substantial need for 'quality improvement' in healthcare management education faculty's approaches to the teaching of QI.     

The identification of best practices in teaching quality competencies for preparing future healthcare leaders

The mandate for quality in all aspects of clinical practice, service delivery, and management practice has never been greater. The Institute of Medicine's (IOM) landmarkwork To Erris Human heightened the urgency of this serious issue. In a follow-up report, the IOM's Crossing the Quality Chasm called for radical change to achieve numerous quality objectives throughout the continuum of the healthcare system including the preparation of future healthcare leaders. This study was conducted to assess how effectively healthcare management education faculty are meeting the challenge of integrating quality improvement into their curricula and how faculty perceived their quality expertise. Another goal was to identify the student learning assessment strategies, teaching methods, content, and resources utilized by faculty to achieve this integration and to suggest a framework for "best practices" in teaching qualitycompetencies citing the literature.The study's findings raise a number of important issues with respect to the ways in which QI is conceptualized and integrated into curricula and concludes that there is substantial need for 'quality improvement' in healthcare management education faculty's approaches to the teaching of QI.     

"How can we stay healthy when you're throwing all of this in front of us?" Findings from focus groups and interviews in middle schools on environmental influences on nutrition and physical activity.

This study aimed to identify factors in school physical and social environments that may facilitate or compete with programs and policies to improve student physical activity and nutrition. Focus groups and interviews were conducted with students, faculty, and staff of two public middle schools. Participants identified numerous aspects of the school environments as significant. Competition, teasing and bullying, time, and safety were described as major barriers for students to be physically active during physical education class, on sports teams, and before and after school. The quality of the food served, easy access to nonnutritious snacks, limited time for lunch period, and weight concerns emerged as significant reasons why students do not eat nutritious meals in school. When developing programs and policies to improve the health of students, environmental influences that undermine efforts to improve student health behaviors must be addressed.     

Preparing currently employed public health nurses for changes in the health system

OBJECTIVES: This article describes a core public health nursing curriculum, part of a larger project designed to identify the skills needed by practicing public health workers if they are to successfully fill roles in the current and emerging public health system. METHODS: Two focus groups of key informants, representing state and local public health nursing practice, public health nursing education, organizations interested in public health and nursing education, federal agencies, and academia, synthesized material from multiple sources and outlined the key content for a continuing education curriculum appropriate to the current public health nursing workforce. RESULTS: The skills identified as most needed were those required for analyzing data, practicing epidemiology, measuring health status and organizational change, connecting people to organizations, bringing about change in organizations, building strength in diversity, conducting population-based intervention, building coalitions, strengthening environmental health, developing interdisciplinary teams, developing and advocating policy, evaluating programs, and devising approaches to quality improvement. CONCLUSIONS: Collaboration between public health nursing practice and education and partnerships with other public health agencies will be essential for public health nurses to achieve the required skills to enhance public health infrastructure.     

Interdisciplinary education for community health: the case for nursing and social work collaboration.

A nurse educator and a social work educator developed an interdisciplinary team-taught course in community health for both social work and nursing students. This account of their experience elaborates the implications of interdisciplinary education for the student learning experience including theory and practice content, socialization, and transition; faculty development; and the larger university community. Although this particular instance is limited to baccalaureate education, the authors underscore the potential of interdisciplinary course work for the enrichment of all levels of nursing and social work education.     

Training health educators for social change. 1984-85

Health education practice reflects the ideology of the social forces that support it. Currently, health educators approach their task from two divergent viewpoints: one group emphasizes changing individual behavior while the other focuses on organizing people to change health-damaging institutions, policies and environments. This report provides a rationale and examples of the latter approach. It then describes the kind of training program that would be necessary to prepare health educators to work effectively for social change. Specifically, it is suggested that graduate students in health education need more preparation in social epidemiology, environmental sciences and policy analysis, particularly the analysis of the impact of non-health policies on health status. Health education training programs also need new approaches to the process of learning. The social movement of the last decades, health education programs in developing and socialist countries and some projects in this country provide a rich source of case studies. Training programs also need to recruit students who will be prepared to serve populations most in need of help. This suggests attracting students who have in the past been excluded from graduate education. Finally, several methods are suggested by which students, faculty and practitioners can begin the process of transforming the institutions that prepare professional health educators.