Global Health Education in Public Health

Transcription

1 Global Health Education in Public Health Suzanne Jackson, Donald Cole, Roger Gray Dalla Lana School of Public Health University of Toronto CPHA Conference June 15, 2010

2 Masters Global Health Masters Global Health Concentration in Dalla Lana School of Public Health at University of Toronto Like a collaborative program Crosses all public health disciplines (health promotion, epidemiology, community nutrition, occupational and environmental health, family and community medicine)

3 Key Features Use elective space in each core disciplinary program to meet 2 requirements: Required course in Global Public Health for all GH students One international health or global health elective Plus use one of 2 practicum placements as a global health related placement Above requirements were tailored to each core disciplinary program in discussion with Program Directors

4 Enrolment Health Promotion Epidemiology Comm ty Nutrition Occup & Env Hlth Fam & Com Med Total

5 Research Questions 1. What is the influence of prior student experience, training and expectations on overall graduate experience? 2. What components of the formal curriculum lead to better student outcomes and greater mastery of competencies? 3. What can be improved?

6 Alumni Survey Methods Ethics approval from U of T REB Invitation to participate to all those who were part of GH Concentration & those who applied and were not accepted in 2006 & 2007 cohorts from Jackson & Cole 2009 GH student (Gray) conducted the telephone interviews

7 Methods (cont d) Potential respondents chased with up to 3 s (and a phone call in one case) Telephone interviews were taped & transcribed Due to desire for anonymity by respondents (from faculty investigators), Roger had to do all coding Qualitative responses were grouped so individual respondents could not be identified

8 Methods (cont d) Total in Program Total Interviewed Response Rate Health Promotion % Epidemiology % Other % Not accepted in GH % Dropped GH % TOTALS %

9 Interview Sample Number interviewed In GH Concentration (N=25) Dropped or not Accepted (N=16) 18 (72%) 8 (50%) Prior Training Prior Overseas Experience 4 MDs, 2 Internat Dev, 6 biol/hlth/nutr sci, 5 social sciences 15 high exper 1 medium 1 no answer 2 clinicians 3 Internat Dev 1 neuroscience 2 social sciences 3 high exper 4 Canadian exper 1 unknown

10 Prior Experience Level of Experience Very high or high Description worked in another country for 6 months to 7 years + had degree in International Development Number N=3 (GH) N=2 (drp) N=1 (na) Medium worked in another country for >6 months + some courses in internat health Low worked in another country for >6 months + no prior training in internat health Very low worked in another country for <6 months + no internat health training N=5 (GH) N=6 (GH) N=2 (na) N=4 (GH) N=3 (na)

11 Prior Experience Conclusions Very High experience prior to program leads to high dissatisfaction and drop out for some International placements were greatest for those with medium experience or better and contribution to learning was good 50% of those not accepted into GH concentration did international placements Those with medium experience got the most from the required GH course 50-60% of students reported that the GH elective courses did not contribute to their learning

12 Results Connecting Prior Experience to Outcomes Learning Medium to High prior experience corresponds to new learning Deeper learning in those with medium low and low experience

13 Core Competencies 1. Political Economy of Health 2. SDOH & Population Health 3. Link global to local 4. Work with International Organizations 5. Work in partnership & build coalitions 6. Cultural Sensitivity 7. Understand ethics and equity 8. Use ethical approaches in all projects

14 Program Success re Core Competencies Difference between GH students & non GH students was not significant on all competencies Only 1 of possible significance understanding of political economy of health was greater in GH students (6.9 vs. 5.6) Issues: All students took GH courses (GH & non GH) Only GH required course was different

15 Relevance of GH Concentration to Career 61-62% said there was a strong connection between their job and their CORE program (N=18, in GH and N=8, not in GH) 44% said MPH provided contacts or led directly to job (N=18, in GH) 28% said they did not gain relevant skills from GH (N=18, in GH) 17% said that the GH concentration broadened or changed their perspective or lens (N=18, in GH)

16 Relevance of GH Concentration to Career Strg ContactsNo skills Connect prov from GH GH broad lens N=18 in GH

17 Relevance of GH Concentration to Career 28% who found that GH/MPH did not contribute to their career (N=18, in GH), had these characteristics: No international placements 20% found GH required course not useful Others found that GH/MPH: Identified or expanded career options (28%) Decided to focus in Canada (17%) Encouraged focus on a particular topic (28%)

18 Issues Raised - 1 Funding not enough for overseas placements Shortage of staff too few faculty available to mentor & no support to find placements Lack of cohesion too many different programs & only connect in core course Need for practical, hands on skills training theory was too far behind practice

19 Issues Raised - 2 More global networking link with CIDA, other programs in Canada, US, globally & other programs at U of T Small Group learning want smaller classes and deeper discussions, learning from other students requires them to have experience Flexibility core program demands were too great, need more GH course options

20 Issues Raised - 3 Mentoring more 1:1 relations with faculty Breadth vs depth some said too broad, some said need for more depth, some want both Part-time not designed for part-time (no different from core programs)

21 Conclusions GH Concentration Style Pros: Basic Disciplinary Skills training is strong - >60% said there was a strong connection with careers Multi-disciplinary focus (students wanted more connections) Can provide breadth of learning

22 Conclusions GH Concentration Style Cons: Faculty spread too thin, serving 2 agendas Too little time on GH elective room not enough to cover topics in depth Students have double loyalties & did not feel strong connection to GH Focus on disciplinary program practica meant little energy & funding to focus on global practica

23 Contacts