Epidemiology MPH (clinical effectiveness and quantitative methods)

Transcription

1 MASTER OF PUBLIC HEALTH DEGREE 2.1.a. An instructional matrix presenting all of the school's degree programs and areas of specialization, including undergraduate degrees, if any. If multiple areas of specialization are available within departments or academic units shown on the matrix, these should be included. The matrix should distinguish between professional and academic degrees and identify any programs that are offered in distance learning or other formats. The instructional matrix of the school s degrees/concentrations is available in Table 2.1.a. The matrix distinguishes between professional and academic degrees. The school meets the basic expectations of a professional degree in each of the core areas of public health as follows: Biostatistics master of science (SM 60 credits) Environmental Health master of public health (MPH) (occupational and environmental health), master of occupational health (MOH), and SM (80 credits in exposure, epidemiology and risk and in occupational health) Epidemiology MPH (clinical effectiveness and quantitative methods) Health Services Administration MPH (health care management and policy plus law and public health), SM (42.5 credits in health care management and 80 credits in health policy and management) Social and Behavioral Sciences MPH (family and community health plus global health), SM (80 credits in society, human development, and health) HSPH offers programs in various public health disciplines leading to the master of public health (MPH), master of occupational health (MOH), master of science (SM), doctor of public health (DPH), and doctor of science (SD), as well as a part-time, nonresidential master of science in health care management (MHCM). The school also offers doctoral programs in biostatistics and biological sciences leading to the doctor of philosophy (PhD) and participates in the university-wide PhD program in health policy. Because PhD students are admitted to, and receive their degrees from, the Graduate School of Arts and Sciences (GSAS), these programs are not included in the instructional matrix. 1 PhD programs are under the auspices of the school by virtue of the faculty as mentors, advisors and instructors of some courses, but the students are not HSPH degree candidates. Students may consider themselves to be HSPH students, but the reality is they apply to the program, register for courses, and attend courses outside of the school (see Resource File 2.1.a for PhD curricula and departmental student handbooks). The MPH program is a 42.5-credit program directed toward professionals who hold a doctoral degree in medicine, dentistry, veterinary medicine, law, or other fields related to public health or a master s degree in a closely related field (e.g., nursing, social work, management) and have at least three years of healthrelated work experience. Medical students may apply to enroll between the third and fourth year of medical school but are not awarded their MPH degree until successful completion and awarding of the doctoral degree. The law and public health concentration ordinarily requires a prior JD or non-us equivalent degree, though law students already holding a relevant advanced degree may also be considered. Students accepted to both Harvard Law School and HSPH may enroll in the joint JD/MPH program, applying to the joint program either concurrently or during their first year of law school; upon 1 The school also offers concentrations (or specializations) within a number of departments, as well as several interdisciplinary concentrations. With the exception of the MPH concentrations and those in the Department of Environmental Health, these concentrations are nondegree programs of study. Students do not apply to these concentrations nor do they receive any type of certificate from them. For this reason, except for environmental health and the MPH program, the concentrations are not listed in Matrix 2.1.a. Harvard School of Public Health Instructional Programs 49

2 successful completion of the program, students are awarded both a JD and an MPH from the respective schools. See Section 2.11 for information regarding HSPH joint and combined programs. A 42.5-credit SM is offered in the Departments of Biostatistics; Environmental Health; Epidemiology; Health Policy and Management; and Society, Human Development, and Health. Programs differ from department to department with respect to both the backgrounds sought in their candidates and the requirements for the degree. The 42.5-credit SM programs are primarily academic degrees, with the exception of MHCM and Environmental Health. In most departments, applicants must hold a prior doctoral degree. However, the Department of Environmental Health will review applicants with a master s degree in a related discipline or significant professional experience, and the Department of Society, Human Development, and Health will consider applicants with a prior related graduate degree and experience in a relevant public health field. The 80-credit SM programs require a prior bachelor's degree or non-us equivalent. Some departments also require work experience. Programs differ from department to department with respect to both the backgrounds sought and the specific requirements for the degree. Seven of the school s nine academic departments offer the academic SD degree. Five departments also offer the DPH degree. There is no substantive difference in the content or requirements of the two programs, except that admission to the DPH program requires applicants to hold a prior advanced degree and an MPH degree or its equivalent in a public health discipline. HSPH does not provide a professional degree for doctoral students. The doctor of public health degree (DPH) is reserved for those individuals to pursue a higher level public health academic degree and is not intended as a professional degree. The DPH abbreviation has not been changed to DrPH which has been used as the abbreviation to designate a professional degree. The DPH degree has existed at HSPH since its founding and was given the DPH abbreviation to match the MPH abbreviation. 2.1.b. The school bulletin or other official publication, which describes all curricula offered by the school for all degree programs. If the school does not publish a bulletin or other official publication, it must provide for each degree program and area of concentration identified in the instructional matrix a printed description of the curriculum, including a list of required courses and their course descriptions. The school catalog can be found online at and is available in a printed version through the registrar s office and in Resource File 1.1.d. A complete description of each department s curricula is included in its student handbook (see Resource File 2.1.a for hard copies of the student handbooks). Sample course schedules for each program are available online in the respective departments degree planners. 2.1.c. Assessment of the extent to which the criterion is met. HSPH offers a breadth of professional and academic degrees reflective of its mission and goals. These are offered in the five areas of knowledge basic to public health and in a variety of other priority areas. This criterion is met. Harvard School of Public Health Instructional Programs 50

3 Table 2.1.a. HSPH Instructional Matrix Academic Professional Biostatistics SM Applied Biostatistics, 60 credits SM Biostatistics, 42.5 credits SM Biostatistics, 80 credits Environmental Health MPH Occupational and Environmental Health MOH 42.5 credits (master s of occupational health) SM Environmental Health (Environmental and Occupational Medicine and Epidemiology), 42.5 credits SM Environmental Health (Environmental and Occupational Medicine and Epidemiology), 80 credits SM Environmental Health (Exposure, Epidemiology, and Risk), 42.5 credits SM Environmental Health (Exposure, Epidemiology, and Risk), 80 credits SD/DPH*** Environmental Health (Environmental and Occupational Medicine and Epidemiology) SD Environmental Health (Exposure, Epidemiology, and Risk) SD Environmental Health (Molecular and Integrated Physiological Sciences) SM in Environmental Health (HSPH) and SM in Primary Health Care Nursing (Simmons) two-year dual degree (HSPH 42.5 credit) Epidemiology MPH Clinical Effectiveness* MPH Quantitative Methods* SM Epidemiology, 42.5 credits* SM Epidemiology, 80 credits SD/DPH*** Epidemiology Global Health and Population MPH Global Health (Social & Behavioral Sciences) SM Global Health and Population, 80 credits SD/DPH*** Global Health and Population Health Policy and Management (Health Services Administration) MPH Health Care Management and Policy MPH Law and Public Health SM Health Care Management, 42.5 credits** SM Health Policy and Management, 80 credits SM Health Policy and Management, 42.5 credits SD Health Policy and Management JD/MPH Joint degree Immunology and Infectious Diseases SD Immunology and Infectious Diseases Harvard School of Public Health Instructional Programs 51

4 Table 2.1.a. HSPH Instructional Matrix (continued) Academic Professional Nutrition SD/DPH*** Nutrition Society, Human Development and Health (Social and Behavioral Sciences) MPH Family and Community Health SM Society, Human Development, and Health, 80 credits SM Society, Human Development, and Health, 42.5 credits SD/DPH*** Society, Human Development, and Health SM in Society, Human Development, and Health (HSPH) and SM in Parent-child Nursing or MSW (Simmons) half-time dual degree over two years (HSPH 42.5 credits) Dual/Combined/Joint Degrees MD/MPH Combined degree (see available MPH concentrations) DMD/DDS/MPH Combined degree (see available MPH concentrations) *The MPH concentrations in clinical effectiveness and quantitative methods, and the 42.5-credit SM in epidemiology in the area of clinical epidemiology, offer qualified students a summer-only option for completing these degrees. **The SM in health care management is a part-time, nonresidential program. ***There is no substantive difference between the SD and DPH programs except that admission to the DPH program requires applicants to hold a prior doctoral degree and an MPH degree or its equivalent. Key: MPH Master of public health MOH Master of occupational health SM Master of science. SD Doctor of science DPH Doctor of public health Harvard School of Public Health Instructional Programs 52

5 PROGRAM LENGTH 2.2.a. Definition of a credit with regard to classroom/contact hours. The school defines a credit as the unit of measure for a specific number of classroom hours, with 1.25 credits corresponding to 16 hours of classroom time; see Table 2.2.a, which also provides an estimate of the amount of time students are expected to devote to a course beyond classroom hours. The academic year comprises two sixteen-week semesters (fall and spring), with each semester composed of two eight-week terms (known as Fall1, Fall2, Spring1, and Spring2). Some courses meet for a full semester, others for a single term. The school also offers courses during a three-week period in January, known as WinterSession, and during two intensive three-week terms in the summer (Summer1 and Summer2). Table 2.2.a illustrates weekly classroom-hour requirements for the fall and spring semesters; credit-bearing courses offered in the winter and summer sessions are subject to the same requirements with respect to the total number of classroom hours but are configured differently to accommodate the shorter term length. Table 2.2.a. HSPH Classroom Hours and Credit Equivalents 1-semester course (16 weeks) Fall and Spring Classroom Hours 1-term course (8 weeks) Fall1, Fall2, Spring1, Spring2 1-semester course (16 weeks) Fall and Spring Outside Hours 1-term course (8 weeks) Fall1, Fall2, Spring1, Spring2 Credits Hours per Week Hours per Week b. Information about the minimum degree requirements for all professional degree curricula shown in the instructional matrix. If the school or university uses a unit of academic credit or an academic term different than the standard semester or quarter, this should be explained and an equivalency presented in a table or narrative. The minimum credit requirements for each degree program are provided in Table 2.2.b(1). The school uses a system of academic credit based on the standard semester, as described in criterion 2.2.a. Harvard School of Public Health Instructional Programs 53

6 Table 2.2.b(1). Instructional Matrix with Degree Credit Requirements Degree Credit Requirements Academic Professional Biostatistics SM Biostatistics (applied) 60.0 SM Biostatistics 42.5 SM Biostatistics 80.0 Environmental Health MPH Occupational and Environmental Health 42.5 MOH (master s of occupational health) 42.5 SM Environmental Health (Environmental and Occupational Medicine and Epidemiology) 42.5 SM Environmental Health (Environmental and Occupational Medicine and Epidemiology) 80.0 SM Environmental Health (Exposure, Epidemiology, and Risk) 42.5 SM Environmental Health (Exposure, Epidemiology, and Risk) 80.0 SD/DPH Environmental Health (Environmental and Occupational Medicine and Epidemiology) >80.0* SD Environmental Health (Exposure, Epidemiology, and Risk) >80.0* SD Environmental Health (Molecular and Integrated Physiological Sciences) >80.0* SM in Environmental Health (HSPH) and SM in Primary Health Care Nursing (Simmons) two-year dual degree (HSPH 42.5 credit) 80.0 Epidemiology MPH Clinical Effectiveness 42.5 MPH Quantitative Methods 42.5 SM Epidemiology 42.5 SM Epidemiology 80.0 SD/DPH Epidemiology >80.0* Global Health and Population MPH Global Health 42.5 SM Global Health and Population 80.0 SD/DPH Global Health and Population >80.0* Health Policy and Management (Health Services Administration) MPH Health Care Management and Policy 42.5 MPH Law and Public Health 42.5 SM Health Care Management 42.5 SM Health Policy and Management 80.0 SM Health Policy and Management 42.5 SD Health Policy and Management >80.0* JD/MPH Joint degree 42.5 Immunology and Infectious Diseases SD Immunology and Infectious Diseases >80.0* Harvard School of Public Health Instructional Programs 54

7 Table 2.2.b(1). Instructional Matrix with Degree Credit Requirements (continued) Degree Credit Requirements Academic Professional Nutrition SD/DPH Nutrition >80.0* Society, Human Development and Health (Social and Behavioral Sciences) MPH Family and Community Health 42.5 SM Society, Human Development, and Health 80.0 SM Society, Human Development, and Health 42.5 SD/DPH Society, Human Development, and Health >80.0* Dual/Combined/Joint Degrees SM in Society, Human Development, and Health (HSPH) and SM in Parent-child Nursing or MSW (Simmons) half-time 42.5 dual degree over two years (HSPH 42.5 credit) MD/MPH Combined degree 42.5 DMD/DDS/MPH Combined Degree 42.5 * Doctoral graduates are required to complete a minimum of 80.0 credits, with the total varying by individual graduate. Key: MPH Master of public health MOH Master of occupational health SM Master of science SD Doctor of science DPH Doctor of public health Table 2.2.b(2) reiterates the number of credits required to graduate for each of the master s degree programs offered at HSPH, as well as the breakdown of the number of ordinal credits (i.e., for a letter grade, as opposed to pass/fail) required to be taken and the number of cross-registered credits permitted. Master's Programs Table 2.2.b(2). Minimum Number of Credits Required to Graduate, by Degree Degrees MPH 42.5 Credit 80 Credit MOH SM SM Total credits required to graduate Number of ordinal credits required to graduate *Number of crossregistered credits No more than 1/2 of total credits for degree program and/or per semester permitted *HSPH students may enroll in courses offered by members of the cross-registration consortium, i.e., the other Harvard faculties, Massachusetts Institute of Technology (MIT), and Tufts Fletcher School of Law and Diplomacy. Credit for cross-registered courses is permissible only for graduate-level courses appropriate to the student's HSPH degree program and if a similar course is not available at HSPH. Harvard School of Public Health Instructional Programs 55

8 2.2.c. Information about the number of MPH degrees awarded for less than 42 semester credit units, or equivalent, over each of the last three years. A summary of the reasons should be included. Beginning in fall 2007, all graduates of the MPH program (and of other master s degree programs that previously required 40 credit units) were required to complete 42.5 credit units to graduate (see the HSPH Catalog in Resource File 1.1.d). Thus, the first cohort of students subject to the 42.5-credit requirement matriculated in fall 2007 and graduated in June In June 2008, 160 MPH degrees and 40 SM or MOH degrees were awarded to students who had enrolled prior to fall 2007 and who were thus exempt from the 42.5-credit requirement; another 16 such MPH degrees were awarded in November In addition, there are 15 remaining MPH or MOH students (2 on leave, 9 pending who have finished their HSPH work but have to complete their MD to graduate, and 4 registered as part-time) who entered prior to the fall 2007 credit requirement change. The part-time SM program in health care management (MHCM) enrolled its first participants required to complete 42 or more credit hours in the summer 2008; this was the first class enrolling after the new policy went into effect. All MHCM graduates will therefore have fewer than 42 credits until the class of 2010 graduates. 2.2.d. Assessment of the extent to which this criterion is met. As of fall 2007, all degree programs require a minimum of 42.5 credits for graduation. This criterion is met. Harvard School of Public Health Instructional Programs 56

9 PUBLIC HEALTH CORE KNOWLEDGE 2.3.a. Identification of the means by which the school assures that all professional degree students have a broad understanding of the areas of knowledge basic to public health. If this means is common across the school, it need be described only once. If it varies by degree or program area, sufficient information must be provided to assess compliance by each program. The school catalog informs students that for all professional master s degree programs, students must fulfill core requirements in the following: Biostatistics, epidemiology, environmental health sciences, health services administration, and social and behavioral sciences. Master of public health (MPH) students, and some master of science (SM) students, are also required to complete an ethics course. Professional degree students must complete courses in the five disciplines or may complete the new Foundations in Public Health course described below to achieve a broad understanding of the areas of knowledge basic to public health. The list of core courses is primarily determined by the relevant departments. In 2005, the school undertook a process of reviewing and revising the core competencies for professional master's students and the list of approved core courses to ensure they were in accordance with the new competencies. The review process included extensive consultation with the faculty in charge of the professional master's programs and appropriate faculty from each department. A revised list of courses resulted from this process. The Office for Educational Programs consults with departments each year to determine if any courses should be added or deleted from this list (for revisions for the fall 2009 see Resource File 2.3.a). Individual professional master's programs can further limit the specific courses from the schoolwide list that may be used by their degree students to meet core course requirements. In fall 2008, the school began to offer a 10-credit core course, Foundations in Public Health, designed to cover the required core competencies in an integrated case-based learning format. The course was developed under the leadership of an associate dean for educational programs and a core curriculum and teaching committee comprising representatives of each of the five areas of basic public health knowledge. The course development process included training faculty in case-based teaching; ensuring the coverage of designated core competencies; writing cases tailored to meet the learning objectives of the course; and coordinating course content, faculty, and course assistants for roughly 120 hours of class time. The course is offered to professional master s degree students with proficiency in math skills who desire a more integrated and participatory curriculum. The competencies are identical to those for the traditional model of separate, discipline-based courses (available in Section 2.6.a); the course syllabus is available in Resource File 1.4.c and materials and evaluations are in 2.3.a. The course was approved by the school s Committee on Educational Policy on July 28, 2008; notification of this substantial change was submitted to the Council on Education for Public Health (CEPH) on August 18, 2008, and the CEPH Board of Councilors accepted the change at its meeting of October 2-4, Required courses by program/concentration are listed in Table 2.3.a; syllabi for the required courses are available in Resource File 2.3.a (available core courses have been revised for , see the Resource File for an updated list). Core competencies for the professional programs are listed in Section 2.6.a. Students may find this information in the MPH curriculum guide (see Resource File 2.1.a), which is available to students online at in departmental student handbooks (see Resource File 2.1.a), in the Foundations course syllabus, and as an insert in the /registration packet. The professional degree programs to which these requirements apply are listed in the instructional matrix, Table 2.1.a. Students who believe they have had prior equivalent coursework in required core disciplines may request the waiver of a core requirement. To request a waiver, the student submits a waiver request form to the designated individual in the department in question, along with a transcript showing the prior coursework and a copy of the course description (for biostatistics and epidemiology) or syllabus of the course taken. The approval of both the relevant course instructor and of the student s advisor is required. (Sample Harvard School of Public Health Instructional Programs 57

10 waiver forms are available in Resource File 2.3.a.) Students enrolled in the biostatistics department are automatically exempted from the introductory core course in biostatistics since they begin with coursework at a more advanced level. Because the school does not accept transfer credit for courses taken elsewhere, students waiving a core requirement must still complete the total number of credits required for their degree program. 2.3.b. Assessment of the extent to which this criterion is met. All professional degree students are required to take coursework in the five core areas of public health knowledge. This requirement may be fulfilled by taking individual courses in each area or by taking the new, integrated course, Foundations in Public Health. This case-based course provides an exceptional opportunity for professional students to learn to use the tools and concepts of the various disciplines to arrive at solutions to real public health problems. This criterion is met. Harvard School of Public Health Instructional Programs 58

11 Table 2.3.a HSPH Professional Master s Degree Programs Traditional Course Requirements for Core Public Health Knowledge Department MPH Program Degree and Program Length MPH (42.5 credits) Concentration Biostatistics Epidemiology Environmental Health All MPH concentrations (including JD/MPH) except quantitative methods and clinical effectiveness BIO200 or 201 or 202 & 203 Quantitative methods BIO200 or 201 or 202 & 203 Clinical effectiveness BIO206 & 207 or approved alternatives* Biostatistics (applied) SM (60 credits) Biostatistics (applied) Several BIO courses required Environmental Health MOH (42.5 credits) SM (42.5 credits) Health Policy and Management Society, Human Development, and Health SM (80 credits) SM (42.5 credits) SM (80 credits) SM (80 credits) SM (42.5 credits) SM (80 credits) SM (80 credits) SM (80 credits) Occupational Health BIO200 or 201 or 206 & 207 or 208 Environmental and occupational medicine and epidemiology Environmental and occupational medicine and epidemiology Exposure, epidemiology, and Risk Exposure, epidemiology, and risk Dual degree with Simmons: Environmental health and primary health care nursing EPI200 or 201 or 500 EPI201 or 201 or 500 EH201, 202, 232, 270, 278, ID215 EH201, 202, 232, 270, 278, ID215 EPI208 EH201, 202, 232, 270, 278, or ID215 Several EPI courses required EH201, 202, 232, ID215 EPI200 or 208 or ID215 BIO200 or 201 EPI200 or 201 EH201 or 202, ID215 EH201, 202, 241 or 243, 262, ID215, BIO201 EPI200 or 201 EH201, 202, 205, 231, 243, 241, 281, ID215 Health Services Administration 2.5 to 5 credits from list of approved courses* Social and Behavioral Science SHH201 or 281 or approved alternatives* RDS280 or 286 SHH201 or 281 or approved alternatives* RDS280 or 286 SHH201 or 281 or approved alternatives* RDS280 or 286 SHH201 or 281 or approved alternative* EH231 SHH201 or 281 EH231 EH231 BIO201 EPI201 ID215 EH231 or from list of approved courses* BIO201 EPI201 ID215 EH231 or from list of approved courses* BIO201 EPI200 or 201 EH243, 262, 281, 231, 232, 241, ID215 & 263 EH231 Health care management HCM757 HCM757 HCM703 All other credits in HCM Health policy and BIO200 EPI200 or 201 EH201 or approved Minimum of 17.5 management alternatives* credits in HPM courses Dual degree with Simmons: Society, human development, and health and parent-child nursing Society, human development, and health BIO200 EPI200 or 201 EH201, 202, 232, ID215 BIO200 EPI200 EH201, 202, 232, ID credits from list of approved courses* 2.5 credits from list of approved courses* SHH201 or approved alternative* SHH 201 or approved alternative* SHH201 or approved alternative* SHH201 or approved alternative* SHS570 (at Simmons) HCM703 SHH201 or 281 or approved alternatives* SHH201 or 281 Minimum of 20 ordinal credits Harvard School of Public Health Instructional Programs 59

12 Key: MPH Master of public health MOH Master of occupational health SM Master of science Key for course numbers and titles: Biostatistics BIO 200 BIO 201 BIO 202 BIO 203 BIO 206 BIO 207 BIO 208 HCM 757 Principles of Biostatistics Introduction to Statistical Methods Principles of Biostatistics I Principles of Biostatistics II Introductory Statistics for Medical Research Introductory Statistics for Medical Research II Introductory Statistics for Medical Research, Advanced Quality Improvement and Quantitative Methods in Quality Management Environmental Health EH 201 Introduction to Environmental Health EH 202 Principles of Environmental Health EH 205 Human Physiology EH 231 Occupational Health Policy and Administration EH 232 Introduction to Occupational and Environmental Medicine EH 241 Occupational Safety and Injury Prevention EH 243 Ergonomics/Human Factors EH 262 Introduction to the Work Environment EH 263 Analytical Methods and Exposure Assessment EH 270 Environmental Risk Management EH 278 Human Health and Global Environmental Change EH 281 Occupational Health Care Delivery HCM 703 Perspectives in Public Health ID 215 Environmental and Occupational Epidemiology ID 263 Practice of Occupational Health Epidemiology EPI 200 EPI 201 EPI 202 EPI 208 EPI 500 HCM 757 Ethics GHP 293 ID 250 ID 251 ID 292 ID 513 Principles of Epidemiology Introduction to Epidemiology: Methods I Elements of Epidemiologic Research Introduction to Clinical Epidemiology Fundamentals of Epidemiology Quality Improvement and Quantitative Methods in Quality Management Individual and Social Responsibility for Health Ethical Basis of the Practice of Public Health Ethical Basis of the Practice of Public Health: Health Care Delivery Justice and Resource Allocation Ethics and Health Disparities Health Services Administration EH 231 Occupational Health Policy and Administration RDS 280 Decision Analysis for Health and Medical Practices RDS 286 Decision Analysis in Clinical Research Social and Behavioral Sciences ID 540 Life Course Epidemiology SHH 201 Society and Health SHH 281 Methods for Research on Social and Behavioral Dimensions of PH SHH 250 Research on Social and Behavioral Health: A Practical Guide *In some degree programs, students are offered approved options or alternatives for core courses. Alternatives are listed in department student handbooks (Resource Files 2.1.a). Alternative choices must be approved by the process described in 2.3.a. Note: MPH students and SM students in the Department of Health Policy and Management are also required to take one of the following ethics courses: ID250, 251, 292, or 513 or GHP293. Note: Students enrolled in Foundations in Public Health fulfill their requirement for knowledge in the five core areas of public health through this course. Students also need to complete the practice requirement and any ethics requirement as well as any additional courses required by their concentration. Harvard School of Public Instructional Programs 60

13 Core Course Descriptions FY As Listed on the Registrar s Website FOUNDATIONS IN PUBLIC HEALTH COVERING ALL CORE COMPETENCIES ID538 Foundations in Public Health At the completion of this course, students will have developed a professional identity and leadership capabilities for public health practice. They will practice the ability to work collaboratively in groups. In addition, students will demonstrate a basic knowledge of the concepts in the five core disciplines in public health, as well as the skills to analyze, think critically, make and effectively execute decisions. The course will include public health cases that offer students the opportunity to apply skills from several disciplines to real public health issues. The course offers a combination of case study method, lecture, and discussion. Course note: Students must have taken the prescreening quantitative test and have permission of the instructor to register for this course. BIOSTATISTICS CORE COURSE OPTIONS BIO200 Principles of Biostatistics Lectures and laboratory exercises acquaint the student with the basic concepts of biostatistics and their applications and interpretation. The computer is used throughout the course. Topics include descriptive statistics, graphics, diagnostic tests, probability distributions, inference, tests of significance, association, linear and logistic regression, life tables, and survival analysis. Course Note: Credit is given for only one of BIO200, BIO201; this course cannot be counted as part of the credit requirement for a major or minor doctoral field course; this course is restricted to students not eligible for BIO201. Other students allowed with signature of course instructor, if space permits; lab or section times to be announced at first the first class. BIO201 Introduction to Statistical Methods This course covers basic statistical techniques that are important for analyzing data arising from epidemiology, environmental health and biomedical and other public health-related research. Major topics include descriptive statistics, elements of probability, introduction to estimation and hypothesis testing, nonparametric methods, techniques for categorical data, regression analysis, analysis of variance, and elements of study design. Applications are stressed. This course is designed as an alternate to BIO200, for students desiring more emphasis on theoretical developments. Background in algebra and calculus is strongly recommended. Course Note: Credit is given for only one of BIO200 or BIO201; this course cannot be counted as part of the credit requirement for a major or minor doctoral field course; the course is restricted to students enrolled in DBS, EH, EPI, NUT, MPH/QM programs, and SHDH doctoral students. Other students are allowed with signature of course instructor, if space permits; lab or section times are to be announced at the first class. BIO202 Principles of Biostatistics I This course is the first part of introductory biostatistics and acquaints the student with the basic concepts and methods of biostatistics, their applications, and their interpretation. The material covered includes: Data presentation, numerical summary measures, rates and standardization, and life tables. Probability is introduced to quantify uncertainty, especially as it pertains to diagnostic and screening methods. Also covered are sampling distributions so that students may be introduced to confidence intervals and hypothesis testing. The computer is used throughout the course, and the student will gain familiarity with the software package STATA. Course Note: Requires a basic knowledge of mathematics and familiarity with use of personal computers. Students taking BIO202 and BIO203 will not be given credit for BIO200 or BIO201. Harvard School of Public Instructional Programs 61

14 BIO203 Principles of Biostatistics II This course is the second part of introductory biostatistics; it continues to explore inference in greater depth. Lectures and laboratory exercises will emphasize applied data analysis, building upon the fundamentals emphasized in BIO202. Topics covered include the comparison of two means, analysis of variance, non-parametric methods, inference on proportions, contingency tables, multiple 2 2 tables, correlation, simple regression, multiple regression and logistic regression, analysis of survival data, and sampling theory. The computer is used throughout the course, and the student will gain more familiarity with STATA. Course Note: BIO202 is required; students who take BIO202 and BIO203 will not be given credit for BIO200 or BIO201. BIO206 Introductory Statistics for Medical Research The course introduces basic biostatistical techniques with an emphasis on applications to clinical research. Topics include probability and statistics, hypothesis testing, confidence intervals, nonparametrics, and power calculations. Course Note: The course is designed primarily for participants in the Program in Clinical Effectiveness; no auditors. BIO207 Statistics for Medical Research II The course presents additional biostatistical techniques that commonly appear in the analysis of clinical databases and trials. Topics include contingency table analyses, log-rank tests, paired and matched analyses, analysis of variance and multiple comparisons procedures. Course Note: BIO206 is required; no auditors. BIO208 Statistics for Medical Research, Advanced The course presents additional biostatistical techniques that commonly appear in the analysis of clinical databases and trials. This course will move at a faster pace than the alternative BIO207 while covering all of the same topics (contingency tables, log-rank tests, paired and matched analyses, analysis of variance and multiple comparisons procedures). In addition, linear and logistic regression will be introduced. Course Note: BIO206 is required; no auditors. HCM757 Quality Improvement & Quantitative Methods in Quality Management This course in quality improvement and quantitative tools (basic epidemiology and biostatistics techniques) is designed for the physician executive or manager whose responsibilities include either oversight or direct involvement in quality management and improvement in a health delivery or health financing organization. Using selected readings case studies, lecture presentations and extensive classroom discussions, students will learn both the conceptual and practical aspects of improving health care quality. Course Note: Enrollment in the part-time non-residential masters in HCM required; ordinal grading option only. ENVIRONMENTAL HEALTH CORE COURSE OPTIONS EH201 Introduction to Environmental Health This course offers a general introduction to environmental health from local to global, addressing fundamental topics and current controversies. The first half of the course covers core topics that prepare students to more fully understand and address environmental health issues: toxicology, exposure assessment, risk assessment/risk management, air pollution, water pollution, and the built environment/urban sprawl. Using the tools from the first half, students then learn about: occupational health, children's health and the environment, injuries, climate change and health, environmental law and policies, debates concerning pesticide use, and environmental justice. Students actively engage with the course material through in-class, and on-line case discussions, debates, and review of environmentrelated current events. This course provides an excellent introductory foundation in environmental health for all professional master's degree candidates, whether or not specializing in environmental health. The course fulfills the environmental health requirement for all professional master's degree programs. Harvard School of Public Instructional Programs 62

15 EH202 Principles of Environmental Health This course focuses on analytic methods for assessing environmental exposures and hazards. It is directed at first year environmental health graduate students and MPH students with basic knowledge of environmental health or who have taken EH201. It is designed for students desiring more emphasis on quantitative approaches, and can be used as a sequel to EH201 or as a substitute for EH201 for those with sufficient background. Students will learn methods for quantitative evaluation and public health responses to environmental hazards through lectures, problem solving, and case studies. The course is structured around specific tools including exposure assessment, epidemiology, toxicology and pathophysiology, risk assessment, life cycle analysis, and environmental policy. EH205 Human Physiology As an introduction to the principles governing function in the human body, this course is designed to provide a framework in physiology for future public health researchers and professionals who have not taken college level physiology courses. Emphasis is placed on the concept of homeostasis and on integrative aspects of physiology. Examples of pathophysiology and environmental physiology will highlight these processes. Course Note: College-level introductory biology or permission of instructor required. EH231 Occupational Health Policy and Administration This course examines the legal, regulatory and economic foundations of occupational health activities in the US. We discuss the roles of government, unions, corporations, and research organizations. Helps students acquire an understanding of management functions in corporations. Course Note: Students develop the necessary knowledge and skills in the above areas to apply medicolegal and risk management principles to achieve a healthful workplace. EH232 Introduction to Occupational and Environmental Medicine Overview of occupational and environmental medicine including: The diagnosis and management of illnesses following exposure to specific workplace substances, environmental and community hazards, such as asbestos, lead, organic solvents, and vibration; methods of diagnosis of early organ system effects of chemicals and techniques for assessing impairment and disability; as well as, medico legal aspects of occupational health. Course Prerequisites: This is a clinical and preventive medicine course. The material is taught at a postgraduate level, and a medical or allied health background is required. The majority of students will be physicians, nurses, dentists, pharmacists and students in those fields. Persons without prior biomedical training may NOT take the class for an ordinal grade. Such students are welcome to audit the class. In certain exceptions, if discussed with the instructors, such students may be granted permission by the instructors to take the course on a pass/fail basis. Course Note: Basic course in toxicology recommended; instructor's signature required if student has not completed prerequisites. EH241 Occupational Safety and Injury Prevention This course in occupational safety works towards the prevention of work-related injury and illnesses through proactive management and control of workplace hazards. The primary objectives of the course are to: (1) identify fundamental workplace hazards, (2) develop a basis of basic government and voluntary regulations, (3) understand issues pertaining to specific and different industries, and (4) understand various safety management programs. EH243 Ergonomics/Human Factors Occupational ergonomics applies the fundamental science and theories of epidemiology, physiology, biomechanics, and psychology, to name a few, to the design and implementation of physical environments with the goal of optimizing system performance and human well-being. Within the public health framework, ergonomics focuses on the prevention of work-related musculoskeletal disorders, injury and disability, especially those associates with lifting and repetitive tasks. Prevention efforts will focus on redesigning of sick jobs and a systematic and process approach to physical ergonomics programs. Harvard School of Public Instructional Programs 63

16 EH262 Introduction to the Work Environment The course comprises introductory lectures and discussions on key aspects of industrial hygiene and occupational health covering recognition, evaluation and control of health hazards at work. Consideration is given to chemical, physical and biological hazards, and the criteria for the evaluation of each. Course Note: While intended primarily for students planning a career in occupational health, this course provides basic background to the subject for students studying environmental issues and is strongly recommended for students intending to take ID263. EH263 Analytical Methods and Exposure Assessment This course will examine methodological issues associated with the design and execution of studies designed to measure environmental exposure to chemical and biological contaminants. The first half of the course will be lecture based, and will address topics such as: Study design issues, implementation of quality control/ quality assurance programs, data analysis, protocols for sampling air, water, sediments, and soil for contaminants of concern, and analytical techniques used to measure chemical and biological constituents in the laboratory. During the second half of the semester, groups of students will design and execute their own field investigation using these techniques. The design and results of these projects are presented in class. Course Note: Signature of instructor required for students not in the Exposure, Epidemiology and Risk Program. EH270 Environmental Risk Management Students will learn the skill of using problem solving tools for dealing with environment, health and safety problems and managing the associated environmental risks. A number of tools are presented within a systems approach. These tools are widely used by industries and governmental organizations throughout the world. The student should be prepared to use these skills in team environments once they graduate from Harvard. Means of measuring progress and managing programs using the systems approach will be presented and discussed. Course Note: Ordinal grading only. EH278 Human Health and Global Environmental Change Human activity is changing the atmosphere and altering terrestrial and marine ecosystems on a global scale for the first time in history. Evidence is mounting that these changes may already be having serious effects on human health, and there is growing concern that in coming decades the effects could be catastrophic. This course will provide an overview of the basic physics, chemistry, and biology of global environmental change, and of the potential consequences of these changes for human health. It will cover global climate change, stratospheric ozone depletion, the effects of toxic substance pollution on global ecosystems, the degradation of terrestrial and marine environments, the loss of species and biodiversity, and the impact of these factors on human health. The role of rapidly growing human populations and of patterns of resource use and waste disposal in the genesis of environmental change will be examined. A multi-disciplinary faculty will provide an integrated assessment of these issues. The course will be open to all students at Harvard University, but preference will be given to students from HSPH, HMS, and KSG. Course Note: This course may be taken for either 5.0 credits or 2.5 credits. EH281 Occupational Health Care Delivery This course provides a broad foundation for evaluating the health care needs of employees, including both work-related issues and general health promotion. Through seminar discussions and field experiences, the participants consider the many frames for thinking about worker health, such as the perspectives of employees, managers, companies, insurers, health care providers and labor groups. The goal of this class is to develop a sensible approach to the assessment, planning and evaluation of employee health programs. The class offers individuals who are interested in workers' health care policy and economics, the opportunity to come together in discussion and purpose to propose innovation in the current system of employee health care. Harvard School of Public Instructional Programs 64

17 HCM703 Perspectives in Public Health This course will use case studies focusing on important public health issues, such as smoking, gun violence and HIV prevention and treatment, to give students a sense of the complex environmental, social, and behavioral causes affecting the health of populations. It also explores a variety of analytical perspectives; political, legal, economic and epidemiological. Students will submit a short discussion memo and a longer paper analyzing a public health issue of their choice from various points of view. Course Note: Enrollment in the part-time, non-residential masters in Health Care Management program required. Ordinal grading option only. ID215 Environmental and Occupational Epidemiology This course examines application of epidemiologic methods to environmental and occupational health problems. Objectives are to review methods used in evaluating the health effects of physical and chemical agents in the environment, to review available evidence on the health effects of such exposures, and to consider policy questions raised by the scientific evidence. Topics include lectures on methodology, seminars on the review and criticism of current literature, and presentations by outside experts on specific environmental and occupational health issues of current interest. Course Note: EPI200, 201, 208 or 500 AND BIO200, 201, 202 or 206 are required (concurrent enrollment permitted). ID263 Practice of Occupational Health This course focuses on the assessment of workplace hazards, the physiology and biomechanical aspects of work, and a practical problem-solving approach to health problems in various work settings. It emphasizes the relationship between working conditions and health, with special reference to the recognition, measurement, and control of occupational hazards. Course Note: EH262 recommended; signature of instructor required; no auditors. EPIDEMIOLOGY CORE COURSE OPTIONS EPI200 Principles of Epidemiology This course introduces the basic principles and methods of epidemiology. Lectures are complemented by seminars devoted to exercises or to the discussion of current examples of epidemiologic studies. Course Note: Thursday or Friday lab required. Credit is not given for more than one of EPI200, EPI201, EPI208, or EPI500. EPI201 Introduction to Epidemiology: Methods I The course introduces the principles and methods used in epidemiologic research. The course discusses the conceptual and practical issues encountered in the design and analysis of epidemiologic studies for description and causal inference. The final exam requires the application of the learned skills to a real problem in epidemiology. EPI201 is the first course in the series of methods courses designed for students majoring in epidemiology or biostatistics, and those interested in a detailed introduction to the design and conduct of epidemiologic studies. Students who take EPI201 are expected to take EPI202 (Methods II). Course Note: Thursday or Friday lab required. Credit is not given for more than one of EPI200, EPI201, EPI208, or EPI500; ordinal grading option only; no auditors. EPI202 Elements of Epidemiologic Research: Methods II This course Introduces elements of study design, data analysis and inference in epidemiologic research. Principles and methods are illustrated with examples, and reviewed through homework and in-class exercises. The course serves as an introduction to more advanced study or as a concluding course for those desiring a working knowledge of epidemiologic methods. Course Note: EPI201, EPI500, or EPI208 are required. This course is intended to by taken in conjunction with EPI201 to complete the equivalent of a full semester course in Epidemiologic Methods. BIO201, or BIO202 and 203; or BIO206 and BIO207, BIO208 or BIO209 required. Concurrent enrollment is permitted. Thursday or Friday lab; sign up for the appropriate section at first class meeting. Harvard School of Public Instructional Programs 65

18 EPI208 Introduction to Clinical Epidemiology This course is an introductory-level course and covers the principles and methods used in traditional and clinical epidemiologic research through a series of lectures, exercises, seminars, workshops and presentations. This course is targeted at individuals planning to conduct clinical research. Course Activities: Written assignments, computer exercises, seminar discussion; each student is required to develop a study proposal that addresses a specific clinical problem and to formally present this proposal to the class. These proposals are then written in grant application format as the final paper for the course. Seminars are held during scheduled class time. Course Note: For participants in the Summer Program in Clinical Effectiveness only; no auditors. EPI500 Fundamentals of Epidemiology This course will provide an to epidemiology as a basic science for public health and clinical medicine. It will address the principles of the quantitative approach to clinical and public health problems. The course will discuss measure of frequency and association, introduce the design and validity of epidemiologic research, and give an overview of data analysis. This course is an introduction to the skills needed by public health professionals and clinicians to interpret critically the epidemiologic literature. It will provide students with the principles and practical experience needed to initiate the development of these skills. Lectures are complemented by seminars devoted to case studies, exercises, or critique of current examples of epidemiologic studies. Course Note: No auditors HCM757 Quality Improvement & Quantitative Methods in Quality Management This course in quality improvement and quantitative tools (basic epidemiology and biostatistics knowledge) is designed for the physician executive or manager whose responsibilities include either oversight or direct involvement in quality management and improvement in a health delivery or health financing organization. Using selected readings case studies, lecture presentations and extensive classroom discussions, students will learn both the conceptual and practical aspects of improving health care quality. Course Note: Enrollment in part-time non-residential masters in HCM required; ordinal grading option only. ETHICS CORE COURSE OPTIONS GHP293 Individual and Social Responsibility for Health The concept of responsibility for health plays a key role in health policy, but it is rarely articulated or evaluated. In this course, students will consider alternative understandings of assignments of responsibility for health to individuals, the state, the family, communities, nonprofit and for-profit firms, and other entities. They will identify their occurrences in health policy debates, assess the cogency of their use in ethical arguments in health policy, and trace the policy consequences of their normative analyses. The course will also serve as an introduction to ethical perspectives on public health. ID250 Ethical Basis of the Practice of Public Health This course provides students with a broad overview of some of the main philosophical and moral ideas that are used as a basis for resolving debates of public health policy. Helps students develop their own capacities to analyze, criticize, evaluate, and construct policy-oriented arguments. Course Note: Instructor's signature required, if the student has not completed the prerequisite. ID251 Ethical Basis of the Practice of Public Health: Health Care Delivery This course is intended to provide physicians and public health professionals with an understanding of how politics, economic concerns, law, and ethics interact in health care policy decisions in the US. It also explores these issues internationally through a human rights framework. Through discussion of legal cases and articles from the medical and ethics literature, the course will explore topics such as informed consent, rights to health, rationing, personal responsibility for health, and fetal abuse. Harvard School of Public Instructional Programs 66

19 ID292 Justice and Resource Allocation This course explores the ethical issues, especially issues of distributive justice, raised by health and health care resource allocation methodologies and decisions. We begin with examination of distributive issues raised by measures of summary population health and their extensions into cost effectiveness analysis, paying special attention to the strengths and weaknesses of the underlying welfare economic and utilitarian assumptions. Philosophical and empirical efforts to clarify an individual s beliefs about these distributive issues and our commitments to them will also be discussed. The course will then turn to recent efforts to make health inequalities and inequities a focus of priority in resource allocation, examining both conceptual and moral issues raised by different approaches to such inequalities and by the fact that the distribution of health is so significantly affected by non-health sector factors. Students take up two problems of cross-cutting interest, the different concern shown for identified versus statistical victims, and emerging issues about intergenerational equity concerning the elderly and young. Finally, we turn to fair decision process as a way of resolving disputes about allocation. The goal of the course is to equip students with the ethical basis for addressing resource allocation issues in practical public health contexts, and throughout the course there is a focus on real cases where controversy surrounds such decisions. ID513 Ethics and Health Disparities When is an inequality in health status an injustice or inequity? This course examines various aspects of this issue, bringing appropriate perspectives from ethical theories (utilitarian, libertarian, liberal egalitarian, feminist) to bear on case studies revealing a range of important health disparities. Four main cases will be discussed, each focusing on a central type of health disparity: US racial disparities, class disparities, gender disparities in a developing country setting, and global health inequalities. Key questions to be pursued in each case include: When is an inequality in health between this type of demographic variable unjust? When is a policy that produces, or fails to address, such an inequality race-, gender-, or classbiased in a morally objectionable way? What ethical issues are raised by different methods of measuring health inequalities? How does ascription of responsibility for health affect the fairness of health inequalities? What kinds of obligations exist to address health inequalities across national boundaries? What ethical issues are raised by policy approaches to addressing health inequalities and giving priority to reducing them? HEALTH SERVICES ADMINISTRATION CORE COURSE OPTIONS EH231 Occupational Health Policy and Administration The course examines the legal, regulatory and economic foundations of occupational health activities in the US. We discuss the roles of government, unions, corporations, and research organizations. The course helps students acquire an understanding of management functions in corporations. Course Activities: Students develop the necessary knowledge and skills in the above areas to apply medico-legal and risk management principles to achieve a healthful workplace. GHP211 Management Control of Health Organizations This course is designed for students interested in learning about finance and management of health care in low and middle income countries. The focus will be on the development of knowledge and skills that are needed by managers of health care organizations in a variety of settings. It will cover a broad range of topics including cost analysis, budgeting and control, financial analysis, revenue generation, and performance monitoring. While some theory will be presented, this course will emphasize practical applications of the techniques discussed through the use of the case study method. Although no prior education in financial or managerial accounting is required to take this course, students without any prior training will be expected to do extra work to learn the basics of financial accounting. Course Note: Students who have or are taking HPM219 or HPM220 may not take this course for credit. GHP244 Health Sector Reform: A Worldwide Perspective This course surveys the impact of the global movement to reform national health care systems in the lower and middle income countries. It introduces a framework for analyzing health care systems and designing strategies for system reform, including political dimensions, with specific references to Harvard School of Public Instructional Programs 67

20 developing countries. It then examines some of the major elements of reform strategies as they are being applied in these countries, including goal-setting, financing, the organization of health care and the role of the private health sector, governmental reform, regulation, and change in consumer behavior. Studies and case material from many different countries are used. GHP269 Applied Politics and Economics I The course presents theoretical perspectives, empirical cases and research issues in policy analysis, political economy, political strategies and governance in international health. Focus is on analytical and methodological issues as applied to international health policy. We examine the political economy constraints on national and international health initiatives, the role of international agencies, the impact of non-governmental organizations, and the role of the state. HPM206 Economic Analysis This course is designed to bring students to an intermediate-level understanding of microeconomic theory. It emphasizes the uses and limitations of the economic approach, with applications to public health. HPM209 Economics for Health Policy Students will learn how to analyze important health policy issues through the application of basic economic principles. No previous economics training is required. The course will begin with an introduction to the US health care "system" because we will be using examples drawn almost exclusively from the American context. The concepts we will be learning, however, are widely generalizable and students whose interests and experiences extend beyond the US are welcomed. Among the topics we will discuss are health insurance coverage, benefit design, physician payment incentives, public reporting of quality information, and the pharmaceutical industry. HPM219 Financial Transactions and Analysis This intensive course introduces concepts of financial accounting for the non-accountant user of financial information. Basic accounting transactions, statement preparation, concepts of accrual vs. cash accounting, and nonprofit healthcare accounting are presented in the first half of the course. The second half focuses on statement analysis in a variety of health care organizations. Course Note: Course restricted to students enrolled in MPH/CMP and MS2/HPM programs. Other students allowed with signature of course instructor, if space permits; Completion of Robert Anthony's Essentials of Accounting before class begins required. Working ability with spreadsheets is also required. HPM220 Financial Management and Control The course is designed to introduce students to cost accounting and management control concepts and uses for health service organizations. The first part of the course develops a basic knowledge of cost accounting, including full and differential costing techniques. The remainder of the course focuses on management control structure and process and addresses topics such as responsibility accounting, budgeting, reporting and variance analysis. Course Note: HPM 219 is recommended but not required. HPM232 Operations Management in Service Delivery Organizations Operations management is concerned with evaluating the performance of operating units, understanding why they perform as they do, designing new or improved operating procedures and systems for competitive advantage, making short-run and long-run decisions that affect operations, and managing the work force. To understand the role of operations in any organization, a manager must understand: process analysis, capacity analysis, types of processes, productivity analysis, and the role of operating strategy in corporate strategy. Case studies will be used to introduce students to a wide range of practical operational issues in healthcare delivery. Students will also be introduced to a new variability based methodology and to the quantitative techniques to reduce cost while maintaining or even improving quality of care. Problem oriented software will be used for some of these scenarios. Harvard School of Public Instructional Programs 68

21 HPM235 Managing Health Care Costs This course will use lectures, case studies and a simulation to examine the major factors that determine the cost of health care in the US, and the impact of these forces on system stakeholders. We will review the fundamentals of managed care, with a focus on some of the practical challenges and major public policy issues that arose with the growth and decline of managed care. We will review the advantages, disadvantages and feasibility of different approaches to moderating rising costs, including benefit design, medical management, utilization review, provider profiling and reporting, and regulatory action. We will also review efforts to improve health care affordability in other countries. Students will be encouraged to develop their own critical assessment of the prospects of using these techniques to control health care spending and to improve access and quality of care. A number of guest speakers will provide a first-hand perspective on some topics. HPM253 Improving Quality in Health Care This course is designed for practicing physicians and those with an interest in health care management. It will explore both the theory and practical methods being employed to make improvement in health systems. Clinical cases, organizational lessons and interactive learning modules will guide the learners to an understanding of the necessary elements for improvement and how to identify and eliminate barriers to change. HPM277 Current Issues in Health Policy Current Issues in Health Policy introduces students to the major health policy issues facing the US today. The course focuses on the roles of hospitals, doctors, private and government insurance, and different systems for organizing and financing care (such as traditional fee-for-services, HMOs, and other forms of "managed care"). Individual sessions in the course will be devoted to topics such as malpractice, policy issues related to pharmacologic therapy, physician payment, academic health centers, workforce, physician profiling, managed care, the uninsured, Medicare, and Medicaid. The course will provide insight into how and why particular health policies are developed. It will focus on what the major policy questions are, and present examples of health services research methodology. However, the course concentrates much more on policy questions than methodological techniques. HPM510 Introduction to Management of Health Care Organizations This course provides an introduction to two of the major tasks confronting managers of health care organizations. Building on an introduction to organizational theory, the course focuses on the main problems of organizational strategy and the management of human resources. This course makes extensive use of case based classroom discussions, as well as selected conceptual readings. HPM516 Health Care: Quality Improvement This course explores the theories and methods of quality improvement with a focus on strategies for changing the practices of physicians and organizations. Topics include rapid cycle change, overuse, underuse and misuse of health care services, traditional quality improvement techniques such as regulation, credentialing, education, and new techniques including: Continuous quality improvement, organizational learning, systems design, managed care, practice guidelines, information systems, performance reports, and payment incentives. Course Note: The instructors will emphasize and expect active participation in class discussions. ID242 Policies and Strategies for Changes in Health Policy This is a course for public health professionals who want their work to have a real impact on health policy decision-making. You will learn how to develop political strategies for influencing health care policy, and how political analysis can improve health policy research and its implementation at the national, state and local levels. Topics include political strategy; lobbying and special interest groups; the media and public opinion; campaigns, elections, and health policy; building coalitions; and grass roots advocacy. RDS280 Decision Analysis for Health and Medical Practices This course is designed to introduce the student to the methods and growing range of applications of decision analysis and cost-effectiveness analysis in health care technology assessment, medical decision making, and health resource allocation. The objectives of the course are: (1) to provide a technical Harvard School of Public Instructional Programs 69

22 understanding of the methods used, (2) to give the student an appreciation of the practical problems in applying these methods to the evaluation of clinical interventions and public health policies, and (3) to give the student an appreciation of the uses and limitations of these methods in decision making at the individual, organizational, and policy level both in developed and developing countries. Course Note: An introductory course in probability and statistics is required; BIO200, BIO201, or BIO203 may be taken concurrently; introductory economics is recommended but not required. RDS286 Decision Analysis in Clinical Research Introduces the following topics: decision analysis methods relevant to clinical decision making and clinical research; the use of probability to express uncertainty; Bayes theorem and evaluation of diagnostic test strategies; sensitivity analysis; utility theory and its use to express patient preferences for health outcomes; cost-effectiveness analysis in clinical research and health policy; and uses and limits of decision analysis and cost-effectiveness in clinical decision making and research design. Course Note: Limited enrollment; priority will be given to participants in the Summer Program in Clinical Effectiveness. SOCIAL AND BEHAVIORAL SCIENCES CORE COURSE OPTIONS ID540 Life Course Epidemiology The field of life course epidemiology approaches disease etiology and prevention from the perspective of dynamic risk and protective factors that impact health throughout the human lifespan. Research in the area of life course epidemiology ranges from investigating the fetal and early childhood origins of adult health and disease to understanding how risk and protective processes influence health within specific developmental periods and between them. There are two major themes that will be covered in this course. The first theme, Applications in Life Course Epidemiology, introduces students to the application of life course theories and methods to specific public health problems (e.g., chronic disease, mental health, health disparities). The second theme, Methods in Life Course Epidemiology, introduces the major concepts and methodological challenges in investigating disease risks longitudinally, covering topics such as exposure assessment, analytic methods, and causal inference. Course Note: EPI200 or EPI201 and BIO200 or 201, or ID538 required; no auditors. SHH201 Society and Health During the course we analyze major social variables that affect population health: Poverty, social class, gender, race, family, community, work, behavioral risks, and coping resources. We examine health consequences of social and economic policies, and the potential role of specific social interventions. We review empirical and theoretical literature on mechanisms and processes that mediate between social factors and their health effects, and discuss alternative models for advancing public health. Course Note: Departmental requirement in the Department of Society, Human Development and Health. SHH250 Research on Social and Behavioral Health: A Practical Guide This course is an introduction to research methods that are important to designing, conducting, and evaluating research that involves the assessment of social or behavioral aspects of health. The course will cover study design, measurement, data collection, and analytic issues that are important to this area of public health research. Because surveys are an important tool for social and behavioral research, a major component of this course will focus on survey design and administration. The course will present introductory level research methods and survey design with a focus on practical applications. Students will critique published studies that examine specific aspects of social and behavioral health. Students will be expected to prepare a brief proposal for a study of an aspect of social/ behavioral health that uses a survey instrument, and draft the corresponding survey instrument. SHH281 Methods for Research on Social and Behavioral Dimensions of Public Health The course introduces methodology to explore fundamental social and behavioral science concepts and theories useful in understanding social influences on health status. The course emphasizes quantitative research methods in social sciences applied to social and behavioral issues in public health research. Harvard School of Public Instructional Programs 70

23 Major attention is given to methodology from sociology and psychology in their application to public health problems. Course Note: Departmental requirement for SHDH masters students. Specifically geared to SHDH students in the MPH and other professional master's degree programs; students must register for course section with lab meeting time appropriate for their schedule. No auditors. Harvard School of Public Instructional Programs 71

24 PRACTICAL SKILLS 2.4.a. Description of the school's policies and procedures regarding practice experiences, including selection of sites, methods for approving preceptors, approaches for faculty supervision of students, means of evaluating practice placement sites and preceptor qualifications, and criteria for waiving the experience. HSPH believes that experiences beyond the classroom are an essential part of public health education. Practice placements and internships enable students to apply the skills they are learning in their coursework; help them develop practical skills, experience, and connections to achieve their goals; allow them to gain a deeper understanding of public health in practice; and inspire them to take actions that make a difference in public health. All of the school s professional degree programs require some type of practice experience, and all students in these programs are subject to this practice requirement; no waivers are permitted. The school s policies and procedures regarding these practice experience have traditionally been department and degree specific. The HSPH practice guidelines are available to all students on the practice website at nes/index.html and are provided in Resource File 2.4.a. Specific program or department requirements are listed in the student handbooks available in Resource File 2.1.a. Acceptable practice placements should achieve the following: Require the student to apply graduate level skills and competencies acquired in his/her degree program ( i.e., has "rigor") Address a practical/applied issue or problem in a "real world" setting Address a problem or issue likely to be encountered in the practice of public health Advance the student's skills and knowledge Focus on specific projects and deliverables Be manageable in terms of the student's time, skills, and knowledge Have a preceptor who has the appropriate education and training to oversee the project, is willing to agree to the responsibilities described in the project agreement, and is approved by the instructor Enhance the career potential and professional development of the student. Beyond these general guidelines, each of the professional degree programs has its own process for selection and approval of practice sites, approval of preceptors, approach towards faculty supervision of students, and means and criteria for student assessment. Each student practicum is approved by the instructor of the relevant practice course for each degree program. Most students complete their required practice placement during the academic year, as part of a required practice and culminating experience course for their degree program, although some students engage in practice during the summer. For practice placements during the academic year, students are generally expected to work at an approved practice site a minimum of eight to ten hours per week for one or two semesters in accordance with their program's requirements. In addition to the on-site work, students meet on a regular basis with the instructor of their practice course, along with other students. The practice course instructor is responsible for approving proposed practice placements. This process includes reviewing and approving a written practice placement agreement that must also be signed by the student and the practice preceptor. As part of this agreement (see Resource File 2.4.a.), the preceptor consents to be responsible for the following: Developing a realistic project scope and work schedule with the student Orient the student to the organization and project Harvard School of Public Instructional Programs 72

25 Be available on a regular basis to meet with and supervise the student and to provide performance feedback Provide resources needed to complete the project (e.g., work space, computer, administrative support, access to data) Provide written feedback to the student and the school by completing the placement evaluation form (see Resource File 2.4.a) Agree to assist in the student's professional development activities (e.g., meet leaders of the organization, attend meetings during the practice placement, conduct informational interviews) Any practice project involving research on human subjects or analysis of identifiable data from human subjects may require pre-approval by the HSPH Institutional Review Board (IRB). Students are required to consult the IRB guidelines for research and discuss with their practice course instructor whether their project may require approval. Most practice courses require students to produce a final written project report and to give an oral presentation during the practice course. The course instructor for each practice course is responsible for evaluating the student's practice placement project. Some courses require other assignments, including reflective memoranda and/or self-assessments. At the completion of the practice course, students are required to provide information to the Office for Educational Programs (OEP) regarding their practice placements, including an evaluation of the experience and practice site. The HSPH practice courses and instructors are listed in Table 2.4.a. Table 2.4.a. Practice Course Descriptions Academic Year Department Course Number Current Instructor(s) Biostatistics SM (60 credits) Collaborative Research Practicum (not a course, rather done as individual advising for no more than 10 students) Wypij, biostatistics faculty Environmental Health MPH OEH ID263 Practice of Occupational Health Smith, Herrick, Stewart SM2 EOME ID263 Practice of Occupational Health Smith, Herrick, Stewart Epidemiology Global Health SM2 EER MPH CLE MPH QM MPH GH EH507 Environmental Exposure, Epidemiology and Risk Practicum EPI242 Seminar in Applied Research in Clinical Epidemiology (2 semesters) or ID270 MPH Practicum & Culminating Experience for QM (summer only) ID265 Practice of Quantitative Methods or ID270 MPH Practicum & Culminating Experience for QM (summer only) ID262 Intro to the Practice of Global Health or GHP272 Foundations of Global Population and Health and ID519 Culminating Experience: MPH- IH Thesis Laden, Levy, Herrick Cook/Orav Testa Testa, Simonson Testa Cash Bloom, Lamstein Cash, Bruderlein, Leaning Harvard School of Public Instructional Programs 73

26 Table 2.4.a. Practice Course Descriptions Academic Year (continued) Department Course Number Current Instructor(s) Health Policy & Management MPH CMP & LPH SM HCM SM2 HPM Society, Human Development & Health MPH-FCH SM2 ID261 Practice of Health Care Management & Policy HCM758 Field Project in Quality Improvement HCM707 Practical Field Projects HPM290 Applied Research & Practice in Health Policy & Management (full year) ID506 Theory & Practice of Public Health in the U.S. and ID264 Practice of Family and Community Health SHH259 SHDH Masters Seminar SHH294 Practicum Project Planning & Evaluation Kasten, Hager Silobrcic and Kane Soodalter-Toman Turnbull Connolly Gottlieb Kawachi Silverman The school is in the process of developing and implementing more centralized supports for, and oversight of, required student practice experiences, through the OEP. This change is being undertaken to achieve greater consistency in the goals and expectations for student practice as well as in the quality and rigor of student practice experiences across degree programs, to develop more systematic ways to help students find relevant and meaningful practice placements, to strengthen the school s relationship with practice sites, and to provide better supports to prepare students for practice, including greater coordination and integration between the practice courses and the resources and activities of the school s Career Services Office (CSO) and the Division of Public Health Practice (DPHP). The director of practice, a newly created position, is leading this initiative and working in close partnership with the DPHP and CSO on these activities. The school looks forward to sharing its progress in these areas during the September accreditation visit. 2.4.b Identification of agencies and preceptors used for practice experiences for students, by program area, for the last two academic years. The OEP collects information about placement sites, projects, and preceptors for required practice experiences by degree program. Information for the last two academic years is provided in Appendix 2.4.b. 2.4.c Data on the number of students receiving a waiver of the practice experience for each of the last three years. There have been no waivers granted for the practice experience in the last three years. The school s position is that there is no circumstance under which a student would be exempt from the practice experience. Harvard School of Public Instructional Programs 74

27 2.4.d Data on the number of preventive medicine, occupational medicine, aerospace medicine, and public health and general preventive medicine residents completing the academic program for each of the last three years, along with information on their practicum rotations. The only program offered by the school among those listed in this criterion is the occupational and environmental medicine residency (OEMR) program. The OEMR program is accredited by the Accreditation Council for Graduate Medical Education (ACGME) as a two-year training program for physicians leading to board eligibility in occupational and environmental medicine (one of the three specialties of preventive medicine). The program was reaccredited for five years in March Table 2.4.d. Number of Occupational and Environmental Medicine Residents Completing the Program AY2006 AY2007 AY2008 Number of OEMR graduates The general objective of the program is to provide a firm grounding in disciplines essential to the practice of OEM, including the five core areas of public health. The first year consists of full-time coursework at HSPH leading up to the awarding of the MPH (or MOH) degree with a concentration in occupational and environmental health (see MPH and MOH core course requirements in Table 2.3.a and OEM competencies in Appendix Table 2.6.c). The second year of the OEMR consists of clinical rotations at affiliated and corporate occupational/environmental health clinics; experiences at the Massachusetts Department of Public Health; elective rotations and experiences; and research leading to a final presentation and paper of publication quality. During both years of the program, students are required to attend seminars in occupational/environmental health research, grand rounds, journal club, and board review sessions. As indicated above, residents in the second year of the program rotate through hospital-based occupational medicine clinics, corporate occupational medical settings, and other interdisciplinary practicum sites, where they evaluate individual patients with disease and illness related to occupational and/or environmental exposures; conduct worksite inspections and surveys; perform literature searches and reviews related to diseases and exposures of interest; participate in organizational activities and learn corporate organizational behavior; become knowledgeable in disability issues, workers compensation, and legal testimony; and conduct short-term research projects. Four off-site rotations are required for each resident during the course of the practicum year. The rotations run for an average of two and one-half to three days per week for a period of two to four months. Each resident is supervised by a rotation site preceptor who generally has only a single resident supervisee, enabling close supervision and mentorship. Residents spend the remainder of their time working on their research projects under the supervision of their faculty research advisor. Recent rotation sites include the following: Cambridge Health Alliance (three months): Residents learn about occupational medicine and rehabilitation for occupationally exposed patients with work-related illness, disease, or disability. Supervision in this clinical setting is provided by three physicians, as well as nurses and rehabilitation staff. Fallon Clinic (two to four months): This rotation includes both an in-plant industrial medical service and a clinic-based occupational health service, which provide routine and complex Harvard School of Public Instructional Programs 75

28 consulting services as well as comprehensive occupational health management programs. Residents work with patients in a busy occupational clinical practice, seeing as many as thirty patients per day under the supervision of the preceptor. Massachusetts Department of Public Health (duration dependent on project): This rotation is intended to broaden public health perspectives and provide experience in public health practice, allowing residents to apply knowledge and skills learned in courses. The rotation provides surveillance of selected work-related illnesses and injuries, including fatal occupational injuries, occupational lead poisoning, sharps injuries in hospitals, work-related asthma, acute chemical poisonings, and work-related injuries to youth. Data are used to describe work-related injuries and illnesses of Massachusetts workers, target intervention efforts in Massachusetts, and promote prevention. Massachusetts General Hospital, Occupational Medicine Clinic/Employee Health Service/ Pulmonary Unit (two months): Residents see scheduled and walk-in patients with preceptors and nurse practitioners and review records regarding the occupational health of hospital employees who work across the spectrum of clinical and basic science research settings. Treatment at the clinic includes medical monitoring for work-related exposures, treatment of work-related infectious diseases, immunizations, driver physicals, hearing conservation examinations, and other safety and prevention programs. New England Baptist Hospital, Occupational and Environmental Health Network (three to four months): Under supervision of a preceptor and affiliated staff, residents are assigned patients requiring treatment or management of work-related injury and illness as well as those needing preventive occupational health services. The rotation offers residents a wide range of clinical and worksite experiences in a large hospital network environment, including a strong focus on diagnosis and treatment of orthopedic injuries and pain; worksite visits; and corporate medicine experience. Residents interact with multiple physicians, occupational health nurses, and therapists. Tufts Medical Center, Travel Clinic (two months): Under the supervision of a preceptor and affiliated staff, residents gain experience in the epidemiology of travel-related illnesses and injuries in different regions of the world. They develop clinical skills in performing pre-travel risk assessment; review indications, adverse effects, and geographical regions for which different vaccinations are recommended for travelers; evaluate travelers risk for malarial infection based on the travel itinerary; and prescribe and counsel protective measures. United States National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (two to four months): The rotation provides residents with experience in the practice of environmental medicine and public health in the operational context of a federal public health agency. The resident is assigned by the preceptor to one of the divisions based upon the interest of the resident, project opportunities, and availability of supervision and mentorship. United States National Institute for Occupational Safety and Health, Health Hazard Evaluation Program (two to three months): Residents spend time in the Hazard Evaluations and Technical Assistance Branch offices in Cincinnati, Ohio. Residents participate in the evaluation of known or suspected occupational health hazards in workplaces throughout the United States. They also respond to written or telephone inquires sent to the National Institute for Occupational Safety and Health (NIOSH) and attend NIOSH seminars. United States Department of Labor (OSHA) Office of Occupational Medicine (2 months): Under the supervision of staff occupational medicine physicians, residents participate in all aspects of the office s activities, which deal with health and safety standards, compliance directives, and guidelines. They participate in answering inquiries from professionals and the public concerning occupational health-related issues and OSHA inspection. Harvard School of Public Instructional Programs 76

29 2.4.e Assessment of the extent to which this criterion is met. All students in professional master s degree programs, including residents in occupational and environmental medicine, engage in substantial practice experiences that are tailored to their needs and career interests. While the school has made great progress in formalizing its practice requirements since the last selfstudy, some challenges remain. First, while decentralized management of the practice requirement by individual departments and programs has many advantages, it leads to lack of consistent standards and quality of practice experiences in some areas. In addition, finding appropriate placements for international students and students who want international practice experiences can be difficult. As noted above, the school is developing more centralized supports to help students find placements and prepare for practice. This criterion is met. Harvard School of Public Instructional Programs 77

30 CULMINATING EPERIENCE 2.5.a. Identification of the culminating experience required for each degree program. If this is common across the school's professional degree programs, it need be described only once. If it varies by degree or program area, sufficient information must be provided to assess compliance by each program. There is no single culminating experience designed for all students in the professional master s degree programs at HSPH. Rather, each program/department formulates its own requirements. The culminating experiences required of academic master s degree students and doctoral students are described in Section 2.9.c. Master of public health (MPH) program The culminating experience for each of the seven concentrations varies in order to focus on training relevant to the concentration. While students in each concentration must fulfill a common core, the culminating experiences are designed to integrate knowledge acquired within a particular concentration as well as in the five core areas. It is expected that each of these culminating experiences will, as specified in the interpretation statement for this criterion, synthesize and integrate knowledge gained in coursework with an applied situation that approximates some aspect of professional experience appropriate to the competencies of the concentration and the core. MPH culminating experiences designed to measure proficiency in each of the specialty area competencies are listed in Table 2.5.a below. Professional master of science (SM) degrees In the departments offering professional SM degrees, there are different and defined culminating experiences, shown in Table 2.5.a, designed to measure proficiency in each of the degree program s competencies and the five core disciplines. 2.5.b. Assessment of the extent to which this criterion is met. Each professional degree program requires students to complete a defined culminating experience tailored to the training objectives of that program. Since these experiences are designed by a range of departments and programs, some variations in standards certainly exist. As described in Section 2.7.a, HSPH is developing on a broader approach to assessing competencies and culminating experiences. This criterion is met. Harvard School of Public Instructional Programs 78

31 Table 2.5.a. HSPH Culminating Experiences Professional Programs Department Degree Program Culminating Experience Master of Public MPH Health Family and community health (FCH); health care management (CMP); law and public health (LPH) These three concentrations require students, either in groups or individually, to conduct a field-based project. These projects are typically conducted in the spring semester and culminate with a written report and a formal presentation. The projects are completed as part of formal courses (ID261 for CMP and LPH students, and ID264 for FCH students), which include classroom sessions focusing on the theoretical and practical nature of work in these areas. Students in these three concentrations have engaged in field projects with federal and state agencies, local health departments and community health agencies, not-for-profit settings such as hospitals, and for-profit organizations such as consulting firms. Culminating projects are expected to include demonstration of each student s skills and knowledge in core and specialty areas, as well as in areas that are relevant to the student's plans for professional practice. The projects are expected to be useful for the organization or agency for which the student conducts the work. In each of the concentrations, the formal presentation and the written product describes and documents the work conducted. MPH JD/MPH The requirements are the same as for the LPH program (above), plus completion of the requirements for a Juris Doctor from Harvard Law School, as described in Section MPH Summer only quantitative methods (QM) and clinical effectiveness (CLE) The QM and CLE summer only concentrations require each student to take ID270 or ID320. Students conduct applied population-based research at their home institution. This research involves a population of subjects in a health care setting. The findings and written description of the research culminate with a presentation in the final summer of the student s program. The projects are designed to apply and demonstrate the skills and knowledge gained from the focus on biostatistics and epidemiology, as well as in the other core competencies. MPH QM Students in the QM concentration take ID265 and an additional practice course (BIO212, BIO214, BIO234, EPI233, EPI294, HPM516, ID240, or RDS282) in order to obtain further practice experience in managing quantitative issues in public health. Students in QM plan and write a paper suitable for publication, a grant proposal, and/or a technical report. The projects are designed to apply and demonstrate skills and knowledge gained from the focus on biostatistics and epidemiology, as well as in the other core competencies. Harvard School of Public Instructional Programs 79

32 Table 2.5.a. HSPH Culminating Experiences Professional Programs (continued) Department Degree Program Culminating Experience Master of Public Health (continued) MPH CLE Students in the CLE concentration take EPI242, a year-long seminar during which progress and results on applied, population-based research are presented and critiqued. Similar to the summer-only QM and summer-only CLE experience, the research is population based, involving a population of subjects in a health care setting. The projects are designed to apply and demonstrate the skills and knowledge gained from the focus on biostatistics and epidemiology, as well as in the other core competencies. MPH Occupational and environmental health (OEM) This concentration requires students to participate in a semester-long course (ID263), combining seminar and case studies, and to conduct a series of work site assessments. The course focuses on current issues in the field of occupational and environmental health. Students are required to produce a major paper on a topic in the field before the end of the course, applying the skills and knowledge acquired in their program and the core competencies. MPH Global health (GH) Students must take ID519 as part of the culminating experience. During the course, students must propose and write a thesis in accordance with departmental guidelines. The thesis topic must be on an international health problem that is not US based (unless it is a comparison of a US issue with an international one). The thesis includes program planning, implementation, and/or evaluation. The written thesis is reviewed by a committee for core and specialized skills and knowledge. Biostatistics (applied) SM (60 credits) Biostatistics Students are required to perform a collaborative research practicum, with activities related to the design, conduct, and analysis of research studies with a focus on data analysis and scientific presentation. The project is completed under the direction of a faculty mentor. Students carry out an extensive data analysis, including data summaries and graphical displays, regression methods, data interpretation, and comparison of alternative methods. Usually students develop their projects by working with a group of people with varied disciplinary backgrounds. The students then write a master s paper that describes the medical or public health problem of interest, summarizes the appropriate data analyses, and provides a scientific interpretation of the data in a standard scientific writing style. The student also presents this work in a seminar. The master s paper and oral presentation must be primarily the work of the student, with only advisory input from the mentor(s). The master s paper and oral presentation are evaluated by a review committee consisting of three members, including the student s practicum mentor(s), the director of master s programs, and other biostatistics faculty members as needed to determine skill and knowledge in core and program competencies. A written evaluation is provided to the student. Harvard School of Public Instructional Programs 80

33 Table 2.5.a. HSPH Culminating Experiences Professional Programs (continued) Department Degree Program Culminating Experience Environmental Health MOH (42.5 credits) Environmental and occupational medicine and epidemiology program (EOME) Students take EH263 as part of their culminating experiences. The methods of evaluating the culminating experiences within the course include exams, class presentations, field work, and a final paper. Students apply their accumulated skills and knowledge to the design and execution of their own field investigation at industrial and commercial sites to measure environmental exposure to chemical and biological contaminants. The design and results of these projects are presented in class and in a final paper. The instructor evaluates the students ability to meet required core and program competencies SM/ MSN & SM (42.5 credits) SM (42.5 credits) EOME Exposure, epidemiology, and risk Same as MOH All students are required to fulfill a practicum and culminating experience. Students may participate in a practice experience, research project, or internship that demonstrates proficiency in the environmental health sciences, core competencies, and the practice of public health. Students arrange the experience directly with their advisor. Because each student has different needs, background, and career interests, the program is flexible. Health Policy and Management SM (80 credits) SM (42.5 credits) Exposure, epidemiology, and risk Health care management Same as EER SM (42.5-credit) The practice and culminating experiences are completed as part of HCM707. Students work on a field project for a health care organization that involves the development and implementation of a major change initiative or a new service or organizational structure. The project demonstrates students application of core competencies and management knowledge and skills, as well as the expertise and experience gained through the program. Students produce a written report and make a presentation on their field projects. Harvard School of Public Instructional Programs 81

34 Table 2.5.a. HSPH Culminating Experiences Professional Programs (continued) Department Degree Program Culminating Experience Health Policy and Management (continued) SM (80 credits) Health policy and management The practice and culminating experiences are composed of a summer internship between the two years of the program and completion of HPM290 during the second year. Students work full time for eight to ten weeks during the summer at a health care organization, prepare a short paper, and make a presentation when they return. During the second year, students work eight to ten hours per week for at least sixteen weeks in a setting relevant to health policy, health management, or health research. HPM290 classroom sessions complement the field work, and students produce monthly reflective journals on their experiences. In the spring, students complete a paper and make a presentation on their projects. The report and presentation, graded by the course instructor, demonstrate each student s acquired skills, knowledge, and relevance to the student's plans for professional practice. The student s practicum preceptor(s) completes an evaluation of the student s performance in a range of competencies. Society, Human Development and Health SM (80 credits) Society, human development, and health The culminating experience consists of three components: SHH294, a practicum project or internship, and SHH259. SHH294 is held during the spring semester of the first year of study. This course guides students through the practicum planning process, including a brief introduction to analytic skills useful in practice setting. The field practicum is based on an internship or project opportunity that the student creates and plans during the first year and usually completes during the summer between first and second years or during the fall semester of the second year. In SHH259, a seminar held during the fall semester of the second year, students make a presentation based on their practicum and prepare a written report. The report and presentation demonstrate each student s acquired skills and knowledge as well as relevance to the student's plans for professional practice. SM/ MSN or MSW Dual degree with Simmons As a culminating experience, students in the dual degree program engage in a research project that is part of the second-year Simmons program and take SHH259, the practicum course, with the other professional SM students in the department. The students develop a final paper based on their research project and are encouraged to make their presentation during the practicum course. The final paper integrates the student s public health skills and knowledge and is graded by the instructor. Harvard School of Public Instructional Programs 82

35 REQUIRED COMPETENCIES 2.6.a. Identification of schoolwide core public health competencies that all MPH or equivalent professional degree students are expected to achieve through their courses of study. The school has identified the following schoolwide competencies for the five core knowledge areas of public health for HSPH professional master's students: Biostatistics Demonstrate the roles biostatistics serves in the discipline of public health. Interpret graphical and descriptive techniques commonly used to summarize public health data. Describe basic concepts of probability, random variation, and commonly used statistical probability distributions. Apply common statistical methods for estimation and inference and use them appropriately according to underlying assumptions and type of study design. Interpret the results of statistical analyses to provide evidence within the context of public health, health care, biomedical, clinical and population-based studies and research. Develop basic skills for utilizing statistical computing software for performing data analyses. Epidemiology Describe the role of epidemiology as a quantitative approach to address problems in clinical medicine and public health. Describe and apply the basic principles and methods of epidemiology, including disease measures, association and causation, bias, confounding and effect modification, and susceptibility. Interpret descriptive epidemiologic results in order to develop hypotheses of possible risk factors of a disease. Develop a foundation for designing valid and efficient epidemiologic studies to address public health problems, including understanding the strengths and limitations of descriptive, observational, and experimental studies. Become a critical reader of epidemiologic literature by analyzing the appropriateness of study design, quality of data, methodological strategies, and interpretation of results. Environmental health sciences Characterize the human health effects, both acute and chronic, of major environmental and occupational hazards such as air pollution, metals, organic pollutants, microbial contamination of drinking water, and physical hazards. Analyze sources, pathways, and routes of exposure to these environmental and occupational hazards (and safety), and determine the populations with a high risk of exposure. Assess the factors that can modify the overall impact of environmental and occupational hazards on a population (e.g., age, genetic polymorphisms, nutritional states). Apply risk assessment and risk management concepts to develop effective guidelines and policies to mitigate and manage environmental and occupational hazards. Social and behavioral sciences Compare social, developmental, and behavioral theories of health, health behavior, and illness, and analyze their applicability to different types of health problems. Formulate social and behavioral change interventions based on these theories that are appropriate and responsive to the social and cultural context. Develop program and policy implementation skills, including communication, advocacy, and engaging the media. Design and implement program evaluations using qualitative and quantitative methods. Harvard School of Public Instructional Programs 83

36 Critique the validity of basic behavioral and evaluation research. Indentify individual, organizational and community concerns, assets, resources, and deficits for social and behavioral science interventions. Health services administration (HSA) The HSA core courses are classified into three groups for purposes of core competencies: Health management, health economics, and health policy and politics. Students are required to develop core competencies within one of these groups as well as the cross-cutting HSA competencies. Health management Develop financial literacy. Demonstrate understanding of the human, social, and economic dynamics of organizational behavior. Develop competency in making effective managerial decisions under conditions of uncertainty. Health economics Articulate the functions of supply and demand. Assess the extent to which real markets diverge from perfect markets. Apply models of rational choice to markets. Assess the effects of financial and payment incentives on the behavior of individuals and organizations. Apply these tools of economic analysis to new policy issues and proposals. Health policy and politics Demonstrate capacity to apply conceptual frameworks for understanding political and policy processes in health care. Explain how political institutions and processes influence resource allocation in health care. Understand basic organization, financing, and delivery of health services and public health systems. Discuss the policy process for improving the health status of populations. Cross-cutting HSA competencies Work effectively as part of a team, including getting and receiving candid and constructive feedback. Communicate clearly and succinctly, in writing and orally, to public health professionals and the public. Advocate for a policy or strategy, including developing an appropriate communication strategy. 2.6.b. A matrix that identifies the learning experiences by which the core public health competencies are met. If this is common across the school, a single matrix will suffice. If it varies by degree or program area, sufficient information must be provided to assess compliance by each program. Learning experiences by which students achieve the core public health competencies are listed in Table 2.3.a. The core public health competencies are the same for both pathways described below and listed in Section 2.6.a. Syllabi for core courses are available in Resource File 2.3.a (Foundations course syllabus is available in Resource File 1.4.c). Students may choose one of two core course pathways: A traditional pathway (see Table 2.3.a) in which the student takes five separate courses in the core disciplines of public health (biostatistics, environmental health, epidemiology, health services administration, and social and behavioral science). Harvard School of Public Instructional Programs 84

37 An alternative pathway in which the student takes the integrated 10-credit core course Foundations in Public Health. For students registered in the Foundations core course, competencies are assessed throughout the course, including via a final exam designed to test the application of core competencies knowledge and skill to a public health case (see Resource File 2.3.a for materials). For students following the traditional core courses, competencies are assessed throughout each individual course as described in Appendix 2.6.c and via their culminating experiences. 2.6.c. Identification of a set of competencies for each program of study, major, or specialization, depending on the terminology used by the school, identified in the instructional matrix, including professional and academic degree curricula. Competencies for each program of study or concentration identified in the instructional matrix (Table 2.1.a) are available in Appendix 2.6.c. Courses and activities providing a grounding in core competencies for academic programs schoolwide are listed in Table 2.6.c. (See Resource File 2.6.c for each degree program s required coursework.) 2.6.d. A description of the manner in which competencies are developed, used, and made available to students. Development of competencies The Office for Educational Programs (OEP) is responsible for overseeing the development of schoolwide core public health competencies. The current set of core competencies was developed in the following manner: The MPH Steering Committee, which includes members from each department offering an MPH concentration, reviewed schoolwide core competencies (2002 version) and suggested revisions. The Foundations in Public Health core course committee, which included faculty members representing each of the five core disciplines in public health, then reviewed and suggested revisions to the current set of competencies. As part of this review process, the members of the MPH Steering Committee and the Foundations committee reported to their respective departments and sought comments. The OEP consolidated the proposed revisions into a draft, which was discussed with and distributed to the MPH Steering Committee and the Foundations committee for a final review. The Committee on Educational Policy (CEP), which includes faculty members from each department, reviewed and affirmed the core public health competencies as policy for the first time April 2, Revised competencies are to be used by the CEP in its review process for approval of new course proposals and new degree programs. Departments and programs are responsible for developing competencies for their respective degree programs. The competencies for each degree program were reviewed and revised in spring 2006 and again in 2008 by the originating department or program. New programs and concentrations are developed within a department or interdepartmentally. The Faculty Handbook outlines the process and content needed for approval of competencies within a new program or concentration (see Resource File 1.4.d). The CEP, which evaluates the competencies of the proposed program as part of its review and approval process, has recently adopted a new, more stringent policy with regard to new programs and competencies as described in the handbook. Harvard School of Public Instructional Programs 85

38 Table 2.6.c. Core Public Health Knowledge for Academic/Research Degree Programs Department Degree Concentration Biostatistics* Epidemiology* Environmental Health* Biostatistics Environmental Health SM (42.5 credits) SM (80 credits) SD Biostatistics intermediate and advanced courses EPI200 or 201 lunch seminars Biostatistics 25 credits EPI200 or 201 lunch seminars Exposure, epidemiology, and risk BIO201 EPI201 & 202 EH205, 210, 510, and RDS500 SD/DPH Occupational health BIO200 or 201 EPI200 or 201 and 202 SD Epidemiology SM (42.5 credits) Global Health and Population SM (80 credits) Molecular and integrative physiological sciences EH231, 232, 262, ID215 and 263 Health Services Administration* RDS280 or RDS285 RDS280 or approved alternative lunch seminars EH231 BIO200 or 201 EPI200 EH205 & 208 Epidemiology BIO201, 210 EPI201, 202, 203, 204 Epidemiology BIO201, 210 EPI201, 202, 203, 204 SD/DPH Epidemiology SM (80 credits) *Course titles listed in Table 2.3.a. Global health and population BIO201, 210 or 213, 223 or 226 BIO200 or 201 or approved alternative EPI201, 202, 203, 204, 205, 207, 247, 289, 298 EPI200 or 201 or approved alternative lunch seminars EH205 recommended EH205 and ID 208 GHP272 lunch seminars workshops lunch seminars lunch seminars EPI205 GHP 269 Social and Behavioral Science* ID250 or approved alternative ID250 or approved alternative EH205 ID263 EH513 & 205 lunch seminars EH205 EPI205 GHP272 Harvard School of Public Instructional Programs 86

39 Table 2.6.c. Core Public Health Knowledge for Academic/Research Degree Programs (continued) Department Degree Concentration Biostatistics* Epidemiology* Environmental Health* Global Health and Population (continued) SD/DPH Global health and population BIO200 or 201 or approved alternative EPI201 and 202 or approved alternative GHP272 Health Services Administration* GHP272 Social and Behavioral Science* GHP272 Health Policy and Management Immunology and Infectious Diseases Nutrition SM (42.5 credits) SD SD Health policy and management Health policy and management Immunology and infectious diseases SD/DPH Nutritional epidemiology and Public health nutrition BIO200 or 201 or 206 and BIO207, or 208 or 209 BIO (10 credits intermediate level) EPI200 or 201 or 208 EPI (5 credits) lunch seminars HPM277 BIO200 or 201 EPI200 EH205 BIO201 EPI201, 202 and 205 NUT308 Orientation HPM 10 credits At least 17.5 HPM credits required ethics NUT308 HPM516 HPM277, SHH245 required ethics ID537, NUT308 Society, Human Development and Health SM (42.5 credits) Society, human development and health SD/DPH Society, human development, and health BIO200 or 201 EPI200 or 201 lunch seminars BIO200 0r 201 EPI200 or 201 and 202 lunch seminars 1 course each Orientation in economic 15 analysis, health credits of SHDH services courses research-quality of care, and health decision sciences lunch seminars 15 SHDH credits *Course titles listed in Table 2.3.a. Harvard School of Public Instructional Programs 87

40 Course Descriptions Not Listed in 2.3.b. FY As Listed on the Registrar s Website GHP272 Foundations of Global Health and Population This course is required for all incoming GHP master s of science and doctoral students. It is intended as a broad survey of the main facts, issues, perspectives, methods, results, and conclusions in the areas of global population and health. The course is organized into three blocks. The first block deals with theory, methods, and evidence related to the state of global health and population and reviews salient population and health issues, both past and present. The focus is on patterns and trends in morbidity, mortality, fertility, and reproductive health, as well as the size, structure, and growth of population. Environmental concerns linked to health and populations are also addressed. The second block deals with the economic, social, legal, political, and ecological context in which global health and population issues arise and must be addressed. This block introduces economic, political, and rights-based perspectives on the place of health in the process of international development. The third block covers approaches to the design and implementation of policies and programs to address health and population problems. Medical interventions, non-medical health interventions, and non-health interventions will all be considered. Course Note: Space guaranteed for all SM and doctoral students in the department of GHP; others on a first-come basis. ID536 Business Planning for Health Organizations This course has been developed for students who will be developing and managing health-related programs and projects. Students will be introduced to business plans and management tools used historically by entrepreneurs to gain access to financing for their ideas. Through this course students will also learn basic business skills. Business planning draws upon concepts and tools found in a number of management disciplines from strategic planning to marketing and financial management. Students will learn through doing. Everyone participating will be required to draft a plan to be evaluated by the instructor. Several student plans will also be discussed by the entire class. Thus, everyone must have an idea suitable for business planning before beginning this course. NUT308 Applied Research Practicum in Public Health Nutrition In addition to formal thesis research projects, doctoral students in public health nutrition are required to complete a research practicum in a US or international public health setting involving supervised field work. Graduate students who are not formally enrolled in the public health nutrition doctoral concentration, but who desire nutrition research experience in an applied setting, may take the course after special consultation with the instructor(s). The practicum is completed individually by students under the supervision of a faculty member. It will be pass/fail and worth a minimum of 5 credits. The practicum will cultivate field research skills, leadership skills, integrate and strengthen technical knowledge and quantitative skills, and enhance oral and written communication skills. It will also cultivate the capacity to work with others in a substantial project that responds effectively and creatively to the needs of an organization. Projects may be in the areas of nutrition/physical activity program planning and evaluation, policy development, research methods, project management, mass media communication, information dissemination and intervention. The practicum includes a research component in the form of data collection and analysis, or outcome evaluation. Course Note: NUT306 required; instructor's signature required. SHH245 Social and Behavioral Research Methods Part I The course provides a broad overview of social and behavioral research methodology, including experimental, quasi-experimental and non-experimental research design, measurement, sampling, data collection, and testing causal theories. By case studies, methodological readings, discussion, written assignments, and data analytic homework students learn to conduct social and behavioral research and more applied program evaluations. Homework includes analytic work with observational and experimental studies and development of new measures. Course Note: BIO210, BIO211 or BIO213 or equivalent required; enrollment limited to 20; a multivariate statistics course strongly recommended; course primarily for doctoral students. Harvard School of Public Instructional Programs 88

41 Use of competencies Departments are asked to use competencies as they develop their curriculum and individual courses. In addition, departments/programs strive to ensure practice placements that will help students achieve mastery of the program competencies. When reviewing a new course proposal from a department or concentration, CEP evaluates the proposed course s learning objectives vis-à-vis the relevant department's competencies. Availability to students Beginning in fall 2009, the registration packets will contain information about the core public health competencies and the methods by which they can be achieved through the degree planners. The core public health competencies will also be discussed during by faculty members from each department at the session on core courses. The MPH program competencies are available to all current and prospective students on the MPH website: The Foundations course syllabus, which outlines the core competencies, is provided each semester online. Program competencies are available online in each department s degree planner and will also be listed in departmental student handbooks beginning in fall e. A description of the manner in which the school periodically assesses the changing needs of public health practice and uses this information to establish the competencies for its educational programs. The school has a variety of ways for ensuring that the competencies of its educational programs remain consistent with the needs of public health practice. First, HSPH faculty who are actively involved in public health practice bring these experiences to their work on departmental curriculum committees, the MPH Steering Committee, CEP, and OEP, which are the major mechanisms for overseeing competencies for the school s educational programs. The school conducts periodic surveys of alumni about the adequacy of their HSPH education in providing the skills they need in their public health careers. The last alumni survey of MPH alumni was conducted in 2007, the 80-credit SM alumni were surveyed in 2006, and the SD alumni is being conducted in the summer 2009 (see Resource File 1.1.d for surveys and results). The school also surveys and interviews employers and practice preceptors about the performance of HSPH students and graduates in specific areas of competency. The latest employer and preceptor interviews were conducted in July The CEP oversees regular external evaluations of the school s degree programs, which includes review and recommendations about the competencies for the programs (see Resource File 1.2.a). The Advisory Council of the Division of Public Health Practice, whose membership includes distinguished leaders in health care and public health, also provides regular advice and guidance to the school about its educational and practice activities, including regular discussion about the skills and competencies that the graduates of the school will need to be public health leaders. 2.6.f. Assessment of the extent to which this criterion is met. The school has in place schoolwide competencies in the five core knowledge areas of public health for all professional master's students and specific competencies for all degree programs. At the same time, the development and use of competencies is still relatively new in many programs. Some have been subject to frequent revision, making it difficult to achieve long-term planning. Another challenge is to develop competencies that are specific enough to be meaningful but can be achieved within HSPH s historically flexible educational approach. The school expects that greater experience with this process will embed the development and use of competencies within the framework of the institution. This criterion is met. Harvard School of Public Instructional Programs 89

42 ASSESSMENT PROCEDURES 2.7. a. Description of the procedures used for monitoring and evaluating student progress in achieving the expected competencies. MPH and other professional master s programs For the MPH and other professional master's programs, the competencies of the various degree programs and the means for evaluating students attainment of these competencies are largely expressed in the context of the various components of each degree program: Required courses (both individual courses and program core groupings), field placements, and culminating experiences. Various components are evaluated by course instructors, practice course instructors, other faculty and advisors, department/program faculty, and internship and practicum preceptors. Students who successfully complete the required courses for a particular program, as indicated by grades or other evaluations of the student s performance in each course, are judged to have attained the competencies for that program. Completion of required courses is monitored by the Office for Educational Programs (OEP) for MPH students and by departments for other degree programs. Each MPH and professional master's degree student is also required to complete a practice course, designed to provide an experience where the student can apply new skills and knowledge learned in the core and required courses to situations in practice settings or to an applied research problem. In the practicum, students are expected to integrate and use core public health skills relevant to their practicum project, which may include biostatistics, epidemiology, health services administration, environmental health, and social and behavioral sciences, as well as ethics. Practice instructors encourage students to address the relevance of the competencies of core areas in their field experience. In spring 2008, the school pilot tested a new preceptor evaluation form for assessing student competence (see Resource File 2.4.a). The new form is available online to preceptors and practice instructors. Regarding the required culminating experience, as noted in Section 2.5.a, there is no single format for all students in HSPH professional master s degree programs. Each program/department formulates its own requirements as specified in Table 2.5.a. Depending on the degree program, the culminating experience is monitored and evaluated by the relevant course instructor, the student s advisor, or the director of the degree program. Each degree program s competencies, required courses, and methods of evaluation are described in Appendix Tables 2.6.c (1), (2), (3), (4), (5), and (6). OEP, in collaboration with the Committee on Educational Policy and HSPH departments/programs, is considering developing a new student portfolio system as an additional means of monitoring and evaluating the attainment of expected core competencies by all professional students. Student portfolios are an intriguing means for assessing competencies for many reasons, including that the process of creating a portfolio would itself help students hone important professional skills, such as the ability to think and synthesize knowledge across courses and disciplines, reflect and self-evaluate, and write clearly and effectively. If the school proceeds with such a portfolio system, it would be implemented for students matriculating no earlier than fall Then, upon completion of the development phase and pilot testing, a substantive change would be submitted to the CEPH Board of Councilors. Academic masters and doctoral programs The completion of required courses and progress of academic master s students is monitored by departments. For doctoral programs, oral and written exams and a dissertation defense are part of the evaluation process to measure achievement of core competencies in biostatistics, epidemiology, and the student s specific program. The student s research advisor and research committee are charged with monitoring his or her progress; the school requires formal progress reports, filed with the registrar's office, every six months. See Section 2.9 for more information about requirements for academic masters and doctoral programs. Harvard School of Public Instructional Programs 90

43 2.7.b. Identification of outcomes that serve as measures by which the school will evaluate student achievement in each program, and presentation of data assessing the school's performance against those measures for each of the last three years. As noted, individual academic achievement is for the most part monitored at the department and program level, with completion of the degree program as the ultimate measure of success. HSPH tracks each cohort of entering students by department and program to evaluate student achievement and the school's effectiveness as an educational institution. Exit surveys are conducted with graduating students to evaluate their experience and satisfaction in a variety of educational and other areas (see Resource File 1.1.d for student exit survey results for the past three years). The student exit survey data are reviewed by CEP each year, and the committee s yearly agenda generally includes some issues that have been targeted for improvement as a result, as well as an annual review and revision of the survey instrument itself. Table 2.7.b(1). Graduate Survey Results Outcome Measure Target AY2006 AY2007 AY2008 Met graduate s expectations Graduates would choose HSPH experience again Greater than 90% respond adequately met to fully met Increase to 90% 93% 94% 93% 85% 91% 91% Student graduation rates are another key outcome measure used by the school to assess student achievement. Graduation rates have been relatively consistent over recent academic years. The MPH program, with the largest numbers of students, has experienced very low attrition during this time period. Table 2.7.b(2). Graduation Rates Outcome measure Graduation rates of greater than 80% over last three years Target* Greater than 80% graduation rates in all degree programs Degree Program AY2006 AY2007 AY2008 MPH/SM1 SM2 SD DPH Full time 90% 96% 96% Part time 98% 96% 97% Full time 98% 98% 98% Part time N/A 75% 100% Full time 91% 85% 82% Part time 100% 80% 67% Full time 100% 100% 100% Part time 50% N/A 100% Harvard School of Public Instructional Programs 91

44 *The schoolwide graduation rate for full-time students has been substantially higher than 80 percent for the past three years in all degree programs. The graduation rate for part-time students has also been above 80 percent, with the exception of a few programs with very small enrollments (in , one of two part-time DPH students withdrew; in , one of four part-time 80-credit SM students died before graduation; in , two of six part-time SD students withdrew). 2.7.c. If the outcome measures selected by the school do not include degree completion rates and job placement experience, then data for these two additional indicators must be provided, including experiential data for each of the last three years. If degree completion rates, in the normal time period for degree completion, are less than 80%, an explanation must be provided. If job placement, within 12 months following award of the degree, is less than 80% of the graduates, an explanation must be provided. Degree completion rates are provided in Criterion 2.7.b. Table 2.7.c. Job Placement Experience Outcome Measure Target AY2006 AY2007 AY08 Job placement rates, within 12 months of graduation Maintain an 80% job placement rate 72% 80% 88% Rates reflect the percent relative to the number of responses to the job placement surveys. The school has begun to utilize more faculty contacts to ensure that its job placement data are accurate; this approach has resulted in an improvement in the employment rate. Nevertheless, the process of assessing graduate employment rates has been challenging. Many students provide data at graduation, at which time they may not yet have employment. Often they find employment shortly thereafter but may not respond to the school s attempts to gather that information. In addition, in many cases, employment information becomes available after the timeframe stipulated in this criterion. Those individuals truly not employed include some choosing not to seek employment for various reasons, including pregnancy and childcare, the desire to pursue volunteer opportunities before seeking employment, and other unknown choices. In addition, about 32 percent of the HSPH student body consists of international students, who often find it difficult to find positions in the US. 2.7.d. A table showing the destination of graduates by specialty area for each of the last three years. The destinations of graduates by specialty area for each of the last three years are listed in Tables 2.7.d (1), (2), and (3). Harvard School of Public Instructional Programs 92

45 Table 2.7.d(1). HSPH Graduate Employment Data 2006 Degree Department/Concentration Government Non-profit Health Care Private Practice University/ Research Proprietary Further Education Not Employed # % # % # % # % # % # % # % # % MPH Clinical Effectiveness 1 7% 9 60% 3 20% 2 13% 15 Family and Community Health 2 10% 1 5% 6 29% 1 5% 5 24% 6 29% 21 Health Care Management 1 5% 4 20% 3 15% 2 10% 6 30% 4 20% 20 International Health (Global Health) 2 7% 12 44% 3 11% 2 7% 8 30% 27 Law and Public Health 1 33% 2 67% 3 Occupational and Environmental Health 1 25% 1 25% 2 50% 4 Quantitative Methods 3 21% 3 21% 2 14% 3 21% 3 21% 14 SM Biostatistics 2 40% 1 20% 2 40% 5 Environmental Health 1 11% 2 22% 4 44% 2 22% 9 Epidemiology 1 5% 1 5% 7 32% 1 5% 7 32% 5 23% 22 Health Care Management 1 100% 1 Health Policy and Management 1 3% 1 3% 8 26% 1 3% 7 23% 1 3% 12 39% 31 Global Health and Population 2 22% 0% 1 11% 3 33% 3 33% 9 Society, Human Development, and Health 3 13% 1 4% 2 8% 3 13% 3 13% 12 50% 24 DPH Epidemiology 1 100% 1 SD Environmental Health 1 14% 4 57% 2 29% 7 Epidemiology 0% 1 100% 1 Epidemiology 1 9% 6 55% 1 9% 3 27% 11 Nutrition 2 67% 1 33% 3 Society, Human Development, and Health 1 25% 3 75% 4 PhD Biostatistics 1 11% 5 56% 2 22% 1 11% 9 Biological Sciences 1 33% 1 33% 1 33% 2 1 Grand Total 15 6% 7 3% 50 20% 0 0% 45 18% 21 9% 38 16% 68 28% 244 Grand Total Harvard School of Public Instructional Programs 93

46 Table 2.7.d(2). HSPH Graduate Employment Data 2007 Degree Department/Concentration Government Non-profit Health Care Private practice University/ Research Proprietary Further Education Non- Health Related Not Employed Grand Total # % # % # % # % # % # % # % # % # % MPH Clinical Effectiveness 2 5% 1 3% 13 33% 2 5% 16 41% 1 3% 4 10% 39 Environmental Health 1 100% 1 Family and Community Health 1 5% 2 10% 4 19% 5 24% 7 33% 2 10% 21 Health Care Management 1 2% 3 7% 14 30% 1 2% 4 9% 4 9% 7 15% 12 26% 46 International Health (GH) 3 8% 6 16% 7 18% 1 3% 8 21% 13 34% 38 Law and Public Health 3 50% 1 17% 2 33% 6 Occupational and Environmental Health 1 14% 1 14% 1 14% 3 43% 1 14% 7 Quantitative Methods 2 7% 13 43% 1 3% 1 3% 8 27% 5 17% 30 SM Biostatistics 1 14% 1 14% 1 14% 2 29% 2 29% 7 Environmental Health 2 25% 3 38% 1 13% 2 25% 8 Epidemiology 1 3% 4 14% 6 21% 1 3% 14 48% 3 10% 29 Health Policy and Management 1 3% 4 11% 13 37% 1 3% 5 14% 1 3% 7 20% 3 9% 35 Immunology and Infectious Diseases 1 100% 1 Global Health and Population 1 5% 1 5% 1 5% 1 5% 9 43% 8 38% 21 Society, Human Development, and Health 1 8% 1 8% 1 8% 1 8% 1 8% 5 38% 3 23% 13 DPH Epidemiology 1 100% 1 Society, Human Development, and Health 1 100% 1 SD Biostatistics 2 100% 2 Environmental Health 1 14% 2 29% 2 29% 1 14% 1 14% 7 Epidemiology 2 33% 4 67% 6 Nutrition 1 100% 1 Global Health and Population 1 25% 2 50% 1 25% 4 Society, Human Development, and Health 1 33% 2 67% 3 PhD Biostatistics 1 50% 1 50% 2 Biological Sciences 1 100% 1 Grand Total 18 5% 24 7% 72 22% 7 2% 52 16% 9 3% 80 24% 2 1% 66 20% 330 Harvard School of Public Instructional Programs 94

47 Degree Table 2.7.d(3). HSPH Graduate Employment Data 2008 Department/ Concentration Govt Non-profit Health Care Private Practice University/ Research Proprietary Further Education Not Employed # % # % # % # % # % # % # % # % MPH Clinical Effectiveness 5 11% 3 6% 13 28% 9 19% 1 2% 10 21% 6 13% 47 Family and Community Health 1 4% 3 11% 8 29% 1 4% 5 18% 1 4% 6 21% 3 11% 28 Health Care Management 7 12% 7 12% 8 14% 10 17% 3 5% 19 32% 5 8% 59 International Health (GH) 6 13% 4 8% 14 29% 8 17% 2 4% 9 19% 5 10% 48 Law and Public Health 2 25% 4 50% 2 25% 8 Occupational and Environmental Health 2 50% 1 25% 1 25% 4 Quantitative Methods 6 17% 8 22% 8 22% 1 3% 6 17% 7 19% 36 SM Biostatistics 1 20% 1 20% 2 40% 1 20% 5 Environmental Health 2 13% 2 13% 8 50% 3 19% 1 6% 16 Epidemiology 4 18% 3 14% 4 18% 1 5% 5 23% 4 18% 1 5% 22 Health Policy and Management 1 3% 1 3% 10 29% 1 3% 8 23% 1 3% 8 23% 5 14% 35 Population and International Health 7 23% 1 3% 3 10% 9 29% 1 3% 4 13% 6 19% 31 Society, Human Development, and Health 1 6% 1 6% 3 18% 1 6% 1 6% 1 6% 6 35% 3 18% 17 DPH Epidemiology 1 100% 1 Population and International Health 1 100% 1 SD Environmental Health 3 38% 2 25% 2 25% 1 13% 8 Epidemiology 2 13% 6 38% 2 13% 3 19% 2 13% 1 6% 16 Immunology and infectious Diseases 1 100% 1 Nutrition 1 25% 2 50% 1 25% 4 Population and International Health 1 50% 1 50% 2 Society, Human Development, and Health 1 7% 1 7% 3 20% 2 13% 6 40% 2 13% 15 PhD Biological Sciences 1 25% 3 75% 4 Health Policy 1 100% 1 Grand Total 49 12% 28 7% 93 23% 6 1% 81 20% 11 3% 90 22% 51 12% 409 Grand Total Harvard School of Public Instructional Programs 95

48 2.7.e. In public health fields where there is certification of professional competence, data on the performance of the school's graduates on these national examinations for each of the last three years. Thirty-three graduates of the Occupational and Environmental Residency program have taken the American Board of Preventive Medicine special licensing examination. The pass rate of program graduates has exceeded 97 percent during Information on graduates who have passed the National Board of Public Health Examiners certification exam will be available for the next self-study. 2.7.f. Data describing results from periodic assessments of alumni and employers of graduates regarding the ability of the school's graduates to effectively perform the competencies in a practice setting. Alumni surveys and focus groups HSPH conducts periodic surveys of alumni to assess their views regarding the training they received at the school and to identify areas for improvement, particularly in terms of curriculum and courses. Since the last self-study, the school has undertaken three significant assessments, a survey of alumni of 80- credit professional master's degree programs, focus groups with alumni of several professional master's degree programs, and current focus groups of doctor of science alumni. As part of a general assessment of its 80-credit SM degree programs, the school conducted an online survey of alumni who had graduated five, ten, and fifteen years previously (see Resource File 2.7.f for the overall evaluation and the survey results). The purpose of the survey was to review the strengths and challenges of the programs and to determine if graduates were emerging as leaders in public health. Eighty alumni participated (33 percent response rate). A similar assessment of SD degree programs is currently being conducted. Alumni reported strong satisfaction with their HSPH education and a strong belief that HSPH has had a positive effect on their careers. Eight-one percent believed their HSPH education was worth the investment and 72 percent would recommend their degree program to others. In assessing the training they received at HSPH in the skills that were "essential" or "important" in their work, they reported having received solid training in many areas, particularly epidemiology, statistics, research skills, written and oral communication, and working with those from diverse backgrounds. They believed they had not received sufficient preparation in several areas, including project management, developing and managing budgets, leading teams, and managing and developing others. The Office for Educational Programs (OEP) contracted an outside agency to perform online focus groups with graduates of the 80-credit master s programs and selected MPH concentrations. Graduates chosen were all in professional practice, not in academic/research. Participants were asked about the relevance of their HSPH educational experience to their current professional requirements. Findings of the focus groups (Resource File 1.1.d) included the following educational strengths: Good introduction to basic public health concepts and theories; a focus on developing analytic and scientific skills; good exposure to competencies in diversity and culture, industry-specific knowledge, and systems thinking. Educational areas that needed improvement included opportunities to gain in-depth knowledge and skills beyond an introductory level, training in applied analytics, personal/social interactions, basic management skills, and communication skills. Opinions varied considerably by department or concentration around the value of the practice experience, academic advising, and access to faculty. Career advising was generally viewed as inadequate, as were opportunities for post-graduate connections to HSPH. Satisfaction with the quality of fellow students was regularly cited as one of the best aspects of HSPH experience. Harvard School of Public Instructional Programs 96

49 OEP is currently conducting similar focus groups with SD and DPH alumni. The results will be used to help improve education and training in the doctoral programs at the school and will be available in the Resource File 1.1.d. Employer surveys As part of the school s review of the 80-credit SM degree programs mentioned above, interviews were conducted with twenty-one employers who had hired alumni of 80-credit SM programs. The purpose of the survey was to collect information about the strengths and weaknesses of the training and skills of the alumni. Although this was a small sample, employers described the school s graduates as intelligent, professional, and articulate, with sound learning capabilities, analytical and technical skills, quantitative research skills, and basic public health knowledge. Their suggestions for improvement included the following: Require more relevant full-time work experience before students enroll in HSPH Provide more training in qualitative research Offer more training in certain professional skills (writing, presenting, leadership, conflict resolution, project management) Tailor courses and curricula more to the needs of the job market Require more projects that cut across multiple disciplines Use the case-study method in more courses Provide better training in preparing resumes and interviewing OEP and the career services office conducted another survey of employers and student preceptors during the academic year (see Resource File 2.7.f), but the response rate to the survey was too low to provide useful data. OEP has reverted to the interview format with preceptors and targeted employers beginning July Data from these interviews are not yet available but will be in the Resource File 1.1.d for the site visit. 2.7.g. Assessment of the extent to which this criterion is met. At the time of the writing of this self-study, the school is actively pursuing more robust data on graduate employment or employer satisfaction. Better collection methods are required and are being explored. The data available, however, indicate good employment rates (likely higher than can now be documented) and strong employer satisfaction. HSPH has excellent graduation rates, and its graduates report that their education has been valuable to their careers. This criterion is met. Harvard School of Public Instructional Programs 97

50 OTHER PROFESSIONAL DEGREES 2.8 Other Professional Degrees. If the school offers curricula for professional degrees other than the MPH or equivalent public health degrees, students pursing them must be grounded in basic public health knowledge. Not applicable to HSPH. Harvard School of Public Instructional Programs 98

51 ACADEMIC DEGREES 2.9.a. Identification of all academic degree programs, by degree and area of specialization. The instructional matrix may be referenced for this purpose. Five of the nine departments at HSPH offer academic master s degree programs. These are exhibited in Table 2.1.a, the HSPH instructional matrix. The school s doctoral programs, all of which are viewed as academic degrees, are also shown in this matrix. 2.9.b. Identification of the means by which the school assures that students in research curricula acquire a public health. If this means is common across the school, it need be described only once. If it varies by degree or program area, sufficient information must be provided to assess compliance by each program. Students in academic degree programs initially acquire a grounding in public health during the HSPH mandatory fall, specifically via two Public Health: Your Personal and Professional Journey (three hours) and Public Health in Action (a half-day tabletop exercise in public health) (instructional materials located in the Resource File 2.3.a). The seminars, and various other courses provide students with a general to the public health disciplines of environmental health sciences, health services administration, and social and behavioral sciences, as well as a basic foundation in public health that addresses the following objectives: Expanded understanding of public health as a discipline Ability to describe the core functions and ten essential services of public health Knowledge of national and international goals for public health Understanding of the term public health practice Capacity to make linkages between the academic disciplines represented within HSPH and public health practice and fieldwork Understanding of the ways in which teaching, research, and service activities strengthen the public health infrastructure and provide successful health promotion and disease prevention services and policies, both by formal coursework and by participation in special workshops during Opportunity to identify their personal passions and priorities as they start their public health journey At the end of, students are surveyed to ascertain whether learning objectives were met. Survey results are shared with the planning committee and instructors and used to revise and improve the workshops for the next year. Required coursework is the other component of public health process (see Table 2.6.c). All students in academic master s degree programs must take at least 5 credits of biostatistics and 2.5 credits of epidemiology. Doctoral students must successfully pass two intermediate-level biostatistics courses (10 credits) and one epidemiology course (2.5 credits). They must also complete coursework in one major and two minor fields. (See Resource File 2.6.c for a list of required coursework for each academic degree.) In addition to formal requirements, all students, including those in academic degree programs, have the opportunity to attend numerous lectures, panels, seminars, and working groups on topics that cross disciplinary boundaries. For example, the Center for Public Health Preparedness Speaker Series and the Barry R. Bloom Public Health Practice Leadership Speaker Series are offered to all students each year. A daily time slot (12:30 1:30 p.m.) is traditionally kept free of formal course sessions to enable students to attend the wide variety of these special talks (see Resource File 2.9.b for a list). Harvard School of Public Instructional Programs 99

52 2.9.c. Identification of the culminating experience required for each degree program. If this is common across the school's academic degree programs, it need be described only once. If it varies by degree or program area, sufficient information must be provided to assess compliance by each program. Academic master s degree culminating experiences There is no single culminating experience designed for all master s students in academic degree programs at HSPH. Generally it is required that all students work with a faculty member to develop a research question, conduct the research, and complete a research paper. The culminating experiences required for each academic degree program are listed in Table 2.9.c. Academic doctoral degree culminating experiences The schoolwide culminating experience for doctoral students encompasses the completion of an oral qualifying examination (some departments also require a written qualifying examination) and the completion and defense of a dissertation based on a program of independent and original research. For a complete description, see Table 2.9.c. Harvard School of Public Instructional Programs 100

53 Table 2.9.c. HSPH Culminating Experiences Academic Programs Department Degree Program Culminating Experience Master s Degrees Biostatistics SM (42.5 credits) Biostatistics Each student participates in departmental seminars and working group activities, which are ongoing each year, where faculty can assess student skills and knowledge. In addition, required courses have final projects and/or group projects that focus on analysis of complex data sets and involve written project reports, which serve an important role in the training of students as a part of the culminating experience. A student can become involved with independent reading and research courses and with the departmental biostatistical consulting laboratory course, BIO312 (Consultation), in which students work on applied projects with clinical and epidemiological investigators in the HSPH and HMS community. SM (80 credits) Biostatistics Same as 42.5-credits SM program described above. In addition, in their first and second years in the program, many students work on collaborative projects with department faculty and their medical and public health colleagues in other departments, while some others gain practical experience on the job, often in a hospital or pharmaceutical company position. Epidemiology SM (42.5 credits) Epidemiology A supervised research project and participation in EPI315 (Research: Clinical Epidemiology) are the culminating experiences for these students. Students have a local mentor who has agreed to the project and its supervision. A school faculty member assists in the supervision of the student and determines when the project is completed. The project is expected to demonstrate the student s acquired skills and knowledge as well as the relevance to the student s plans for research. SM (80 credits) Epidemiology Students complete a master s thesis that demonstrates proficiency in key aspects of acquisition, analysis, and presentation of epidemiological data. The requirement can be fulfilled in one of two ways: Presentation of a published or publishable manuscript on topics in epidemiology, or presentation of a feasible study protocol in the general form of an RO1 grant (or a major role in an RO1-equivalent grant for submission). Faculty advisors and mentors evaluate the student s acquired skills and knowledge. Global Health and Population SM (80 credits) Global health and population Students are required to complete a thesis focused in an area of health disadvantages of populations worldwide. Its purpose is to bring together the analytic skills acquired in courses and apply them to a single problem through independent study. This extended paper is written during the spring semester of the student s second year in the program and reviewed and approved by the advisor and a second reader. Harvard School of Public Instructional Programs 101

54 Health Policy and Management Table 2.9.c. HSPH Culminating Experiences Academic Programs (continued) Department Degree Program Culminating Experience SM Health policy and (42.5 management credits) In addition to coursework in biostatistics, epidemiology, economics, decision sciences, and quality of care, students are required to complete 5 credits of independent study (HPM300), under the direction of a faculty advisor, which demonstrates the student s ability to synthesize knowledge and skills from coursework and apply them to a relevant research question. Society, Human Development, and Health SM (42.5 credits) Society, human development, and health SHH281 (Methods for Research on Social and Behavioral Dimensions of Public Health) is required for all students as part of a culminating experience in research methods. In addition, programs are tailored to the interests of the individual, leading to an individualized culminating experience. Students are encouraged to organize a tutorial, research study, or an independent study to complete the course of study and to demonstrate their acquired skills and knowledge. The experience is to prepare students for relevant work in academia and/or research. Doctoral Degrees All Departments SD and DPH All departments All doctoral students complete a two- to three-part culminating experience, including an oral examination, a written examination, and a dissertation based on original research (not all departments require the doctoral students to take the written or laboratory examinations prior to taking the schoolwide oral qualifying examination). For the oral qualifying examination, members of the student s oral examining committee participate by preparing questions to assess the student's potential to perform research in his or her chosen field. At least two members of the oral examining committee must hold HSPH faculty appointments in disciplines representing the student s major field as well as the minor fields. Doctoral students who have passed their schoolwide oral qualifying examination and who are prepared to undertake original and advanced work along the lines of fundamental or applied research in their department may enroll for research credit toward the completion of their dissertation. Students, in consultation with their advisor, nominate a research committee to oversee progress toward the completion of the dissertation. The committee consists of the research advisor, who serves as the chair of the committee, and at least two other faculty members. When the dissertation is complete, students must defend it to the entire research committee at a public presentation. Dissertations are original research studies, which generally take the form of three publishable papers; when a traditional dissertation would be more appropriate, the Committee on Admissions and Degrees and the research committee may make an exception. Harvard School of Public Instructional Programs 102

55 2.9.d. Assessment of the extent to which this criterion is met. The school requires a culminating experience for each academic degree program. Through changes to its program, HSPH has also developed a mechanism to assure that students in academic degree programs receive a basic to public health beyond that acquired through the schoolwide mandatory coursework (biostatistics and biological sciences) and other public health courses completed for their degrees. Although the programming is a good start, the school needs to develop additional ways of providing a stronger public health foundation for these students. In particular, students in the PhD programs in biostatistics and epidemiology, administered by the Graduate School of Arts and Sciences rather than by HSPH, are not required to attend at the school and so may not receive any basic to public health beyond their required courses. This criterion is met with commentary. Harvard School of Public Instructional Programs 103

56 DOCTORAL DEGREES 2.10.a. Identification of all doctoral programs offered by the school, by degree and area of specialization. The instructional matrix may be referenced for this purpose. If the school is a new applicant and has graduates from only one doctoral program, a description of plans and a timetable for graduating students from the other two doctoral programs must be presented, with university documentation supporting the school's projections. As noted in Section 2.1.a, seven of the school s academic departments offer the doctor of science (SD) degree. (Two other departments, biostatistics and genetics and complex diseases, offered the SD degree during the period covered in this self-study in order to grandfather those students who had enrolled prior to the departments elimination of the SD in favor of the PhD degree.) Five departments also offer the doctor of public health (DPH) degree. There is no substantive difference between the SD and the DPH, except that admission to the DPH program requires applicants to hold a prior doctoral/advanced degree and an MPH degree or its equivalent. Each doctoral program requires coursework of up to two years, a qualifying examination that usually includes both written and oral components, completion of a program of research, and the preparation and defense of a thesis, which generally takes the form of several publishable papers. Through the Biological Sciences in Public Health (BPH) program, the Division of Biological Sciences (DBS) offers a PhD program, under the auspices of the Graduate School of Arts and Sciences (GSAS), which controls the awarding of this degree at Harvard University; previously, the BPH program was a component of the Division of Medical Sciences at Harvard Medical School. The school also now offers a PhD program in biostatistics under GSAS auspices; this is new since the previous self-study. The biostatistics PhD degree was changed from SD in The SD degree in this particular field was not readily understood leading to the change in degree. The department could not support both degree programs. In the above programs the number of PhD enrolled students from was 191, 175, and 170, respectively. The Department of Health Policy and Management participates in the interfaculty PhD program in health policy, also administered by GSAS; Harvard s medical, business, and government schools are other collaborators in this program. Because PhD programs are administered by GSAS and not HSPH, they are not included in this self-study document. The instructional matrix in Table 2.1.a lists the HSPH doctoral degree programs. Descriptions of each program can be found in the school catalog in Resource File 1.4.d. Required coursework for each doctoral degree is provided in the Resource File 2.6.c b. Data on the number of active students in each doctoral degree program as well as applications, acceptances, enrollments, and graduates for the last three years. Data on the number of active students and graduates in each doctoral degree program is located in Table 2.10.b(1). Data on the number of applications, acceptances, and new enrollments is located in Table 2.10.b(2). Harvard School of Public Instructional Programs 104

57 Table 2.10.b(1). Active Doctoral Students and Graduates by Department AY2006 AY2007 AY2008 SD Biostatistics Students 2 2 * (program ended in 2000) Graduates 2 * * SD/DPH Students Environmental Health Graduates SD/DPH Students Epidemiology Graduates SD Genetics and Students Complex Diseases (program ended in Graduates 1 * * 2003) SD/DPH Global Students Health and Population Graduates SD Health Policy and Students Management Graduates SD Immunology and Students Infectious Diseases Graduates SD/DPH Nutrition Students Graduates Students SD/DPH Society, Human Development, and Health Graduates *The SD in BIO and GCD are no longer offered, having been replaced by PhD degrees granted by GSAS. Table 2.10.b(2). Applicants, Acceptances, and New Enrollments by Department AY2007 AY2008 AY2009 Applied SD/DPH Accepted Environmental Health Enrolled Applied SD/DPH Accepted Epidemiology Enrolled Applied SD Immunology and Infectious Diseases Accepted Enrolled Applied SD/DPH Global Health and Population Accepted Enrolled Applied SD Health Policy and Management Accepted Enrolled Applied SD/DPH Nutrition Accepted Enrolled SD/DPH Society, Applied Human Development, Accepted and Health Enrolled Harvard School of Public Instructional Programs 105

58 2.10.c. Assessment of the extent to which this criterion is met. The school offers doctoral programs in each of the five specified areas of public health knowledge, though in the case of biostatistics, that program is offered under the auspices of the Graduate School of Arts and Sciences. Additional, doctoral programs are offered in the other fields encompassed by the school s academic departments. The school has extensive faculty expertise, course offerings, and vibrant research programs in each doctoral program area. This criterion is met. Harvard School of Public Instructional Programs 106

59 JOINT DEGREES 2.11.a. Identification of joint degree programs offered by the school and a description of the requirements for each. The school distinguishes between combined degree programs, in which students undertake two separate degrees; joint degree programs, which are integrated programs of study with integrated curricula; and dual-degree programs, which are collaborations between HSPH and another degree-granting institution. In all three cases, students are admitted separately to each degree program and must meet all requirements for each. Each program is administered separately by the identified school or institution. Combined degree programs MD/MPH combined degree Students currently enrolled in MD programs who have a career interest in public health and/or preventive medicine are eligible to apply for admission to the HSPH master of public health program. Students from medical schools across the US and Canada have participated in this program. Medical students undertake the MPH program while on a leave of absence between the third and fourth year of medical school. MD/MPH students receive the MPH degree upon successful completion of both programs and conferral of the doctoral degree. Students in the MD/MPH program select one of seven MPH concentrations listed in Instructional Matrix 2.1.a and must complete all of the requirements of that concentration detailed in Tables 2.3.a, 2.5.a, and 2.6.c of this document, including the practice experience. Credits may not be shared between the two programs for this combined degree. DMD/MPH combined degree HSPH also offers a DMD/MPH combined degree, to which students from the Harvard School of Dental Medicine may apply. This program follows the same guidelines for admission, requirements, and procedure for awarding of the degree as the MD/MPH program. Details are provided in Tables 2.3.a, 2.5.a, and 2.6.c of this document. Joint degree program JD/MPH Joint Degree The Juris Doctor/MPH (JD/MPH) is an integrated program offered jointly by Harvard Law School (HLS) and HSPH. All students in the program fulfill all requirements necessary to earn a JD from HLS and an MPH from HSPH. Students enroll in the law and public health (LPH) concentration of the MPH program and pursue a program focused on public health law and policy in their MPH coursework. The goal of the program is to encourage individuals with an interest in public health in developing interdisciplinary knowledge and skills in preparation for careers in health law, public health policy, or a related field. As noted, the MPH requirements for students in this joint program are the same as for the separate LPH program. The required HLS curriculum for joint degree students includes the following: the standard firstyear curriculum, including a spring elective; a professional responsibility course; and the written work and pro bono requirements. Joint degree students, like other JD students, are permitted to select their upperlevel law courses from HLS s wide array of offerings. JD/MPH students may count no more than 10 credits toward both their JD and their MPH degrees. Students may double count credits in any or all of the following three ways: Up to 5 HSPH credits from classes taught at HLS (on any subject) may be counted toward the MPH degree Up to 10 HLS credits from classes taught at HSPH may be counted toward the nonclassroom credit requirement for the JD degree Harvard School of Public Instructional Programs 107

60 Up to 4 HLS credits (5 HSPH credits) from an approved list of health law classes may be counted toward the requirements for both degrees. If students earn additional credits in these courses beyond that number, they may count those credits toward the requirements for one degree but not both Since credits are not counted in the same way, JD/MPH students are strongly encouraged to consult the registrars of their respective schools. Students must obtain approval from their HSPH faculty advisor for the credits/courses they intend to count toward both degrees because some courses may have overlapping content. The program is completed in three academic years, plus one summer semester. Students spend their first academic year solely at HLS. Following the first academic year, students must then enroll full-time in both HSPH summer sessions, where they complete courses totaling 12.5 credits in biostatistics, epidemiology, the ethical basis of the practice of public health, and the economics of health policy. During the second and third years of the program, students take courses at both schools. Students may choose to spend their second-year fall semester entirely at HLS in order to accommodate the demands of searching and interviewing for summer jobs. No coursework is required during the second-year summer, which is typically used to pursue health law-related work experience of the student s choice. Students are encouraged to structure one upper-level semester in which at least half of their course load consists of HSPH credits. This allows students to achieve an immersion experience at HSPH while permitting flexibility to register in required or elective courses at each school. In the third year, students must satisfy the criteria for and complete the MPH program s practicum requirement and HLS s written work requirement. The 5-credit practicum is generally completed in the spring semester. The practicum is designed to give students real-world experience in applying their knowledge and skills in law and public health. Joint degree students can integrate their practicum work with their legal work either by designing an integrated written project, or by selecting a job experience for the summer after their second year in which they will do work that meets the same substantive requirements for a practicum internship as those for MPH students who complete their practicum during the spring semester. Integrated projects must involve both a substantial writing component and a substantial experiential component and must be approved by a faculty member at each school prior to undertaking the work. The amount of time required to complete an integrated project must approximate the amount of time that would be required to satisfy the two requirements separately. Students who complete their practicum in the summer must work at least eight to ten hours per week for twelve to fourteen weeks. The complete program requirements are set forth in the Juris Doctor/Master of Public Health Joint Degree Program Description , available in Resource File 2.11.a. Dual-degree programs SM/MSN dual-degree with Simmons College (occupational health and primary care nursing) This professional dual-degree program, offered by HSPH and Simmons College, leads to an SM degree in primary health care (occupational health) from Simmons College and an SM degree in environmental health (occupational health, 42.5 credits) from HSPH. The program provides expertise in occupational safety and health and research methodology and prepares students to sit for the adult nurse practitioner and the occupational health nurse certification exams. Emphasis is placed on identification of health hazards, workplace assessment, program planning and intervention, worker health promotion, and disease and injury prevention. Candidates for the program must have a bachelor's degree, be licensed nurses, and have the equivalent of one year of recent clinical nursing experience. Candidates must apply to and be admitted by both institutions. Courses are taken concurrently. Full-time students complete the required courses over two years including the same courses as the 42.5 credits master of science in Environmental Health (Environmental and Occupational Medicine and Epidemiology). Harvard School of Public Instructional Programs 108

61 As shown in Appendix 2.6.c, these requirements meet the standard public health core course requirements for professional master's degree students at HSPH. Courses and didactic training are enhanced by visits to a variety of workplaces to learn survey techniques and methods of identifying hazardous processes. Industrial settings, clinics, hospital-based occupational health programs, and governmental agencies also serve as sites for clinical experiences. Students must complete a research project at a clinical or industrial site. The work experiences and research project fulfill the practice and culminating experience requirements of the HSPH degree. A description of this program is available online through Simmons College at SM/PCN or SM/MSW dual degree with Simmons College Both of these professional dual-degree programs are offered by HSPH and Simmons College and lead to a SM degree in society, human development, and health (42.5 credits) from HSPH and either a SM degree in primary care nursing or social work from Simmons. The SM (42.5 credits) requires the same coursework, practicum and culminating experience as a stand alone degree in the department of Society, Human Development, and Health (SHDH) with an area of interest in maternal and child health. These dual degree programs are designed to prepare nurse practitioners or social workers for leadership roles in public and private agencies and institutions serving children and their families. The programs require that 42.5 credits be earned at HSPH and 40 at Simmons. Students enroll in halftime study at both Simmons College and HSPH for two academic years, in addition to studying at Simmons for one summer session. Applicants must have a relevant bachelor s degree and the equivalence of at least three years of relevant experience. International applicants with equivalent degrees, experience, and licensure are eligible to apply. Applicants must also meet the general admission requirements of both HSPH and Simmons College. The HSPH course requirements include the standard public health core course requirements for SHDH professional SM degree students listed below. All students are also required to take a minimum of 15 ordinal credits of coursework in the Department of Society, Human Development, and Health (SHDH), including one of two SHDH core courses designed to introduce the field of study and research approaches and provide a conceptual and empirical foundation for practice and research: SHH 201, Society and Health (2.5 credits), or SHH 281, Methods for Research on Social and Behavioral Dimensions of Public Health (2.5 credits). The HSPH practicum and culminating experience requirements are met through the research project that is required as part of the second year of the Simmons program and the Master s Seminar (SHH259) at HSPH, which includes a project, and presentation. HSPH Core Course Requirements: Biostatistics BIO200, Principles of Biostatistics, 5 credits Epidemiology EPI200, Principles of Epidemiology, 2.5 credits or EPI201, Introduction to Epidemiology, 2.5 credits Environmental Health EH201 (Intro. to Environmental Health) EH202 (Principles of Environmental Health) EH232 (Introduction to Occupational and Environmental Medicine) ID215 (Environmental & Occupational Epidemiology) Health, Policy & Management 2.5 credits course options Students may petition for waivers and substitutes. Approvals must be granted by the departments within which the course resides. Harvard School of Public Instructional Programs 109

62 SHDH Departmental Requirements: All students are required to take a minimum of 15 ordinal credits in SHDH courses. This includes the 2.5 credits of required SHDH courses listed below and an additional 12.5 credits of elective SHDH courses. The SHDH core courses have been designed to introduce the field of study and research approaches and provide a conceptual and empirical foundation for practice and research. SHH201, Society and Health, 2.5 credits or SHH281, Methods for Research on Social and Behavioral Dimensions of Public Health, 2.5 credits. Descriptions of these dual-degree programs are located online through Simmons College b. Assessment of the extent to which this criterion is met. The school s combined, joint, and dual-degree programs are academically strong and valuable. They involve the same admissions and degree requirements and provide the same skills, training, and knowledge base as their freestanding counterparts. This criterion is met. Harvard School of Public Instructional Programs 110

63 INSTRUCTIONAL PROGRAMS 2.12.a. Identification of all degree programs that are offered in a format other than regular, on-site course sessions spread over a standard term, including those offered in full or in part through distance education in which the instructor and student are separated in time or place or both. The instructional matrix may be referenced for this purpose. The school offers three degree programs in a nontraditional format: Summer-only MPH program (clinical effectiveness and quantitative methods); Summer-only SM in clinical effectiveness/clinical epidemiology, Department of Epidemiology Nonresidential SM in health care management, Department of Health Policy and Management 2.12.b. Description of the distance education or executive degree programs, including an explanation of the model or methods used, the school's' rationale for offering these programs, the manner in which it provides necessary administrative and student support services, the manner in which it monitors the academic rigor of the programs and their equivalence (or comparability) to other degree programs offered by the school, and the manner in which it evaluates the educational outcomes, as well as the format and methodologies. Summer-only MPH program Students in the summer-only MPH program (42.5 credits) are subject to the same expectations and general requirements as students enrolled during the academic year. The program, available in two concentrations, clinical effectiveness (CLE) and quantitative methods (QM), permits qualified students to complete an MPH program by taking courses in three summer sessions. Summer sessions are divided into two intensive 3-week sections (Summer 1 and Summer 2). The summer-only option is built upon the long and successful history of the CLE summer program and the Summer Session in Public Health Studies. These programs were created to provide opportunities for students to take biostatistics and epidemiology courses in an intensive fashion in the summer. The CLE program also offers courses in decision analysis and quality of care, areas of strength at the school. With increasing requests for part-time study options, essential MPH courses have been added, with particular emphasis on core public health courses in health services administration, environmental health sciences, social and behavioral sciences, and ethics. A seminar that is part of the culminating experience requirement for applied research is also offered during the summer for the two summer-only MPH concentrations. While the coursework for the program is primarily campus based, the culminating experience requires applied research (a practicum) at the student s home base and must at a minimum extend between summers two and three. The culminating experience and practicum must be developed at least one year prior to the graduation date and must have the approval and support of an HSPH faculty sponsor and written agreement from a preceptor at the student s home base. Students consult with the HSPH faculty sponsor and with fellow students via during the year. A final seminar is held each summer for formal presentation of the student s work to faculty and fellow students. Summer-Only CLE: Students follow the same requirements as all students in the CLE concentration selecting from summer session options listed in Table 2.3.a. The practice course is the key difference in the program. All summer only CLE students must take ID320: ID320 [Summer 2] The Summer MPH Practicum for CLE ( credits) Summer-Only master of public health students develop on off-site practicum at their home institution under the supervision of a local mentor and a member of the faculty at HSPH. This practicum may include Harvard School of Public Instructional Programs 111

64 aspects of epidemiology, biostatistics, decision sciences, or other quantitative aspects of public health. Students should apply the competencies learned in core courses to an actual investigation. Following the first CLE summer course work, students must submit a written proposal for the practicum along with a letter of support from an investigator from the student s home site, indicating an agreement to act as the local mentor for the project. This proposal is reviewed and an HSPH faculty supervisor is identified. Students ordinarily will write a paper suitable for publication, a grant proposal or a technical report. This exercise will culminate with a presentation in the final summer of the student s program. Summer-Only QM Students follow the same requirements as all students in the QM concentration selecting from summer session options described in Table 2.3.a. The practice course is the key difference in the program. All summer only QM students must take ID270: ID270 [Summer 2] Summer MPH Practicum and Culminating Experience 5.0 Summer-Only master of public health students develop an off-site practicum at their home institution under the supervision of a local mentor and a member of the faculty at HSPH. This practicum may include aspects of epidemiology, biostatistics, decision sciences, or other quantitative aspects of public health. Students should apply the competencies learned in core courses to an actual investigation. Following the first QM summer course work, students must submit a written proposal for the practicum along with a letter of support from an investigator from the student s home site, indicating an agreement to act as the local mentor for the project. This proposal is reviewed and an HSPH faculty supervisor is identified. Students ordinarily would write a paper suitable for publication, a grant proposal or a technical report. This exercise will culminate with a presentation in the final summer of the student s program. All students are expected to present their ID270 project in the third summer of their studies. Students who do not complete all preparatory material by the established deadlines jeopardize completion of the degree. All summer courses are evaluated in the same manner as courses offered during other times of the academic year. The MPH Steering Committee and the associate dean for educational programs meet monthly during the academic year to assess program guidelines and the development of policies related to the practicum and culminating experience. At the end of each summer, students are asked to evaluate the program. The Office for Educational Programs (OEP) reviews the information, shares it with the MPH Steering Committee, and helps develop and implement needed changes. The faculty and administrative leadership of all summer programs meet during the year with the dean for academic affairs to review progress and courses and to ensure that the necessary academic resources are available to maintain rigor and depth. Administrative and student support for the summer MPH are furnished jointly by OEP staff and the summer program in CLE, which is based at Brigham and Women s Hospital (a Harvard-affiliated hospital). Students participate in summer ; enjoy all the usual services, including those provided by student affairs, career services, and the registrar; and are assigned mailboxes and addresses. In addition to a range of other activities, two weekly lunchtime discussion series feature presentations by Harvard faculty and other health professionals. Summer-only SM program in clinical epidemiology, Department of Epidemiology This summer-only SM program (42.5 credits) is designed for clinicians seeking the quantitative and analytical skills needed for clinical research. The program is currently limited to students who complete the Summer Program in Clinical Effectiveness. The program begins with an intensive seven-week, 15- credit summer course of study, which includes core offerings in clinical epidemiology and biostatistics. All participants select two courses from a list of offerings in decision analysis, health services research, health care ethics, health outcomes, research with large databases, and quality improvement of health care. For students with previous experience, second-level courses are also offered in clinical epidemiology, survival analysis, and the principles of clinical trials. Harvard School of Public Instructional Programs 112

65 The sequence of courses taken by a student to satisfy this degree s requirements depends on whether the student begins training with the Summer Program in Clinical Effectiveness or with the Summer Session for Public Health Studies. Requirements: Program in Clinical Effectiveness EPI208 (5 credits) BIO206 (2.5 credits) BIO207/BIO208 (2.5 credits) EPI236 (5 credits) EPI202 (2.5 credits) or BIO214 (2.5 credits) or EPI295 (2.5 credits) BIO224 (2.5 credits) or BIO501 (2.5 credits) EPI315 Supervised Research Project ( credits) Electives ( credits) Total = 42.5 credits Summer Session for Public Health Studies EPI500 (2.5 credits) EPI202 (2.5 credits) BIO202 (2.5 credits) BIO203 (2.5 credits) BIO214 (2.5 credits) or EPI295 (2.5 credits) BIO224 (2.5 credits) or BIO501 (2.5 credits) EPI315 Supervised Research Project ( credits) Electives ( credits) Total = 42.5 credits Elective courses can be chosen from any course offered in the Summer Session or the WinterSession at HSPH. Students in the Summer-Only SM program in epidemiology are not allowed to take courses at the school during the fall or spring semesters. Supervised research project (EPI315) A potential proposal for a supervised research project is required with the application to HSPH. The application should include a letter from local mentor indicating that the mentor has read the proposal and agrees to supervise the student on the project. In addition, a faculty member is identified by the end of the second summer of course work and assists in the supervision of the student on the research project and determines when the project is completed. The administrative and student support and methods of oversight and evaluation are the same as those described above in the summer-only MPH program. SM in health care management, Department of Health Policy and Management The SM degree in health care management (HCM) develops practical management skills for midcareer physicians with leadership positions in health care organizations. The program is nontraditional in that it is nonresidential. Participants are employed full time in either nearby or distant locations, and their time on campus is limited. The program design promotes the growth of a cohort of individuals who work and learn together as supportive peers in a challenging educational environment. The cohesive cohort culture is fostered by a prescribed curriculum, with no electives, no exemptions, and required class attendance policies, as well as group projects and study groups that convene via phone or during times that students are not on campus. The program involves an intensive three-week summer session during each of two summers and ten fourday weekends of intensive on-campus instruction over the course of two academic years (one weekend every eight weeks). The number of classroom hours is the same as those required for the department s traditional 42.5-credit SM program. Courses cover executive functions, finance, and system improvements and incorporate the other core public health disciplines (biostatistics and epidemiology, environmental health, and health and social behavior). Eligible students can earn CME credits after taking specific courses within the program. Program alumni can also earn CME credits during their annual reunions. Harvard School of Public Instructional Programs 113

66 Courses covering the five core areas of public health were described in Criterion 2.3.a. The program culminates in a practicum course (HCM707, Health Care Management Field Project) during the second academic year, in which students complete a field project, generally in the organization in which they are employed as managers. The field project must involve the application of skills and concepts learned in the program to develop and implement organizational change, or to implement new services or organizational structures. Progress is monitored through periodic reports to faculty and classmates who provide consultation and feedback. (See Resource File 2.12.b for more detail on the program s curriculum.) Table 2.12.b. Health Care Management Schedule and Curriculum Schedule Summer 1 Academic Yr 1 Summer 2 Academic Yr 2 On campus courses Curriculum 3 weeks in July One 4-day weekend each month: September, November, January, March, May 3 weeks in August One 4-day weekend each month: September, November, January, March, May Executive function Finance Systems improvement Integration HCM701 Organizational Behavior HCM703 Public Health Perspectives HCM732 Operations Management HCM719 Financial Accounting & Analysis HCM720 Cost Accounting & Control HCM702 Marketing Health Services HCM709 Negotiation & Communications HCM722 Financial Management HCM757 Improving Health Care Quality HCM704 Managing Information HCM731 Corporate Strategy HCM706 Physician Leadership HCM755 Health Policy & Payment Systems HCM758 Quality Field Project HCM707 Practical Field Projects Evaluation of student performance is accomplished through traditional means of exams, papers, presentations, field practica, and classroom participation. The program maintains the standards of rigor imposed upon students in the school s traditional master s programs, such as the MPH program (see Tables 2.3.a, 2.5.b, and 2.6.c for details). Students are given regular opportunities, particularly during the weekend sessions, to meet informally with the program director and administrator to provide feedback on course relevance and other issues, both academic and nonacademic. Students complete standard evaluation forms at the end of each course and also program evaluations in the month before graduation; this feedback is used to fine tune course offerings and forms part of the basis for planning during the program's annual faculty meeting. Harvard School of Public Instructional Programs 114

67 The program faculty director and program administrator run the program throughout the year; they oversee marketing, admissions, housing, classroom facility arrangements, faculty and curriculum, student and alumni career support, and internal administrative needs c. Assessment of the extent to which this criterion is The school offers three programs in nontraditional formats. Each is consistent with the mission of the school and within its established areas of expertise, is subject to the same rigorous evaluation and quality control processes of other programs, and provides students with the necessary supports. While in the HCM program, the course selections are specified and limited by design, one disadvantage to the two summer-only options is that those students have a smaller selection of available courses than do HSPH students enrolled during the academic year. These programs nevertheless offer a strong educational experience and are a valued alternative to programs requiring longer residence. This criterion is met. Harvard School of Public Instructional Programs 115