CURRENT & FUTURE CHALLENGES WITH PUBLIC HEALTH EDUCATION IN CANADA CPHA MAY 2015 KAREN DICKENSON SMITH & DR. MARCUS LEM



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Solutions Gaps Needs CURRENT & FUTURE CHALLENGES WITH PUBLIC HEALTH EDUCATION IN CANADA CPHA MAY 2015 KAREN DICKENSON SMITH & DR. MARCUS LEM Strategy

Perspective of the employer (Health Authority, Government) Perspective of licensed professional categories working in PH Experience with MPH and professional programs as preparation for both frontline PH work and policy Experience with standards, design and operation of specialty level training in PHPM Different Public Health Perspectives We Bring

Topics for discussion Workforce Needs Critical Gaps & Challenges Public Health Education Current Education Programs Future Directions / Ideas

Vary in base credentials and experience pre-requisites Vary in focus Current PH Educational Programs Vary in curriculum and graduate qualifications Vary in success of graduates

Fraser Health Environmental Scan August 2014 Professional development Workforce Needs Public Health Competencies/skills Innovative, cost-effective approaches/ financial models to re-tool workforce

Competency Education/Skills Training Most Needed for our Workforce: Leadership Top 3 Competencies Partnerships & Collaboration Communication

Skills/Experience Desired by Employers: Public Health Competencies Public Health or Related Work Experience Systems & Critical Thinking Community Engagement; Health Equity Project Management &Change Management Leadership, Planning & Evaluation Health Informatics; Administration & Finance Chronic Disease Prevention Quality Improvement Employer Needs

Skill and Experience Gaps Quantitative analytic skills Health informatics Geospatial statistical analysis Familiarity with PH and Health Care environments Depth of knowledge regarding evidence base for performing and evaluating public opinion research, social marketing, social media, etc. High Demand Skill Sets

Gaps (Skills/Experience Difficult to teach Remotely): Contextual knowledge and familiarity Detailed analytic skills Critical Thinking and decision making Communication skills Leadership and management Professional behavior Not Conducive to Remote Education

In some cases: Mismatch of graduate qualifications to employer current and future workforce needs. Narrow/lack of interface between employers and educational institutions Risk of diluting the meaning of Public Health due to the wide variety of programs and graduate credentials/ experience Challenges/Gaps

Broader interface between employers and educational institutions Base credentials and experience prerequisites match employer job requirements Greater consistency in core programming so the meaning of PH is clear Ideas for Future

Co-op programs Specialty streams for Public Health More instruction by front line PH practitioners More instruction on policy by government agencies Transition to practice Ideas for Future cont d.

Fraser Health Authority FH Population & Public Health Workforce Development Committee FH Population & Public Health Senior Leadership & Management Teams UBC PHPM Residency Program Liliana Tapia, UBC MPH Graduate Valerie Whittaker, Clearview Consulting Acknowledgments

The Future of Public Health Education in Canada Skills Enhancement for Public Health Centre for Public Health Capacity Development Health Security Infrastructure Branch Building a Solid Foundation for Public Health Practice 1

The Future of Public Health Education in Canada Objectives 1. Acknowledgements 2. Disclaimers 3. Trends 4. Predictions 5. More Predictions 6. Predicted outcomes 7. Suggestions 2

The Future of Public Health Education in Canada Acknowledgements Bonaventure Alexandre Carmen Ma James Jung Sabah Sarker 3

The Future of Public Health Education in Canada Disclaimer The views expressed in this presentation are the views of the speaker and do not necessarily reflect the views of the Government of Canada. Les opinions de ce haut-parleur ne représentent pas nécessairement celles de la direction. This product is meant for educational purposes only. Any resemblance to real persons, living or dead is purely coincidental. Void where prohibited. Use only as directed. No other warranty expressed or implied. Subject to approval. This is not an offer to sell securities or cookies. Apply only to affected area as needed. May be too intense for some viewers. For recreational use only. All models over 18 years of age. Subject to change without notice. Times approximate. Colors may, in time, fade. Keep cool; process promptly. Facts were current at time of printing. Not responsible for direct, indirect, incidental or consequential damages resulting from any defect, error or failure to perform. Do not write below this line. Employees and their families are not eligible. Contestants have been briefed on some questions before the show. Limited time offer, call now to insure prompt delivery. You must be present to win. Not recommended for children. Reproduction strictly prohibited. This supersedes all previous notices. 4

The Future of Public Health Education in Canada Trends 5 Public Health Agency of Canada Agence de la santé publique du Canada 5

The Future of Public Health Education in Canada Trends 1. 34 Schools of Public Health at 30 Universities 2. 23 Master s level programs 3. From 3 to 14 MPH programs since SARs (five fold) 4. 30% annual increase in undergraduate degrees 5. 25% annual increase in master s level degrees 6. 4 schools accredited (international) 7. Half reference public health competencies in curriculum 6 Public Health Agency of Canada Agence de la santé publique du Canada 6

The Future of Public Health Education in Canada Not Trending 1. Tracking of graduates to the workforce 2. No new school accreditations 3. No professional designation for PH professionals 4. Core Competencies for Public Health 1.0 5. MPH Guidelines 6. Use of new online learning technologies 7. Public Health Nursing remains primary PH position 7 Public Health Agency of Canada Agence de la santé publique du Canada 7

The Future of Public Health Education in Canada Predictions 8 Public Health Agency of Canada Agence de la santé publique du Canada 8

The Future of Public Health Education in Canada Predictions 1. Public health will continue to be a popular academic stream 2. The number of PH schools will continue to grow 3. There will be mixed degrees (eg dental and public health) 4. Increase in tailored core competencies generated 5. The pace of PH graduates will continue 6. International online degrees 9 Public Health Agency of Canada Agence de la santé publique du Canada 9

The Future of Public Health Education in Canada But.. 1. No change in accreditation of schools 2. No change in professional training options 3. No monitoring workforce gaps and needs 4. Reduced emphasis of Canadian competencies for public health practices to meet Canadian population needs 5. PH graduates will be employed outside of public health 6. No change to Core Competencies 1.0 10 Public Health Agency of Canada Agence de la santé publique du Canada 10

Skills Enhancement for Public Health So what now? Dilution effect of multiple competencies what so now MPH degree will be variable Public Health science and practice will be variable Schools will consider changing names/focus Strong international / U.S. influence International online degrees more competitive Employers will continue to recruit from existing streams of professional health (nursing,.) Professional training will continue to fill a gap Public health practice will vary by region 11

Skills Enhancement for Public Health Possible priorities Consider ownership of the MPH guidelines Better coordination of public health competencies Engage public health employers Repository of education materials Professional designation for Public Health Practice Confirm what is so Canadian about public health» Population? Infrastructure? Practice?. 12

Tools for Democratizing Public Health Education: Current Challenges and Future Directions NextGenU.org Kate Tairyan, MD, MPH Senior Lecturer, SFU; Director of Public Health, NextGenU.org Erica Frank, MD, MPH Founder and President, NextGenU.org Professor and Canada Research Chair, UBC

Challenge #1 Current and anticipated shortage of public health workforce in Canada and globally

Kampala Declaration 2006 - WHO identified a need for 4.3 million more trained health workers 2013 shortage of 7.2 million health workers by 2035 12.9 million WHO also said that this will require greater use of training innovation, especially information and communication technologies

Land Mass: typical view

Nurses Working

Physicians Working

Deaths of Women from Pregnancy

Shortage of public health workforce? CDC Report, 2012 Throughout the country, states and communities report a need for more public health nurses, epidemiologists, laboratory workers, informaticians, and environmental health professionals. ASPPH estimates that 250,000 more public health workers will be needed by 2020 to maintain capacity only 20% 25% of the public health workforce graduates from an accredited school or program of public health Four out of five current public health workers have not had formal training for their specific job functions

Any estimates for Canada? PHAC Report: Learning from SARS - Renewal of Public Health in Canada It was abundantly clear during the SARS outbreak that Canada needs more epidemiologists with an orientation to field investigation and outbreak response. Canada has many university epidemiology programs, but most of these are research-oriented. Existing human resources, in sum, are insufficient to meet current and future public health challenges.

Challenge #2 Despite growing number of programs public health education is not accessible

Challenge #3 Shortage of course offerings and instructors to teach public health courses

Tools to democratize public health education Challenge #2 - public health education is not accessible Challenge #3 - Shortage of course offerings and instructors to teach public health courses Challenge #1 - Current and anticipated shortage of public health workforce

Internet Users - 1990

Growth in % of internet users = 1997-2013 Source: Jeff Ogden CC BY-SA 3.0

Match existing competencies and resources

Organize in modules

Average Score: Emergency Medicine Exam 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% USUHS/Bethesda EM Scores 80.90% 80.30% Traditionally Trained 2011-12 NextGenUsers 2012-13 Average Score: Emergency Medicine Exam 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% University of Missouri EM Scores 71.40% 71.20% Traditionally Trained 2012-13 NextGenUsers 2012-13 Average Score: Environmental Health Exam 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Simon Fraser University EH Scores 86.40% 88.80% Traditionally Trained 2012-13 NextGenUsers 2012-13 Course Rating 5.0 4.5 4.0 3.5 3.0 Student Course Satisfaction for EH Class at Simon Fraser University 4.7 4.3 4.1 3.9 3.7 2009 2010 2011 2012 2013

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Assessment Security Students can be video-recorded sitting the examination Computers cut and paste functions can be frozen Sites accessed during exam-taking can be tracked (Customized) examinations can be printed and administered locally under direct supervision

Traditional (6) Novel (11) - Credit - Competency-based - Human interactions - Best resources - 360 assessment - Coordinated curriculum - Higher-level education - Tested efficacy - Customizability - Multiple languages - Warm prestige - Advertisement-free MOOCs (6) - Asynchronous - Free - Active educational partnerships - Limitless scalability - Teacher/learner respectful - Low risk - Open research policy - Low barriers - Financial efficiency - Low carbon emissions - Computerized interactions

THANK YOU Contact us if interested in using NextGenU or partnering to democratize public health education! www.nextgenu.org ktairyan@sfu.ca