Integrated Public Health Core Program diversifies education

In 2014, the Association of Schools and Programs of Public Health (ASPPH) issued its landmark report, “Framing the Future: The Second Hundred Years of Education for Public Health.” Framing the Future represented the first sweeping re-imagination of public health education since the 1915 Welch-Rose Report. Most radically, Framing the Future recommended that schools and programs in public health move away from the five traditional core disciplines—biostatistics, environmental health sciences, epidemiology, health policy and management, and social and behavioral sciences—and develop “an integrated common core rooted in professional practice.”

Some 24 schools have now launched an integrated core curriculum. The Texas A&M School of Public Health core program is not only part of that vanguard, but is also one of a handful of schools to have developed and delivered a fully integrated master of public health (MPH) core curriculum. Traditionally, schools offered siloed core courses in epidemiology, biostatistics, health policy, environmental health and social and behavioral health. Often, students would take the course in their concentration right away, leaving the other foundational courses till the end of the two-year MPH degree.

Texas A&M’s revised four-course sequence begins with an intensive two-week course prior to the start of the traditional semester: Thinking in Populations. This course sets the stage for the kinds of questions and approaches that are central to public health framing and analysis of health challenges that cannot be resolved one patient at a time.

With this as backdrop, students spend the first half of the fall semester tracking and responding to a simulated acute outbreak. In the second half of the fall semester, students help to generate and synthesize evidence to inform an unfolding policy drama involving a wicked chronic disease problem—that is, a complex problem with multiple determinants requiring diverse but contested solutions.

The new integrated program changes the way master’s students think. They focus on populations at the outset while also solving real problems. Rick Danko, PhD, one of the creators and the MPH core director, explained, “We are teaching students how to figure things out—not just how to select the right answer on a test.”

“This approach requires us to teach as a team,” said Itza Mendoza-Sanchez, PhD, assistant professor in the Environmental and Occupational Health Department. “In any given week, you might analyze leadership and then the determinants of health on Tuesday before turning to methods and interventions on Thursday.”

Amy Fairchild, PhD, MPH, associate vice president for faculty and academic affairs at the Texas A&M Health Science Center, added, “But we aren’t teaching to the case. The case with all of its specific details is just a medium for students to apply skills as they learn them.”

It isn’t only faculty who have to work as a team. In practice, interdisciplinary teams come together to solve problems. In the classroom, then, students work with peers from other backgrounds. Only in this way can students grasp the different perspectives and skills required to solve a case. This is another way the interdisciplinary learning style is helping students enhance their education.

“There are so many people from different backgrounds immersed in the core,” graduate student Tyrone Bethune said. “Being a health policy student, I wouldn’t approach the same issue or the same question the way an environmental student would.”

The program better prepares students for the workplace through understanding how certain disciplines relate to one another, providing a tighter network outside of their own department and provides a real cohort experience.

“I gained experience working with students from other concentrations,” graduate student Oscar Hernandez said. “Everybody comes in thinking ‘Oh, I’m just a student again,’ but the core program really bonds you together as a cohort.”

Graduate student Joshua Brog said the core helped him see things in a different way from what he would traditionally learn in his discipline alone. The core program teaches students not only what policy works, but how to know if it is effective and making a difference.

“I’m kind of a policy junkie so I liked writing policy briefs,” Brog said. “The interactive assignments where we had the opportunity to work in groups provided a way to get perspectives from all the different disciplines. Normally you would only hear what the other people in your specialization think, but it was really cool to hear about what the people in other departments thought about the issue we were addressing.”

“Faculty gave us the basic idea from the point of view of all the concentrations,” said Sadia Najneen, a doctoral candidate with a focus in epidemiology. “Without the integrated core, I would never have been exposed to health policy to the degree we were, which I really enjoyed learning about.” She also described a workload that resulted in new writing skills as well as great opportunities to practice public speaking.

“I’ve enjoyed the opportunities to communicate with students outside of my concentration,” said Samia Tasnim, MD, a graduate student from Bangladesh in the Health Promotion and Community Health Department. “Two-way communication made for clear discussion. A new idea would be taught and we all had the chance to ask questions and give our opinions.”

Tasnim hopes to return home to Bangladesh after completing her degree and use what she has learned to create more holistic care for her patients through improved communication.

“When you begin to learn about different ways of knowing simultaneously, it not only reshapes the ways you first approach problems, but it can allow you to reimagine that path you want to go down as a professional,” Fairchild said. “If you don’t learn about something we teach in the core requirements until your last semester here, you’ve lost all opportunities now to explore public health in a new way. Our integrated core program eliminates those issues.”