Karl Umble

Impact studies in continuing education for health professions: Update

Introduction: This article critiques the questions asked and methods used in research syntheses in continuing education (CE) in the health professions, summarizes the findings of the syntheses, and makes recommendations for future CE research and practice. Methods: We identified 15 research syntheses published after 1993 in which primary CE studies were reviewed and the performance (behavior) of health professionals and/or patient health outcomes were examined. Results: The syntheses were categorized by the research questions they asked using a wave metaphor. Wave One (n = 3) syntheses sought to establish a general descriptive causal connection between CE and impact variables, asking. “Is CE effective, and for what outcomes?” Wave Two syntheses (n = 12) sought to explain the relationship between CE and impacts by identifying causal moderators, asking, “What kinds of CE are effective?” Discussion: Wave One findings confirm previous research that CE can improve knowledge, skills, attitudes, behavior, and patient health outcomes. Wave Two syntheses show that CE, which is ongoing, interactive, contextually relevant, and based on needs assessment, can improve knowledge, skills, attitudes, behavior, and health care outcomes. The most important implication of the present review is that there are differential impacts of CE programs, and the reasons for those impacts cannot be fully understood unless the context of the program is considered.

Impact studies in continuing education for health professionals: A critique of the research syntheses

Documenting impact has been a continual pursuit in continuing education (CE) for health professionals. Hundreds ofprimary impact studies have been published, along with 16 impact study syntheses that have sought to generalize about the effectiveness of CE and sometimes how and why the effects occur This article describes and critiques the methodology of the 16 syntheses and summarizes their findings. Afirst wave of syntheses established a general causal connection between CE and impacts, but explained impact variability only in the dependent variable-knowledge, competence, performance, or outcome. A second wave added a search for causal explanation through analysis of variables that moderate impact. This wave has begun to identify the most appropriate types of programs for promoting performance changes. The article concludes by suggesting questions and methods forfuture primary studies and meta-analyses, including improved experimental and metaanalytical methods, along with case and naturalistic studies and action research.

The National Public Health Leadership Institute: Evaluation of a Team-Based Approach to Developing Collaborative Public Health Leaders

Recent public health literature contains calls for collaborative public health interventions and for leaders capable of guiding them. The National Public Health Leadership Institute aims to develop collaborative leaders and to strengthen networks of leaders who share knowledge and jointly address public health problems. Evaluation results show that completing the institute training increases collaborative leadership and builds knowledge-sharing and problem-solving networks. These practices and networks strengthen interorganizational relationships, coalitions, services, programs, and policies. Intensive team-and project-based learning are key to the programs impact.

An interdisciplinary MPH via distance learning: meeting the educational needs of practitioners.

This article describes a distance learning master of public health program that prepares students to lead programs and organizations. Evaluation showed that the curriculum, format, and teaching methods were accessible, affordable, acceptable, and appropriate for the working professional, and equivalent to residential masters programs aimed at experienced professionals. Students interacted with professors and other learners using the World Wide Web, weekly videoconferences, and face-to-face meetings. Students, whose main motivations for enrolling included improving job performance in leadership and career advancement, reported strengthening of knowledge, perspective, skill, technical facility, confidence, and job performance. Learner satisfaction was high, with 100% agreeing they would recommend the program to others.

The management academy for public health: A new paradigm for public health management development

Research has established a need to develop management skills among public health professionals. The University of North Carolina-Chapel Hill created the Management Academy for Public Health as a pilot program for this specialized training need. This article describes why a management academy for public health managers was formed, its curriculum and instructional methods, and the evaluation findings from its first year. The program sponsors hope to effect individual and organization level change, eventually leading to improved community health. Results suggest that this innovative program gives public health professionals needed skills and improves their job performance.

Impact of an Online Analytic Skills Course

This article describes the effect of an online analytic skills training course on professional development and practice and discusses recommendations for using this training modality in the public health workforce. The Enhancing Data Utilization Skills Through Information Technology initiative trained professionals in maternal and child health from 13 Southern-tier state and local health departments to collect, analyze, and interpret data via a year-long Web-based course. The evaluation of this initiative was based on a model of change for health professionals that holds that training influences behavior by increasing knowledge, influencing beliefs related to the behavior, enhancing self-efficacy, and improving skills. Participants’ knowledge, beliefs, and self-efficacy all increased significantly during the course. Participants’ self-assessed skill levels increased significantly for each of 12 selected skills and overall for all skills combined. Distance learning is potentially an effective means for professionals to advance their skills while continuing to fulfill their work-related responsibilities.

Negotiating About Power, Frames, and Continuing Education: a Case Study in Public Health

Drawing on the Cervero and Wilson theory of program planning as the negotiation of interests, the purpose of this study was to examine the utility of the distinction between meta-negotiation and substantive negotiation. A case study approach was used to examine a continuing education course in public health. Historically, the course had represented an attempt to implement federal immunization policy. After the course was under way, stakeholders whose interests were not being fully met engaged in meta-negotiations to change the power relationships at the planning table and in substantive negotiations to change the content of the course and audience for it. The redesign and implementation of the course represented a recurring series of substantive negotiations of personal, organizational, and societal interests within relations of power and meta-negotiations about the power relations themselves as stakeholders sought to have their interests represented at the planning table.

Linking learning methods to outcomes in public health leadership development.

PURPOSE The purpose of this research is to present evaluation findings from the National Public Health Leadership Institute (PHLI) regarding how the curriculums learning methods work singly and together to produce outcomes for learners and their organizations. DESIGN/METHODOLOGY/APPROACH Six months after graduation from PHLI, four recent cohorts of PHLI graduates were asked to report overall reactions to PHLI by using an online survey. The survey consisted of quantitative questions about key leadership behaviors taught in the program and the usefulness of PHLIs five learning methods as well as qualitative questions about changes in understanding, skill, practices, and outcomes. FINDINGS The evaluation survey yielded a 66 percent response rate (n=133). PHLIs learning methods are interrelated and lead to such outcomes as changed leadership understanding, knowledge and skill development, increased confidence, increased self-awareness, leadership practice changes, and organizational results. The learning project was strongly associated with development of collaborations, whereas assessment tools and coaching were most often associated with increased self-awareness. RESEARCH LIMITATIONS/IMPLICATIONS These preliminary findings support the idea that particular learning methods are related to specific outcomes. However, graduates often integrate information and skills from multiple methods to achieve outcomes. Future research should investigate whether the associations identified in this evaluation are present in other leadership development programs. ORIGINALITY/VALUE This is the first published evaluation that has attempted to link specific learning methods with outcomes for participants of a public health leadership development program.

Online analytic and technical training.

The authors describe the effect of online analytic and technical skills training tools on professional development and practice. Three questions were addressed: (1) Will maternal and child health and other public health professionals register for and engage in online training opportunities? (2) Was this mode of instruction perceived to be an effective means for learning specific skills? and (3) What was the impact of the tools on user knowledge, confidence, practice, and sharing of skills with colleagues? Evaluating open-enrollment online training posed significant challenges. Nonetheless, registration data and the responses to the online surveys affirmed that the opportunity for asynchronous, online learning was an effective means for learning specific skills.

The UNC Management Academy for Public Health: How the UNC School of Public Health and the Kenan-Flagler Business School created a winning partnership

The University of North Carolina Management Academy for Public Health is a unique training program that combines a business education with a public health focus, to enhance the performance of individual public health managers and improve organizational strength throughout governmental public health. This article considers the implications of decisions made in creating this program, which, after initial funding through the Centers for Disease Control and Prevention Foundation, is now self-sustaining through participant fees. It details the principles behind the programs design, curriculum, evaluation, and sustainability strategies; presents results of the ongoing partnership; and draws conclusions about the programs future ability to meet a national need for public health management training.