Curriculum renewal in undergraduate public health at The University - - PowerPoint PPT Presentation

Curriculum renewal in undergraduate public health at The University of Adelaide: increasing coherence, engagement and vocational focus

Dr Rebecca Tooher, School of Population Health

SPH BHlthSc Working Party

• Dino Pisaniello
• Annette Braunack-Mayer
• John Lynch
• Caroline Laurence
• Emma Miller
• Shona Crabb
• Adriana Milazzo
• Paul Rothmore
• Catherine Chittleborough
• Gillian Laven
• Tanya Wittwer
• Dylan Coleman
• Jenny Baker
• Vivienne Moore
• Rebecca Tooher

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Need for curriculum renewal in PH

• BHlthSc at University of Adelaide – since 1990
• Broad degree with mixture of population health and

biomedical sciences at first year

– Then students choose from various majors

• Large first year intake – 350 equiv full time student load

– Has doubled in last five years (from 110 in 2008 to 290 in 2012)

• Retention from first year to second year has been

declining

– From 94% in 2001 to 56% in 2012 (down to 50% in 2010)

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Need for curriculum renewal in PH

• All students complete Public Health 1A and 1B in first

year

– Enrolments in 2013 c. 390

• Far fewer students continue on to second year public

health

– This has been declining over past 5 years – Thus retention for Public Health specifically is worse than for degree as a whole

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Retention in PH at second year

2008 2009 2010 2011 2012 Level I (year prior) 109 142 195 209 258 Level II 36 47 59 46 58 % retention 33% 33% 30% 22% 22% Program retention 62% 60% 50% 54% 56% PH Sc II 33 38 45 33 44 PH Inq II 26 41 47 36 45 Total (load) 59 79 92 69 89

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Retention in PH at second year

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0% 10% 20% 30% 40% 50% 60% 70% 2008 2009 2010 2011 2012 PH retention Program retention

Majors in the BHlthSc

• Currently 10/12 majors biomedical sciences (anatomy,

pathology, physiology, pharmacology, reproductive health, nutrition, neuroscience, biochemistry, microbiology, genetics)

• Single PH major (no differentiation)
• Proportion of students completing PH majors has been

relatively small and declining

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Proportion of all majors by Discipline

22% 16% 18% 12% 12% 0% 5% 10% 15% 20% 25% 30% 35% 40% 2008 2009 2010 2011 2012 PH major pathology major pharmacology major

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SPH BHlthSc Working Party

• Convened in late 2011
• Met regularly throughout 2012 and 2013
• Worked to meet University timelines for Program and Course

renewal Initial objectives 1. Consider opportunities for expansion/revision of SPH

• fferings

2. Identify relevant PH courses (existing in SPH, outside SPH; proposed for SPH; other) 3. Map several streams for BHlthSc majors to be coordinated by SPH, in consultation with other schools 4. Recommend new courses (including a vocational course)

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SPH BHlthSc Working Party

Ultimate objectives 1. Develop new vocationally focused population health majors for the BHlthSc

• 2. Develop related coursework to feed into the majors
• 3. Ensure curriculum coherence across the three years of

the majors

• 4. Ensure quality and external validity by mapping

curriculum against existing frameworks Context for change: New VC and new Strategic Plan, SPH assumed admin responsibility for BHlthSc in 2012

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Steps in the process

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Brainstorming what needed to be done

Identify new majors

Epidemiology Health Promotion Indigenous Health

Map curriculum against frameworks

Develop new courses

Introduce new majors in 2014

• To fit with new UG

curriculum structures

• To fit with University

Program and Course approval timelines (long lead time before teaching)

• ALTC Threshold Learning

Outcomes

• AQF
• Blooms taxonomy
• RSD framework
• ASPH UG Learning Outcomes
• CDAMS Indigenous curriculum
• New Level II courses
• New Level III courses
• Reconfiguration of

existing capstone/s

Initial brainstorming

• Realised that interdisciplinary teaching might not be

possible in short term

• Recognised urgency of addressing poor retention of PH

students especially into the third year

– Course enrolments becoming so low that viability coming into question

• Concluded that changes to PH curriculum needed to

happen sooner rather than later

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3 new majors

• Epidemiology
• Health Promotion
• Indigenous Health
• Related to identified workforce planning needs and

aligned with the core strengths of the SPH

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Structure of new majors

• To comply with new UG curriculum structures

– All majors at UoA to be 24 units across three year levels with at least half at the highest level

• In practice:

– 6 units (0.25 EFTSL) at Level I – 6 units at Level II – 12 units at Level III

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Structure of new majors

• Level I

– Public Health 1A and 1B (each 3 units)

• Level II

– Essentials of Epidemiology (compulsory for all Pop Hlth majors) – Social Foundations of Health – Investigating Health and Disease in Populations

• Level III

– Specialist 3 units course: Epi in Action, Health Promotion III, Indigenous Health III – 6 unit capstone course: PH Internship or PH Theory and Practice – 3 units of PH electives: Evaluation III, Rural PH, International Health or one of the other specialist courses

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Structure of new majors

PH1A and PH1B Essentials of Epi PH Theory & Practice PH Internship Other PH electives Investigating Hlth Epi in Action Social Foundations Hlth Prom III Indig Hlth III

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Level I Level II Level III +

• r
• r
• r
• r

+

Development of new courses

• Year level attributes

– First year - enabling, inspiring and introductory – Second year - focused content – Third year - pre-professional and advanced topics/methods

• Core competencies for PH graduates

– Well developed research literacy – Well developed data numeracy and literacy – Highly developed communication skills

• Mapped curriculum against frameworks to ensure

coherence and identify any gaps

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Mapping the curriculum

• First compared various pedagogical/curriculum

frameworks for congruence

– ALTC Threshold Learning Outcomes for Health Science – Australian Qualifications Framework – Blooms taxonomy – Research Skills Development framework – American Schools of Public Health UG Learning Outcomes – Council of Deans of Australian Medical Schools Indigenous curriculum

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Reference to Threshold Learning Outcomes (FHS Strategic Plan)

Threshold learning

• utcomes

ASPH domains AQF

descriptors

Blooms taxonomy RSD Level Professional behaviours

Personal & social responsibility Purpose Application 6 5

Assess health status and formulate mgmt plans

Knowledge Intellectual & practical skills Integrative & applied learning Skills 1,2,3,4,5,6 2,3

Promote health and welfare of ind/pop

Knowledge Intellectual & practical skills Integrative & applied learning Personal & social responsibility Skills Application 3,4,5,6 4,5

Retrieve, critically evaluate and apply evidence

Intellectual & practical skills Integrative & applied learning Skills Application 4,5 3,4

Deliver safe & effective healthcare

Knowledge Intellectual & practical skills Personal & social responsibility Application 1,2,3,4,5,6 4,5

Reflexive practice

Personal &social responsibility Integrative & applied learning Knowledge Application 1,2,3,4,5,6 ?NA

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Mapping against ASPH UG Learning Outcome

• Satisfied that there was congruence between different

frameworks

• Concluded that ASPH UG Learning Outcomes most

useful for our purposes

– Clearly differentiate the requirements of UG – Ensured program quality against international benchmark – Process used to derive ASPH domains thorough and transparent

• Detailed process of comparing each of our existing

courses against the ASPH domains

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ASPH domains

1. Knowledge of human cultures and the physical and natural world as it relates to individual and population health

• 2. Intellectual and practical skills
• 3. Personal and social responsibility
• 4. Integrative and applied learning

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Results

 Across all four domains we were able to map coverage of almost all learning outcomes across the available public health courses (including first and second year)  We did identify some gaps

– In our current offerings there is limited coverage of environmental health and hazard management (a bit in first and second year but no third year course with this focus) – Relationship between human rights and health, and fundamental right to health and health services not clearly articulated – We were not covering the reciprocal relationships among literature, the arts and public health – We were not ensuring students had opportunities to be advocates for evidence-based social change to improve health of communities

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New course development

• Concurrently developed/revised 3 new Level II courses

and 4 new Level III courses

– Courses not changing for 2014 will be reviewed for 2015 – First year public health undergoing separate but related renewal project

• Series of workshops (2-3 hours) with working party to

jointly develop

– Learning outcomes – Learning and teaching modes and activities – Assessment

• Course approval documentation then developed for

approval by small teams led by one member of WP

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New course development

• Advantages of co-creation of courses

– Program level coherence for the Pop Hlth majors – Consistency of assessment without duplication – Enabled gaps in learning outcomes identified in curriculum mapping process to be addressed across the whole program

• ffering

– Brainstorming process also increased ownership of program

• fferings across all teaching staff – avoided typical individual
• wnership of courses by academic developing it

– Teaching team identity strengthened – Confirmation of shared norms around teaching practices for SPH – Capacity building for course development

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New course development

• Challenges

– Finding time to get people together – benefits may not have flowed as effectively to those who could not make multiple meetings – General overview of courses clear but detail still required to finalise paperwork (so still substantial work required) – Despite multiple heads on task still failed to completely satisfy course approval committee on first submission

• Case study: Development of our capstone course

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How did we meet identified gaps?

• Awareness of gaps has informed selection of learning activities

across all three years particularly in core courses Specifically:

• Environmental health and hazard mgmt

– slated for new major if/when enrolments can support it

• Human rights and right to health

– incorporated into Indigenous Health major and will be further strengthened in International Hlth and Rural PH when revised

• Reciprocal relationships among literature, the arts and public

health

– Indigenous Health major developed and taught by Indigenous academic with PH and creative writing background

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What have we learned?

• Codevelopment of courses effective, efficient and

rewarding

• Students respond positively to curriculum renewal
• Systematic approach is both reassuring (we are on the

right track) and provides excellent guidance for how to proceed

• What would we do differently?

– Student consultation – Interdisciplinary teaching – Direct involvement of industry/employers

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Retention into second year after new majors

2012 2013 Level I (from year prior) 258 316 Level II (unique students) 58 110 % retention 22% 34% Program retention 56% 62% Essentials of Epi (44) 75 Social Foundations of Health (45) 65 Investigating Hlth and Disease in Pop 34 Total student numbers (load) 89 174

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89% increase in students enrolments at Level II Almost double student load 54% increase in retention (5x the increase in

• verall program

retention)

Retention into second year after new majors

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33% 33% 30% 22% 22% 34% 62% 60% 50% 54% 56% 62% 0% 10% 20% 30% 40% 50% 60% 70% 2008 2009 2010 2011 2012 2013 PH retention Program retention