Online Public Health Professional Development in Canada and Internationally

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Online Public Health Professional Development in
Canada and Internationally
Canadian Network for Innovation in
Education Annual Conference, Ottawa, May 2009
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Outline of Panel Discussion

• Skills Online Program Overview
• Carla Troy, Program Director
• Program Evaluations
• Jennifer Lowe, National Core Competencies
  Coordinator
• Outcomes A Learners Perspective
• Jacquie Sarna, Winnipeg Regional Health Authority
• Adaptation to New Contexts
• Jamie Rossiter, E-learning Specialist

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Skills Online Program Overview

• Carla Troy
• Program Director
• Skills Enhancement for Public Health

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Skills Enhancement for Public Health Who Are We?

• Multi-disciplinary program within the Public
  Health Agency of Canada
• Working with many partners across Canada
• public health practitioners and organizations
• academic institutions
• To help strengthen the public health workforce

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The Need to Strengthen the Public Health
Workforce

• Public health events, such as SARS, emphasized
  the need to re-examine public health
• Public health priorities
• Strengthen the public health system
• Develop a competent public health workforce

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National Response to Strengthen the Public Health
Workforce

• Federal/Provincial/Territorial Advisory Groups
  develop pan-Canadian strategies to strengthen
  public health capacity
• Disseminate public health core competencies
  common to all public health professionals
• Enhance knowledge skills throughout the public
  health workforce

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Core Competencies for Public Health in Canada
Release 1.0
Identify the knowledge, skills attitudes
required across an organization or program to
fulfill public health functions
Provide guidelines for the basic knowledge,
skills attitudes required by individual
practitioners
Provide rationale for consistent job descriptions
performance assessments
Develop orientation programs for new or existing
staff
Identify staff development training needs
Facilitate collaboration, shared goals
interdisciplinary work
Inform curriculum development
Support the development of other complimentary
sets of competencies (e.g., discipline-specific,
program-specific)
Support the recruitment retention of staff,
ensuring the right number mix
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How do we meet the Core Competencies?

• The role of continuing education.
• Skills Online

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What is Skills Online?

• Internet-based continuing professional
  development program for front line public health
  practitioners
• Facilitated modules in English French
• Offered at no cost to public health professionals
  since 2002
• Over 3,500 individuals have completed one or more
  modules

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Skills Online Implementation

• Relevant, timely practical Canadian content
• Easily accessible through Web browser
• Help Desk for technical support
• Cohorts of 15-20 learners led by experienced,
  trained facilitator
• 8 weeks to complete a module
• Modules range from 25-40 hours in length
• Modules offered three times per year

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Key Features of Modules

• Based on principles of adult learning
• Self-assessments with instant feedback
• Discussion boards to share ideas
• Learning exercises that encourage application of
  knowledge to practice
• Links to external resources useful to practice
• Content mapped to the Core Competencies for
  Public Health in Canada Release 1.0

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Module Development Process
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Modules Available Under Development
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Modules Available Under Development
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Recognition, Endorsement Support

• Certificate from Public Health Agency of Canada
  the Institut national de santé publique du
  Québec after successful completion of each module
• Endorsed by professional organizations
  associations
• Support from provinces, territories local
  organizations
• University recognition, e.g. Master of Public
  Health programs

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Skills Online International

• Australian Pilot Project with LaTrobe University
• Pan American Health Organization (PAHO)
  Collaboration in English-speaking Caribbean
• International French Learners in sub-Saharan
  Africa
• World Health Organization (WHO) Collaborating
  Centre for Public Health Competencies and
  Training

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Program Evaluations

• Jennifer Lowe
• National Core Competencies Coordinator
• Public Health Agency of Canada

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Evaluations of Skills Online

• Formative outcome evaluations
• Post-module surveys to explore
• Learners experiences with the modules to help
  inform future module development implementation
• Recommendations for program improvement
• Pilot case study to explore
• How Skills Online learners apply knowledge into
  practice
• Organizational effects of new learning

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Post-Module Survey Methodology

• Analysis of English French post-module survey
  data collected between Spring 2005 Winter 2008
• 9 modules
• 4,261 surveys completed
• Demographic, Likert-scale item responses
  open-ended questions

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Post-Module Survey Results

• 3 times more English modules completed than
  French
• 44 of learners Public Health/Community Health
  Nurses
• 85 female
• 70 less than 10 years public health experience
• 63 aged 30 to 49 years
• 88 university degree 6 doctoral degree

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Post-Module Survey Results

• Access at work sometimes insufficient need home
  access too
• Unrealistic estimation of time required to
  complete some modules
• Some not prepared for intense learning experience
• Some find it difficult to relate to others in an
  online environment

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Post-Module Survey Results

• Discussion boards assignments challenging for
  non front line professionals
• Some links dont function well or are difficult
  to find some instructions vague or incomplete
• Translation doesnt always reflect terminology or
  practice in other language

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Post-Module Survey Results

• Like the pace, resources flexibility afforded
  by 24/7 access to modules
• Improved confidence to learn, creative
  problem-solving abilities understanding of
  topics studied
• Facilitators a critical element rated high for
  skills, timeliness quality of feedback
• Access technical problems not overwhelming,
  except for international learners

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Post-Module Survey Results

• Most would take another module /or recommend
  Skills Online to their colleagues
• Many shared resources held informal discussion
  with others from their workplace about module
  topics
• Content relevant applicable to day-to-day work

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Case Study Evaluation Methodology

• 2 pilot sites in Nova Scotia Ontario
• January March 2008
• Online survey of 54 Skills Online learners 142
  other front line staff who have not taken modules
• In-person focus group individual interviews
  with front line practitioners managers

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Case Study Evaluation Results

• Individuals
• Greater appreciation of public health practice
• Increased ability to collaborate with colleagues
• Enhanced interest in further education
• Organizations
• Greater confidence competence of staff
• Greater communication amongst staff through use
  of common terminology
• Changes to hiring practices

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Next Steps in Evaluation

• Extend the case study method to more sites
• Revise the post-module surveys
• Conduct attrition studies to explore why some
  learners dont complete modules
• Explore why some professionals dont participate

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Program Outcomes A Learners Perspective

• Jacquie Sarna
• Communicable Disease Coordinator
• Winnipeg Regional Health Authority

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Benefits to Learners

• Expand public health knowledge, skills
  abilities to help meet the core competencies for
  public health
• Access a wide range of information resources
  available to support learning, including online
  facilitators
• Learn with other public health practitioners from
  across Canada
• Enhance critical thinking, effective use of data
  data sources computer skills
• Become professionally stimulated dynamic
  learning
• Supports professional, continuing education

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Benefits to Organizations

• Better trained employees equipped with public
  health tools better decision-making planning
  abilities
• Provides consistent common baseline
  understanding of public health principles
• Supports health standards mandatory programs
• Enhances staff skills in using data sources to
  understand community health status
• Creates a community of public health
  practitioners
• Contributes to a national program to build public
  health capacity

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Adaptation to New Contexts

• Jamie Rossiter
• E-learning Specialist
• Public Health Agency of Canada

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Research Study Adaptation of Modules to New
Contexts

• Broad interest in reuse of online content
• Reduce costs
• Reduce duplication
• Continuum of granularity
• Small, context-neutral learning objects, to
• Full courses with implicit pedagogy
• How are modules adapted in practice?
• What can be learned from these examples?

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Two Cases Studied

• College of Medicine, University of Saskatchewan
• Third-year, on campus undergraduate medical
  students
• Similar culture, different learners
• Adapt content and delivery
• English-speaking Caribbean countries
• Public health professionals at a distance
• Similar learners, different culture
• Adapt through delivery and discussions

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Research Questions

• Why did organizations undertake these projects?
• What were their motivations? What issues arose?
• How was content localized?
• How were appropriate language, examples
  identified?
• How was the course delivered?
• How were cultural, educational differences
  addressed?
• How is content authenticated?
• What were/are intellectual property issues
  addressed?

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Case Study Research Methodology

• Appropriate to how? and why? questions that
  explore complex social phenomena
• Qualitative research approach
• 13 semi-structured, in-depth interviews with key
  stakeholders
• 2 focus groups with U. of Saskatchewan students
• Caribbean learners post-module questionnaires
• Debriefings with Caribbean facilitators
• Other related documents and information

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University of SaskatchewanImplementation

• Four modules combined into a single online
  module, with some content removed
• Part of a year-long community-health course
• Approximately 60 students, on campus, but studied
  content online and submitted assignments
  electronically
• Met in class with tutors after each module

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University of SaskatchewanFindings, 1

• Initial offerings had mixed success
• Content deemed excellent and appropriate
• Work load for students difficult to manage
• Wide range of effort applied by students
• We are preparing students for lifelong learning
  in using a method that they will encounter. The
  chalk and blackboard theyre not going to have
  much of that when they are professionals.
• - College of Medicine, Faculty member

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University of SaskatchewanFindings, 2

• College wants to offer more online courses
• Revising medical school curriculum
• Some of the content in first year
• Working with other faculties of medicine across
  Canada on public health curricula
• This use of web-based learning may have more
  applicability in the next decade, as medical
  schools go to satellite campuses.
• - College of Medicine, Faculty member

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CaribbeanImplementation

• Content similar to Canadian offerings, but with
  Caribbean cohorts
• Canadian facilitators, with a Caribbean shadow
  facilitator for one module
• Five cohorts (to end of 2008)
• Overall 67 completion rates

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Participation by Country
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CaribbeanFindings, 1

• Most problems were technical issues with Internet
  access
• Early cohorts struggled with online modality
• Most learners very pleased with modules
• Caribbean-only cohorts well received
• Im very strongly in support of this program.
  There is a lot of expertise in the Caribbean, but
  they need to be able to harness it and
  disseminate it through a virtual mechanism.
• - PAHO Co-ordinator

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CaribbeanFindings, 2

• Most learners appreciated the opportunity to
  learn without having to travel
• Its the wave of the future. The less we have
  to dislocate people from their settings to teach
  them something, the better off well be.
• Interesting social issues around online
  interaction
• The anonymity of the online process gave them
  some added freedom and some added comfort.
• - Caribbean Facilitator

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Adapt or create?

• Adaptation can provide a relatively easy entry
  point to online learning
• Allows recipient to gain confidence, expertise,
  organizational support for online learning
• Overall level of effort over time may be similar
• Care needs to be taken in pedagogical approach
• Learners access, abilities, time constraints,
  culture
• A variety of adaptation options available

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Strategic Issues

• In both cases, the motivations were greater than
  satisfying immediate educational goals
• Strategic requirements of both donor and
  recipient organizations
• Partnering agreements, although informal, allowed
  both parties to support each other effectively
• Intellectual property issues are still
  outstanding and are being addressed
• Adaptation of courses can be effective
• Not restricted to small-granularity learning
  objects