Challenges in public health pedagogy

Abstract

Challenges in public health pedagogy Critical Public Health (CPH) readers hardly need to be reminded that the education of the global public health workforce isor should beculturally located and circumscribed. Nor need I explain the importance of the now-enduring coinage, 'social determinants', or share infographics explaining that most health outcomes stem from social and environmental causes. Readers know that direct medical care drives only a slice-10% is the widely cited figure from the US Centers for Disease Controlof health outcomes (Artiga & Hinton, 2018). Readers also do not need me to tell them that we must guard against some of our most important conceptsdiversity, wellness, equitybeing reduced to buzzwords that lose their critical edge and radicality. Indeed, one of this journal's most important contributions to public health discourse is keeping the edge of such concepts fresh and the discourse meaningful. These conceptual engagements become especially important when considering the nature of public health education. As CPH's Associate Editor for the Americas, and an educator at an American medical school, I can report that a division persists in which the US medical and public health schools are too often bifurcated, the result being the continual recreation of the same medical-public health divide that public health scholars have for decades sought to bridge (Fineberg, 2011). Canadian programs struggle with a similar problem, though to less of a degree than the US does (Tyler et al., 2009). Latin American health care training, in contrast, more fully integrates public health and clinical training in a way that honors that region's long-standing commitment to 'social medicine' (Waitzkin, Iriart, Estrada, & Lamadrid, 2001). Physicians in Cuba, as just one example, see themselves as essential parts of a public health systeman identity that is the exception in the US where being a physician is seen mostly as an isolated profession. This dynamic is reflected in other ways. Advocacy within the profession, led by national organizations such as the American Medical Association, tends to concern matters of physician autonomy and reimbursement instead of larger, systemic changes intended to improve the lives of patients and populations. This professional identity shapes not only how physicians contextualize their clinical practice, and think about what they do, but risks stunting physicians' curiosity about root causes, willingness to expand their social horizons, and to venture beyond traditional clinical spaces to try to improve health outcomes. Socialization into an identity that often brackets public health begins in medical school, if not long before. In all cases, throughout North America, health systems remain in flux. Medical education is becoming slowly more open to public health (Maeshiro et al., 2010) while public health is in the process, as it always is, of rethinking its theoretical foundations (Dew, 2014). These are only two reasons why the articles in this section are so important. CPH scholar...

Defining and utilizing individualized learning objectives to achieve learning priorities for global health leaders

“…While there is benefit to north-south exchanges and pooling learning resources in order to make more opportunities available to all, the roles of the individuals can vary greatly, as do their learning needs [ 8 – 10 , 25 , 26 ]. Training programs also need to be mindful regarding pedagogical approaches that support the training needs of both groups, including the level of learning that is expected and the degree of direct application of learning to practice [ 14 , 16 , 27 , 28 ]. This aligns strongly with adult learning theory, of which a key component is engaging learners in their own learning process and ensuring that they can see the value and utility of whatever learning activities they are taking on [ 5 , 29 – 31 ].…”

Developing a High-Impact Learning Program for Global Health Professionals: The STAR Project

“…Finally, identifying courses suitable for senior technical professionals in highly niched and/or emerging subspecialties is challenging (Sadana et al, 2007). STAR recognized the need to diversify the nature of learning opportunities to match participants’ individual needs (Adams, Wagner, Nutt, & Binagwaho, 2016; Skinner, 2019). In addition, the project has shifted the focus of learning toward new and often underemphasized topics such as development practice and communications.…”