View Entire Collection
By Clinical Topic
Diabetes – Summer 2012
Future of Nursing Initiative
Heart Failure - Fall 2011
Influenza - Winter 2011
Nursing Ethics - Fall 2011
Trauma - Fall 2010
Traumatic Brain Injury - Fall 2010
Fluids & Electrolytes
"Academic Perspectives" is a column within the Journal of Public Health Management and Practice that examines the linkages between academic public health and practice. The contract column editor, Louis Rowitz, PhD, contributes the first column of this two-column feature for this issue.
Inherent in public health practice is a number of built-in rewards. In practice, public health professionals can often see the results of their activities and interventions directly. The practice professionals can see change in action since public health is enmeshed in a constant state of change. Practice is a labor-intensive series of activities that impacts all aspects of the public health system. Public health practice also is built on a framework of academic and practice linkages in which science becomes reality in a short time span. Practice also is interactive in that it builds on strong personal relationships that usually take place in a climate of collaboration and affects the infrastructure of the public health system on a daily basis.
Training components are often part of these practice relationships. Workforce development has become a primary emphasis in the practice arena because it is critical that public health workers be cognizant not only of the elements of a public health system, but also of the skills necessary to promote an effective public health system-a system that is prepared for any public health emergency that may arise, such as the terrorism acts of September 11, 2001. This will require a high level of leadership to build public health infrastructure and to maintain a strong public health system. Many successful national, regional, and state public health leadership programs have evolved over the last decade, which means that more than 40 states now have regular access to a regional or state leadership program in order to attain the leadership needed, if public health preparedness is to be a reality.
Many new initiatives related to public health practice have developed and been promoted over the last few years. Examples include the National Public Health Performance Standards for state, local, and governance levels; community-based public health community assessment programs (MAPP); Turning Point; Health Alert Networks (bioterrorism prevention initiatives and disaster preparedness); Public Health Training Centers; Public Health Preparedness Training Centers; National Public Health Law Center; Management Academies; data use and public health informatics training initiatives; and other public health practice initiatives.
However, public health practice programs have fared less well and more unevenly in academic settings. It has seemed at times that practice is seen merely as service in a new guise. Thus, practice is seen as secondary to the more important educational and research activities that drive the academic enterprise. Although public health practice programs have appeared in a number of schools of public health thanks to funding from the Health Resources and Services Administration and the Centers for Disease Control and Prevention, they have not led to major changes in more traditional academic programs. Practice is often seen as skill based and not science based. Further, the issue of rewards in academia is complicated by criteria set by institutions of higher learning for academic advancement. Practice faculties have been frustrated by their inability to get tenure-track academic positions, lack of success in the promotion and tenure process due to limited peer-reviewed publications and research grants, low prestige for training grants with low or nonexistent indirect cost recovery monies that support the infrastructures of most universities, and minimal academic acceptance in traditional public health academic departments. Although these concerns are major ones for practice faculty, they have compounded the problem by arguing that they should not be held to the same standards as other faculty because the work of practice is different and critical for the future of community-based public health programs.
If practice as an academic discipline is to progress and lead to rewards within academia, then practice will need to redefine its roles within the institutional context in which academics function. Practice needs to increase its science base and also develop a research agenda that will determine the issues of what makes practice effective or ineffective. The development of competencies for practice is part of this agenda. Curriculum issues need to be addressed with an educational rationale for practice courses as part of the overall public health curriculum.
Following is a series of recommendations that hopefully will lead to academic rewards for practice faculty:
* Practice programs need to be integrated into the academic programs of schools of public health. This will not be easy since academic institutions often see skill or practice activities as not scientific and as not something to strive for in graduate programs. This is further complicated by the blurring of the distinction between academic and professional education. Practice is not seen as equal to the academic disciplines of biostatistics, epidemiology, health management, behavioral and social sciences, and environmental and occupational health sciences. The linkage between academic learning and practice implementation is often off the radar screen of public health faculty with strong research agendas. Skill development is not seen as graduate-level learning.
* Practice needs to be recognized and supported by the Council on Education in Public Health as the sixth core academic field of public health. Until practice gets a scientific foundation and a research agenda, practice will be hard to market as an academic discipline. In addition, practice competencies need to be developed, tested, and built into existing academic disciplines. Competency development is beginning to occur and perhaps will bring changes in academic programs over the next several years. The interesting dilemma is that practice faculty will have to become more academically oriented as academic faculty become more willing to incorporate practice competencies into their academic, research, and service activities.
* Practice faculty must become tenure-track eligible. Clinical faculty appointments in public health are often second-class appointments and not tenure-track based. Practice is critical in public health since that is where prevention becomes reality. Community is where we prove the benefits of health promotion and disease prevention as critical factors in improving the health status of the population. There is nothing more important to strengthening the fabric of American society.
* All schools need to develop centers for public health practice as school-wide centers (or institutes) with directors with strong academic credentials. Practice should not be hidden away in one academic department without overall visibility as a school-supported series of activities. It needs to be a high priority of every school of public health in this country. No society will survive long without a healthy populace. Public health practice also needs to develop a science basis. It is critical that these programs show the connection between the science and the practice of public health.
* Public health practice needs to develop a research agenda. Practitioners need to prove that their activities work. This requires that practice models be tested and validated. Best practices need to be documented. Sound research protocols are necessary to prove that practice is a researchable area. Since research drives the university enterprise, practice faculty need to be part of this activity if they are ever to gain acceptance in the academic community. It follows that public health practice faculty need to do research, as do all other public health faculty. All faculty activities need to be based on a common professional standard. This standard is excellence in teaching, research, and service.
* Peer-reviewed publications on practice need to be pursued. It is critical that practice activities get documented. All faculties are judged by their peers and need to publish the results of their activities. Public health practice faculty need to be held to the same high academic standards as all faculties are. The quality of practice-based journals also needs to be high.
* Public health practice courses need to be required as part of the master of public health and other public health professional degree programs. Practice needs to be part of the requirements of the educational program and not left to chance. This means that there not only needs to be courses that are primarily oriented to practice topics, but also that existing courses have practice content built into them.
* Training of the public health workforce needs to be treated as equal to the training of degree-seeking students. Adult education is equal to traditional academic education. Training courses should garner academic credit.
Practice has to be recognized as a legitimate specialization in academic public health arenas. Public health practice faculty need to be seen as equal to faculty in all other fields of public health science. This means that public health practice professionals who choose academic careers must demonstrate expertise necessary to satisfy tenure requirements at their universities. It is only in this way that public health practice will become a legitimate part of public health academic training.
Not a member? Join now for Free!
Sign up for our free enewsletters to stay up-to-date in your area of practice - or take a look at an archive of prior issues
Join our CESaver program to earn up to 100 contact hours for only $34.95
Explore a world of online resources
Back to Top