The Development and Implementation of a Case-Based EO Health Curriculum for Public Health Students: A Multi-Media Approach

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The Development and Implementation of a
Case-Based EO Health Curriculum for Public Health
Students A Multi-Media Approach

• Grace K. Paranzino, MS, RN, CHES, FAAOHN
• David J. Tollerud, MD, MPH

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Program Overview

• Full-time program2 years
• Semester basistotal credit requirement of 64
  hours
• Students select major (concentration)
• Community Health Prevention
• Health Management Policy
• Epidemiology and Biostatistics
• Occupational Environmental Health

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• Part-time program
• MD/MPH program
• Begin MPH during 3rd year
• 4th year in medical school
• 5th year completion of CBMP and
  concentration-related work

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Blocks

• Systemic and contextual integration
• Emphasis on public health competencies
• Foundation skill development
• Content knowledge in the core disciplines of PH
• Perspectives, values, and mission of PH

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Block continuum-Year 1

• Block 1 Introduction to PH
• Block 2 Population Assessment 1
• Block 3 Population Assessment 2
• Block 4 Behavioral Assessment
• Block 5 Community Assessment

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Block Continuum-Year 2

• Block 6 Management/Leadership
• Block 7 Program Planning Evaluation
• Block 8 Concentration
• Block 9 Environmental Occupational
• Health
• Block 10 Policy Advocacy

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Educational Methods

• Process objectives and content objectives
• Process objectives
• Ability to generate issues from presented
  problems
• Frame learning tasks around the objectives
• Seek, appraise, synthesize, apply and present
  information
• Evaluate performance on an ongoing basis

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Content Objectives

• Defined by center and block director
• Reflect the core disciplines in public health
  including epi, biostats, behavioral sciences,
  study of health behaviors, health promotion,
  management, EOH, and health policy
• Integrative approach health human rights,
  health care services, program planning eval.,
  health law, and policy assessment assurance

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Group Learning Process

• First group session (2.5 hrs)
• Initial case discussion
• Brainstorming and identification of learning
  issues
• Distribution of learning issues into tasks
• Group evaluation

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• Second group session (2.5 hrs)
• Group discussion of learning issues
• Presentation via LCD projector
• Discussion/integration encouraged
• Group evaluation
• Study groups-meet prior to 2nd session to discuss
  material

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Conceptual Framework

• Six week block with a focus on EOH
• 5 cases
• C1 Health Safety in the Nursing Home Industry
• C2 Pesticides in the Environment
• C3 Safe Drinking Water
• C4 Hazardous Waste and the Community
• C5 Bioterrorism

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• Site visit/walk-through
• Case debriefing (HWS)
• Resource sessions
• Public health department
• Clean Water Action
• Bioterrorism
• Content exam

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Block Goal

• To acquire a basic knowledge of EOH as it
  applies to principles of PH practice from
  individual, organizational, political, and
  community perspectives

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Occupational Health Objectives

• Discuss the laws and regulations protecting
  worker health safety
• Examine occupational hazards and their impact on
  health
• Describe interventions used to eliminate or
  reduce workplace hazards
• Discuss the extent of work-related injuries
  illnesses
• Discuss the economic impact on health status
• Describe approaches to promote HS programs

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Environmental Health Objectives

• Describe the framework for and major pieces of
  legislation
• Discuss the potential and actual impacts of the
  environment on the health of individuals and
  communities
• Propose the role of advocacy and justice in env.
  health

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• Explain the principles of how and why
  environmental risk is perceived
• Discuss factors of risk communication in program
  planning
• Describe the basic mechanism of exposure to
  environmental hazards
• Describe the components of an exposure history

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Case example

• You are an occupational and environmental (OE)
• health specialist working at an OE medicine
  clinic
• affiliated with a large academic health center.
  The
• Agency for Toxic Substances and Disease Registry
• (ATSDR) recently awarded you and your colleagues
• a contract to formulate a response to a situation
  in
• which community residents believe that they are
• suffering from a variety of medical and other ill
  
• effects from exposure to hazardous waste at two
• former industrial sites.

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• As public health professionals, you and your
  colleagues are intrigued by the challenges that
  await you, as you consider how you will go about
  working with this community to assess,
  understand, and address the risks that these two
  hazardous waste sites present on both an
  individual and community-wide basis.

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Learning Issues

• What is ATSDR and what is its role?
• What are hazardous wastes and hazardous waste
  sites?
• What ill effects have been associated with
  exposure to hazardous waste?
• How might residents of communities near hazardous
  waste sites be exposed to hazardous substances?

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• What steps are involved in assessing individual
  and community risk?
• What measures might individuals and communities
  demand or take themselves in order to address a
  hazardous waste situation?

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Student Evaluation

• Knowledge
• Problem solving
• Critical thinking
• Professionalism
• Group contribution
• Learning skills
• Communication skills

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• Evaluation at the end of each session
• Student performance/group performance
• Facilitator performance
• Areas for improvement
• What worked/what didnt

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Block Grading

• Case-related group activities including learning
  issues 50
• Integrated content exam 50
• Symposium presentation and/or written papers are
  options for other blocks

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Future curricular initiatives

• Increase group sessions to 3 hours
• Addition of air quality case
• Review of other cases in curriculum to
  incorporate learning issue (s) related to EOH
• Current lead case in epi/biotstats
• asthma case in block 5
• water case in block 7