① Drph Program Reflection

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Drph Program Reflection



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Nicole Cooper, DrPH, MPH (Head of Healthcare Policy, Lyft) - 2007 HCC Alumni

Peer Review reports. At the time, there was no standardized public health training system to educate future health officials; governors, mayors, or city councils appointed health officials through political patronage or bonds of friendship [ 1 ]. The original purpose of the DrPH program was to bridge the gap between research and applied fieldwork by training students to become cross-disciplinary researchers, researcher-practitioners, transdisciplinary scientists, and integration and implementation scientists.

Rather than focusing on rigorous research skills, DrPH programs emphasize knowledge translation and transformative leadership [ 9 ]. In addition, the DrPH applied practice experience enables students to engage in collaborative practice with professionals outside of public health to satisfy interprofessional education requirements. DrPH programs have been encouraging DrPH students to become collaborative, practice-ready health workers, or researchers with strong leadership skills who understand how to effectively collaborate and work in an interprofessional environment.

However, little is known about how each of the CEPH-accredited schools and programs interpreted and provided practice- and leadership-oriented DrPH education. Depending on the program type, a core curriculum has been interpreted differently at each institution. For example, while the departmental type has provided five core public health specialties e. Over the past years, very few studies have been conducted to comprehensively search the current list of CEPH-accredited DrPH programs and collect insights from experts about the future education and training required for a DrPH degree. While most studies regarding CEPH and a DrPH degree were quantitative, no clear evidence of qualitative data analyses has been reported.

Qualitative research would uncover professional opinions and deep intuitive understanding of the future of DrPH education. Thus, the purpose of this research was to answer the following research question about doctoral education and public health through a qualitative study: What is the desirable future direction and optimal education strategy for a DrPH degree in the United States? We reviewed the literature to have a better understanding of the existing analysis about DrPH education and training from particular programs or schools as well as from general perspectives in the United States [ 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. There were three criteria of identifying DrPH programs: 1 program locations: The United States and its territories, 2 program quality: CEPH-accredited, and 3 recruitment status: active for the — academic year.

Thus, a total of 28 programs fit the criteria of CEPH-accredited DrPH programs that had a student recruitment plan for the — academic year. After taking all those situations into account, a total of 28 programs that met the criteria of CEPH-accredited DrPH programs were identified for inclusion in the present study Table 1. Purposive sampling was used to select participants; to reach the broadest set of perspectives possible from CEPH-accredited DrPH programs, we invited the program directors of each of the 28 selected programs to ask to participate in a semi-structured qualitative interview.

We conducted in-depth interviews during February 3—25, The first author conducted all in-depth interviews, who had a wide variety of experience in conducting qualitative studies both domestically and globally. At the time of conducting interviews, he was a DrPH candidate. All of co-authors earned a doctorate degree. The first author had no established relationship with participants before the study initiated, except two participants from universities where he studied: George Washington University Milken Institute School of Public Health and Johns Hopkins Bloomberg School of Public Health.

Method of approach was email invitation, with the introduction of the goal and reasons for conducting this study. The total number of completed interviews was 22, and participants were numbered in the order of interview conducted, from 1 to Since it was designed as one-time 1-on-1 interview, participants were not further contacted after an interview for feedback or a repeat interview. We excluded a completed interview from Indiana University Richard M. Participants 4 and 6 and Participants 8 and 10 were from the same institutions Table 2.

To ensure confidentiality of participants, all interviews were only audio recorded in a private and soundproof place, and there was no one else besides the participants and the first author. Many of the institutions provide multiple DrPH degrees from different departments or concentrations, which means there are several DrPH directors in the same institution. Data saturation—a criterion to discontinue data collection or analysis until it has been observed that the point of no new themes or information has been reached [ 24 , 25 , 26 ]—is an important methodological principle in qualitative research.

Collecting sample for this study was purposeful, and sampling criterion was the theoretical saturation [ 27 , 28 ]. This study concluded that the theoretical saturation point was reached after completing 22nd interview and there was no need to follow up with potential participants who did not respond to the invitation, based on the fact that no new themes or code was emerged. The entire interview questionnaire was developed by the first author to understand the common themes and variations of CEPH-accredited DrPH programs and desirable future direction of DrPH education in the United States.

For this study, we used the following questions to understand desirable future direction of DrPH education in the United States:. Should the program structure be a school college choice, or should it be more standardized across the country? What would be fundamental, desirable future directions for DrPH degrees as a whole in the United States that you would like to see in the next 5 years? The entire interview questionnaire is available in Supplement 1. Content analysis was conducted to underpin the study. Thus, a total number of interviews that we used for final analysis was 20, and a verbatim transcription from each of the 20 recorded interviews was separately stored as a Microsoft Word documents docx.

The first author conducted the coding process through the combination of deductive and inductive approach, and the second and third authors cross-checked this process to prevent any potential bias. For this study, themes and their supporting quotes—particularly related to the future directions of DrPH program in the United States—that were identified or derived from the analytical process were organized in the results section. After the completion of qualitative data analysis, we created two categories: 1 future development of DrPH program and 2 desired future direction of DrPH program as a whole nationwide. Table 3 demonstrates those two categories and their subcategories.

Participants were asked what changes they expect to see in their DrPH programs in the future. Their answers leaned towards the DrPH program in general from their institution, not related to specialty e. Eight participants emphasized the importance of establishing a partnership with local communities and universities to connect their students to various organizations. The academic community expected that students would lead this collaboration, and it would have a positive effect on complex public health issues around the globe:. They had a recent APHA meeting. They had their first conference in Philadelphia, and we also have a group of DrPH students from Boston.

Participant 2. Twelve participants shared plans for restructuring their DrPH programs. Two participants are considering or have already been transitioning from departmental to schoolwide programs. All of the DrPH curriculums have been restructured with various components: a better reflection of CEPH competencies; addressing the real public health issues in the twenty-first century; making a clear distinction from Master of Public Health MPH and PhD programs; teaching more research-related skills; providing more diverse coursework; and developing a leadership course, practicum, and qualifying examination for moving onto all but dissertation stage; and providing better guidance for dissertation development. All respondents indicated there was a need to secure internal and external funding to support students financially.

Two participants revealed their desire to have more funds to attract competitive students and increase the diversity of the student group:. The next big step is to try to get more funds so that we can support our students and increase diversity. The number one priority right now for all of us is increasing funding for the DrPH. Participant 6. Program directors indicated that they planned to further grow a DrPH student group by recruiting more applicants; ensuring a diverse student group, including part-time students; actively absorbing student feedback; and retaining motivated students and guiding them well:.

Participant DrPH programs focus on educating students to become either generalists or specialists. Although branding of DrPH programs is generally important, different directions from individual DrPH programs may confuse students, faculty, and future employers. Overall, none of the participants wanted to see standardization of DrPH programs across the United States. All of them advocated for the current trajectory, in which direction of structure depends on each individual program.

As to how the direction of the DrPH program should be established, comments from participants were separated into two main groups—schoolwide and departmental—to analyze if there was any trade-off between them. Even if the degree is an executive program focusing on health policy and management, operationalized by the department, the characteristic of the degree can be functionally seen as schoolwide. Generally, participants from schoolwide programs agreed that the core characteristic of the DrPH program, interdisciplinarity, is maintained under the schoolwide approach, when students can explore the broader concept of public health across departments. Furthermore, they highlighted that a DrPH program is a practice-based degree with a broader area of specialty and expertise than other kinds of advanced programs, and it needs to be differentiated from a PhD degree for students who pursue intensive research skills:.

We chose to make ours more of a generalist degree. I think that is the nature of the DrPH because of its practice-based focus. Our students have at their disposal the resources from all departments. How that works is a little different than the way it looks on paper because sometimes students gravitate toward the faculty they interact with most, and there are some departments that are much more interactive with our students. We presumably have access to all of those departments and what they're able to offer. Likewise, participants from the departmental program would prefer to maintain specialties or emphasize that their departmental DrPH program must provide focus for students.

One of the biggest benefits for DrPH students focusing on a specialty is that they can dramatically increase the possibility of becoming involved in a federal grant program. Participant 6 from a schoolwide DrPH program expressed concern about the lack of funding opportunities for students:. Especially because the DrPH is a professional degree, not an academic degree, we do not have access to grant money to support the students like PhD students have. In addition, Participant 13 pointed out that developing a schoolwide DrPH program would cost a lot and would require more administration:. We maintain the DrPH programs because everybody felt that there was a real need and purpose for them at this level of doctoral education.

Schoolwide program is more involved in administration [and is for] students who have been in business school or law school, who are looking at policy or a much more generic program. But we recognize the very high cost of developing a schoolwide DrPH program. We look at the policy and the infrastructure within the United States for [specialty] program, unlike other programs. Being able to have a DrPH in [specialty] really capitalizes on centuries of [specialty] work that has led to Title [number] programs, Title [number] programs, and a national and state structure that supports [number] programming. Some participants admitted that they had not deeply thought about standardization or said it depended on each school and its organizational structures:.

I would think that it would be up to the school. Different schools have different organizational structures, departments, and things of that nature. For some academic institutions, it may be appropriate to have them housed in a department, while for others, it may make sense for them to be collegewide. A participant from a departmental-based executive program in Health Policy and Management introduced the dynamic between schoolwide and departmental programs. Faculty from Health Policy and Management started a schoolwide DrPH program but eventually switched to housing it in their department because other departments did not fully appreciate or clearly understand the concept of a schoolwide leadership-focused DrPH degree. Instead, the other departments continued to treat it as another PhD program.

It appears that as long as the main focus of leadership and management remains intact, the program structure—schoolwide or departmental—could simply be an administrative issue:. We may eventually look at a schoolwide DrPH. I think that would be in addition to [our departmental DrPH program]. We had a schoolwide DrPH when we first started.

So we moved it into the department because our department was the one who embraced it and understood the concept of a leadership-focused degree as well as a practice-based degree. Four participants highlighted that DrPH programs should focus on leadership. A DrPH program does not necessarily steer students into an academic route; rather, it should steer them into a leadership path in which they are incorporated into large organizations. DrPH programs should be recognized for preparing public health leaders by teaching them solid leadership skills, analytical thinking skills, and advanced applied skills:.

The Doctor of Public Health should be seen as an individual. Participant 1. I think paying greater attention to the need for this kind of leadership and building with these kinds of applied skills. Our students do not go down an academic route but go into leadership roles at large organizations. Because recognition of the DrPH degree is crucial to its continued existence, most of the comments from 14 participants were briefly quoted in this section.

Two of these 14 participants wanted to see the DrPH degree as a premier practice degree. Participant 20 mentioned that just as medical schools offer PhD degrees even though their main purpose is to train MDs, the DrPH degree should continue to maintain the integrity of the profession and also to add diverse strengths to the workforce by providing different types of degrees—both academic and professional degrees—in the field of public health:.

Let [the DrPH] be recognized as the premier practice degree in public health. There are a lot of med schools in the country. They may have PhDs but they primarily trained practitioners—same with nursing, same with pharmacology, same with dentistry, right? If we consider ourselves a health science professional, why in the world would we give up a professional degree? We thought it was important to maintain the integrity of the profession by keeping our DrPH.

A DrPH program is different from a PhD program that can bring uniqueness to academia and the community. I would like to decrease this sort of false dichotomy saying that a PhD is a more rigorous degree than a DrPH. Regarding this issue there were several concerns about CEPH competencies among the participants. I would like, in the future, to see more programs make that very clear for students because I feel like most of the time, what I do is explain the difference between the PhD and the DrPH. The CEPH competencies say you have to know how to do a strategic plan. Well, we teach strategic management. They also hoped that people who are in senior positions in those organizations could receive public health training, even if they already hold a medical or a nursing degree:.

I think it would be good if we started to see more DrPHs integrated into those role [s]. Participant 8. I would like to see individuals who have DrPHs have a seat at the table for different advisory groups like National Institutes of Health, health resources, and services administration. I would like to see the executives at the top health-related organizations, the decision-makers, have DrPH degrees. I would like to see more physicians and nurses with public health training. Two participants highlighted that funding opportunities and partnerships with various organizations should be more established for students, to ensure equal opportunities for all:.

Participant 7. A lot of attention to collaborative effort, to be thought leaders, to look at trends and analyze them, to look at that broader scope of systems and partnerships across governments, NGOs, and donors. Although all 20 participants mentioned throughout the interviews that the DrPH is a professional degree, two highlighted that DrPH programs should still focus on methodology to train students in the research skills that translate into public health practice. It is notable that this professional opinion was from participants whose academic backgrounds were PhDs:. I think maybe this is my personal biased because I consider myself more of a quantitative researcher, and able to see more emphasis placed on quantitative methods and translating research into public health practice.

I think that is something that DrPH programs across the nation should focus on and pay more attention to. I think moving in this trajectory is a good path, and I think [we should continue] to make sure the DrPH students still have strong methodological skills. They felt that first and foremost, a DrPH program should address emerging, complex public health issues. Case-based learning would provide DrPH students with insight into working on real public health issues across the globe, such as controlling infectious diseases, global warming, and the social determinants of health.

DrPH programs should train and inspire students to develop the leadership skills needed to be positioned for success in addressing large, complex public health issues and to move up the ladder into higher-level leadership roles in key organizations:. We have to look at what challenges the 21st century in public health is posing, such as infectious diseases or any other public health problems affected by the social determinants of health. I think that in the future, the best programs in the country will be those who actually address more cases. Participant 4. DrPH graduates have to play an increasing role in solving some of the most important problems in society, which are obviously public-health—related but not necessarily labeled as public health problems.

One participant indicated that DrPH programs must align with the needs of the public health workforce to successfully address complex changes in public health. As such, DrPH programs should consider all available resources to find a niche in the field of public health for students:. We have to continue to keep an eye on that, to make sure schools of public health and in particular DrPH programs are really aligning with the needs of the public health workforce.

We need to keep working on finding resources, so that we can promote equity across the workforce for all these students to have an equal opportunity to achieve their academic pursuits through DrPH programs. One participant mentioned the value of creating a shared vision across the DrPH programs of what this degree can provide for students:. If the student cannot complete these courses in the summer, the student may be required to take a heavier course load in Year One.

The pre-requisite courses are as follows:. Year 1: Fall Semester Spring Semester Year 1: Fall Semester 4. Spring Semester 4. Applicants are expected to have earned an MPH or another relevant graduate degree e. Students entering the program with a graduate degree but without an MPH are required to complete the five pre-requisite courses in epidemiology, biostatistics, health policy and management, environmental health, and social and behavioral science, before matriculating into the program. Successful applicants will have relevant public health work experience, a demonstrable potential for leadership in public health, and a clear sense of why they wish to pursue a DrPH.

Applicants to the DrPH program must submit the following documentation:. Tuition and fees vary for NYU students based on your term of admittance and the number of credit hours taken. While there is no financial aid available for this degree program, you can find more information here. Home Programs. DrPH Learning Outcomes. Foundational Competencies. Program-specific Competencies.

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