A R T I C L E I N F O | A B S T R A C T | |
CASE REPORT | Development of foundational skills among masters of public health (MPH) students is challenging with regard to the mastery of delivering health education and health promotion methods. In this case report we documented the conceptualization details and results from the formative and summative evaluations of one foundational course on health promotion implemented at a Southern US University. The course was based on the constructs of a fourth generation framework of multi-theory-model (MTM) of health behavior change that aimed at helping the students to acquire the behaviors needed for imparting the health education and health promotion methods in the real world settings. In formative evaluation, a qualitative assessment is used, whereas, in the summative evaluation both qualitative and quantitative approaches are applied. We used a SWOT framework to conduct this study. Some of the documented strengths of the course included practical applications, interactive learning, and good use of the Canvas platform, group work, and skill building activities. The weaknesses of the course were the difficult nature of the subject and the fact that some presented methods were not clear. Some suggested opportunities for future offerings included having better environmental props, more online participation, and guest speakers. Some threats identified by the students were decrease of enrolment and possible reduction of face-to-face interactions due to online offerings. Overall, the instructor was successful in imparting skills pertaining to the methods for conducting health promotion within public health. The skill building activities and assignments elaborated in this course can be freely replicated for enhancing the learning acumen of MPH students around the world. This case report forms the basis for critical reflection among educators entrusted with designing such courses. Keywords: Public Health, Health Behavior, Health Education, Health Promotion |
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Article History: Received: 26 Jun 2018 Revised: 1 Dec 2018 Accepted: 2 Dec 2018 |
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*Corresponding Author: Manoj Sharma Email: manoj.sharma@jsums.edu Tel: +601 9798850 |
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Citation: Sharma M. A Case Report of Formative and Summative Evaluations of a Graduate Course on Foundations of Health Promotion for Masters of Public Health Students. Social Behavior Research & Health (SBRH). 2018; 2(2): 275-286. |
Table 1. Course objectives, public health competency addressed and assessment method |
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Objective | Competency | Assessments/Outcomes |
(1) Define basic terms used in health education, health promotion, and public health and identify factors that foster or hinder well-being. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module |
(2) Access existing health related data for assessing needs for health education. | -- Assess population needs, assets and capacities that affect communities' health -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice |
-- Skill building activity at the end of the module |
(3) Delineate the philosophical underpinnings in the field of health education and promotion. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignment #1: Professional philosophy of health education |
(4) Trace the historical genesis of public health and health education and identify contemporary challenges confronting the profession. | -- Explain public health history, philosophy and values | -- Skill building activity at the end of the module |
(5) Explain commonly used behavioral and social science theories/models in planning health education and health promotion programs. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module |
(6) Describe quantitative and qualitative methods used in health education and promotion. | -- Select quantitative and qualitative data collection methods appropriate for a given public health context. | -- Skill building activity at the end of the module -- Assignment #2: Delineation of a health problem |
(7) Discuss the advantages and disadvantages of commonly used cognitive educational, affective educational and environmental change methods. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignment #3: Class presentation of three assigned educational methods |
(8) Formulate a variety of educational methods in implementing health education interventions. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignment #3: Class presentation of three assigned educational methods |
(9) Plan training and instructional programs for diverse populations. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignment #3: Class presentation of three assigned educational methods |
(10) Demonstrate a variety of skills in delivering health promotion and education strategies, interventions, and programs. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignment #3: Class presentation of three assigned educational methods |
(11) Use the code of ethics in health education and promotion professional practice. | -- Applies ethical principles to public health program planning, implementation and evaluation | -- Skill building activity at the end of the module |
(12) Identify graduate level competencies for health educators and hone some of these competencies for own professional career. | -- Identify the core functions of public health and the 10 Essential Services | -- Skill building activity at the end of the module -- Assignments # 1-4 |
(13) Discuss the structure and functions of salient agencies, associations, organizations at local, regional, national, and international levels in health education and promotion. | -- Specifies multiple targets and levels of intervention for social and behavioral science programs and/or policies | -- Skill building activity at the end of the module -- Assignment #4: Presentation on an agency/ association/organization |
(14) Retrieve and critically analyze current scientific literature in health education and promotion. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice | -- Skill building activity at the end of the module -- Assignments # 1-4 |
(15) Identify principles of effective teaching and learning in health education. | -- Explains basic theories, concepts and models from a range of social and behavioral disciplines that contributes to public health research and practice -- Applies ethical principles to public health program planning, implementation and evaluation |
-- Skill building activity at the end of the module -- Assignments # 1-4 |
Table 2. Skill building activities for each module in the course | ||
Module | Topic | Skill building activity |
1. | Introduction to Health Education, Health Promotion, & Public Health | Brain storm on all possible behaviors that can be modified for improving health Classify these behaviors into two categories: positive and negative Choose any one behavior Choose any one target population where this behavior will be most suitable Identify all possible health-directed and health-related reasons why people will or will not engage in initiating and continuing this behavior Present your final work in a matrix in the discussion forum. |
2. | Philosophy of Health Education & Health Promotion | Discuss all philosophical perspectives of health education Choose the one which you like Come up with all advantages and disadvantages of this philosophical perspective Submit it in the discussion forum. |
3. | History of Public Health, Health Education & Health Promotion | Choose an area within public health education such as school health education or poliomyelitis or coronary heart disease or breast cancer etc. Conduct an Internet-based search on the history of that topic Also search PubMed (MEDLINE) for any article delineating historical aspects of that topic Draw a timeline or trace the salient developments within that area that have occurred. Post your findings in the discussion forum. |
4. | Planning Models in Health Education & Health Promotion | Choose any one behavior Choose any one target population where this behavior will be most suitable Draw a diagram explicating the links between various components of the PRECEDE-PROCEED Model and the chosen health behavior Present your final work in a word-processed diagram in the discussion forum |
5. | Theories in Health Education & Health Promotion | Choose a health behavior change of your choice Choose a target population of your choice Develop a health behavior change intervention for initiation and sustenance of health behavior change using the constructs of MTM and specifying the behavioral and learning objectives, educational processes, activities, and duration. |
6. | Qualitative Methods for Health Education & Health Promotion | Choose any one target population with which you want to work Choose any one qualitative method for identifying needs and capacities Develop a detailed protocol for implementing the selected method (as detailed as a cookbook) Present in class or post your protocol on the discussion forum |
7. | Quantitative Methods for Health Education & Promotion | Choose any one disease or health problem Choose any one target population with which you want to work Conduct a data based search to discern descriptive epidemiological data for this population: Mortality, morbidity, other health indicators by population, area, and time. Conduct a data based search to discern analytical epidemiological evidence related to changing behaviors and environments for influencing this problem Integrate the evidence and post to the discussion board |
8. | Ethics in Health Education & Health Promotion | A written system of norms or professional moral consensus is known as code of ethics Brainstorm and develop a code of ethics for health educators based on the four ethical principles Compare your code with that discussed in the class. Discuss the similarities and differences and post them on the discussion forum. |
9. | Cognitive Educational Methods | Form yourselves in small groups Discuss the advantages & disadvantages of each AV device listed in the preceding slide Based on your experience identify ten ways in which Audiovisual aids can be made more effective Summarize your responses through a chosen audiovisual device or post your reflection on the discussion forum |
10. | Affective & Experiential Educational Methods | Form yourselves in a small group (4 - 5 students) One group will observe other groups: participation, task completion, strengths and weaknesses of the discussion, & ways for improving group discussion Other groups will discuss the advantages & disadvantages of experiential methods They will also, based on their experience, identify five ways in which experiential methods can be made more effective The observing group will debrief the exercise. |
11. | Advanced Level Competencies for Health Education Specialists | Choose any one advanced level sub competency. Using your textbook or any other health education textbook develop 2 - 3 multiple choice questions that would measure that sub competency. In a small group evaluate each MCQ as to whether it is measuring Bloom’s level one knowledge, level two comprehension, level three application, level four analysis, level five synthesis, or level six evaluation. Post all MCQs with their sub competency, knowledge level, and reference with page number to the discussion forum. |
12. | Principles of Effective Teaching Learning | Discuss the pros and cons of effective learning-teaching principles presented in this presentation Rate all these principles from most important to least important Post your five top choices in the discussion forum |
13. | Future trends in Health Education & Health Promotion | Form yourselves in groups of 4 - 5 students Discuss and come up with a list of 10 things you would do now in order to prepare yourself for becoming a successful health education specialist 5 years from now. Share your list in the large group or post in the discussion forum |
Table3. Qualitative mid-term feedback from students on the course |
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Question | Feedback |
Please list any two aspects of this course that you like. | • I like the class application of different qualitative and educational methods through which I am able to learn them more intensively and learn the practical aspects • I like the skill building activities which we need to complete in online forum; they are interactive and great learning experience • Importance to health education • Determinants of health • I appreciate the fact that my professor is always prepared when presenting in front of the class. • I also like that all information that is needed is explained thoroughly on Canvas • I like the fact that we have online discussions for class but unlike other online class discussions, instructor keeps us engaged. • Teaching style • Activities • Option to learn from skill builder • I like the way the instructor retouches on past courses • I like the fact that the instructor is willing to give us a chance • I enjoy that the instructor is knowledgeable in the course • I like the hands on approach that is provided • I enjoy the group implementation activities because it allows us to get a real feel for the subject area of focus |
Please list any aspect(s) that you see can be improved in this course at this midpoint. | • More skill building activities can be made compulsory so that we can learn the applications even thoroughly • There is no improvement needed regarding the course itself. it is all dependent on me, the student • Announcement on upcoming assignments • May be public speaking on health promotion • The class is going great and I can’t think of anything at the moment. • I think the instructor is doing a great job in the course, no improvement needed at this time. • I am okay with mostly everything • Not many improvements needed • Be more patronizing |
Please list any topic(s) that you want covered in this course which you have not noticed in the syllabus that seems to be essential for this course for you. | • Nothing • Everything is fine • I would like to have more discussion on the application of theories as well as community empowerment • Not applicable • Good course • The essential materials are being covered throughout the course • We are on target with the syllabus • Ways to perfect my APA style writing • I think we have covered great topics thus far |
Table 4. Qualitative Strengths, Weaknesses, Opportunities, threats (SWOT) analysis by the students on the course | |
Question | Feedback |
Please list any two Strengths (positive aspects) of this course that you found. | • I found that the instructor had an upbeat attitude during class that made me enjoy the class more. I look forward to class every Thursday • Instructor’s teaching style was very hands on incorporating discussions with in class activities. Was very useful. • Practical application of different theories • Interactive learning • That we were allowed to interact with each other in different projects setting and this was positive because we had a chance to work with different attitudes and that brought about a “positive” contribution from each student • I felt the class was very educational, so the strength would be that I learned about different methods in practical way. • Good course • The essential materials are being covered throughout the course. • I love the group projects because it gave us a chance to relate with others • I love that you gave us an opportunity to understand and evaluate the assignments • Instructor was very knowledgeable on course material • The content and sessions were very helpful in teaching how health promotion is supposed to be implemented in the community • Good content • Teacher was always prepared • Learning activities (skill builders) • Hands-on • Group interactions • Implementing methods to understand learning |
Please list any two Weaknesses (areas for improvement) of the course that you found. | • In my opinion the course had little weakness • The subject line is a little tough, so sometimes it takes more time to understand and implicate learnings • There wasn’t any in this class, I found the class to be very informative and educational • Not many improvements needed • Clarity on methods assignments • Allow students to turn in assignments via e-mail • More discussions of case study, assignments • Requiring more class participation from students |
Please list any two Opportunities (areas for growth) of this course in future offerings. | • If the instructor allowed this class to be held in multiple settings like the conference room for focus groups to set the stage • Professional training like set-up • This class has growth from the course in different settings and the opportunities were it allowed us to view the Power Points and do the skill building activities. This was a great opportunity because it gave us a chance to do more than just read the Power points – we had to apply them. • Learning health education, promotion, option to learn from skill building activities, case study and presentations • Understanding the skill builders a little more • More on-line participation • Provide students the opportunity to present presentations in another setting such as conferences etc. • Guest speaker from a local, regional, or national health agency • Providing additional supplemental materials on Canvas to help students in gaining knowledge • Need to be combined with other courses |
Please list any two Threats (factors that may hinder this course) for this course in future offerings | • The declining number of students who are enrolling with School of Public Health • There are no threats • APA style • Some of the workload can be overwhelming if certain concepts are not understood • Teacher can be too blunt sometimes when correcting or criticizing a student’s work personally and or publicly • Online course |
Your final “Take Home” Message(s) from this course that you intend to retain | • Health education is a valuable profession • I have learned the practical application of different theories in a very interactive way so it will retain in my memory for a long time. • This course was very rewarding, and I took home that this class was good and the instructor delivered the intents of the class in a way that was very interesting and in a way that was easy to obtain learning and not confusing. Great class! • If you apply everything is possible • Thank you for everything – you are a great teacher! • If you apply yourself anything is possible. • I really enjoyed this course. I liked how we met in class and online. The course work was designed to educate, inform, and provide knowledge to the students. I really enjoyed the interaction during the sessions and the constructive criticism the instructor provided. • It is important to read and study material in order to be able to apply it in the future. Learning new skills are imperative in public health. • Health education drives public health. • Be clear about your message. • Understanding qualitative and quantitative methods are very important in health education. |
Table 5. Quantitative ratings on student instructional rating survey (SIRS) for the course |
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Attribute | n | Minimum | Maximum | Mean | SD |
My interest in the subject increased | 8 | 3 | 4 | 3.62 | 0.518 |
I learned/understood the subject matter | 8 | 3 | 4 | 3.38 | 0.518 |
Instructor appeared sincere about teaching | 8 | 3 | 4 | 3.75 | 0.463 |
Instructor's style of teaching held my interest | 8 | 3 | 4 | 3.63 | 0.518 |
The instructor used an electronic medium to present course material | 8 | 3 | 4 | 3.25 | 0.463 |
The course format was appropriate for course content | 8 | 3 | 4 | 3.63 | 0.518 |
Instructor presented the course material clearly and logically | 8 | 3 | 4 | 3.50 | 0.535 |
Instructor implemented the course objectives and semester plan as outlined in the course syllabus | 8 | 3 | 4 | 3.88 | 0.354 |
Class discussion was encouraged by the instructor | 8 | 3 | 4 | 3.62 | 0.518 |
Instructor welcomed students seeking help/advice | 8 | 3 | 4 | 3.75 | 0.463 |
Instructor was available to students during posted office hours or by appointment | 8 | 3 | 4 | 3.63 | 0.518 |
Instructor related the course to other fields and/or to life/career situations as appropriate | 8 | 3 | 4 | 3.62 | 0.518 |
Instructor gave different points of view | 8 | 3 | 4 | 3.63 | 0.518 |
Instructor's course assignments were clear and precise | 8 | 3 | 4 | 3.25 | 0.463 |
Instructor's examination questions and graded assignments were related to course content | 8 | 3 | 4 | 3.62 | 0.518 |
Instructor's course examinations/projects were graded and returned in a timely manner | 8 | 3 | 4 | 3.75 | 0.463 |
Instructor used class time effectively | 8 | 3 | 4 | 3.88 | 0.354 |
Instructor was punctual in meeting and dismissing classes | 8 | 3 | 4 | 3.88 | 0.354 |
Instructor treated students with respect | 8 | 3 | 4 | 3.88 | 0.354 |
Instructor expected a high level of academic excellence from students | 8 | 3 | 4 | 3.88 | 0.354 |
Overall, the instructor was a good teacher | 8 | 3 | 4 | 3.75 | 0.463 |
Average | 8 | 3.00 | 4.00 | 3.6776 | 0.35187 |
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