Public Health Education Unbound TOPHC––April April, 1, , 1,2014 2014 TOPHC Diane R. Bewick, RN, BScN, MScN, DPA, CCHN (c) Chief Nursing Officer Director of Family Health Services, Middlesex-London Health Unit Adjunct Professor, Faculty of Health Sciences, Western University London, Ontario TOPHC––April April, 1, , 1,2014 2014 TOPHC The public health professional … TOPHC––April April, 1, , 1,2014 2014 TOPHC Advice … “No attempt to improve public health will succeed that does not recognize the fundamental importance … of highly skilled and motivated health professionals.” “Our national aim should be to produce a cadre of outstanding public health professional … who have clear roles, responsibilities and career paths.” National Advisory Committee on SARS and Public Health, 2003 TOPHC––April April, 1, , 1,2014 2014 TOPHC Warning … “To aim the public health system with more powers and duties without the necessary resources is to mislead the public and to leave Ontario vulnerable …” The SARS Commission, 2005 Resources are not simply funding but perhaps more importantly competent, committed public health professionals. TOPHC––April April, 1, , 1,2014 2014 TOPHC The public health professional organized measures quality of life prolong life promote health prevention disease people TOPHC––April April, 1, , 1,2014 2014 TOPHC The public health professional Poverty Housing Family Health Teams Heart & Stroke Foundation Literacy Ontario Early Years Centres Canadian Cancer Society CCAC Official Public Health Agencies Community Health Centre Boards of Education Primary Care Providers Education TOPHC––April April, 1, , 1,2014 2014 TOPHC Global Social Support The public health professional Official Public Health Agencies ON *PHO - labs 1,000 TOPHC––April April, 1, , 1,2014 2014 TOPHC Local public health units are the backbone of the public health system… Operational Health Protection, 2004 TOPHC––April April, 1, , 1,2014 2014 TOPHC Public Health Professionals • undergraduate programs…variety of disciplines • disciplines form the base … • discipline specific standards/competencies • regulation/registration/certification • professionals will benefit…from education • education will increase health of the province *Unique contribution TOPHC––April April, 1, , 1,2014 2014 TOPHC Public Health Competencies Discipline Specific Core Competencies, Standards and Certification Public Health Core Competencies MPH Core Competencies Inter-professional Competencies TOPHC––April April, 1, , 1,2014 2014 TOPHC Public Health Professionals (20 categories) AMOH/MOH 51 - 63 Epidemiology 65 - 72 Dietitian/Nutritionist 210- 203- (232) Public Health Inspectors 830 - 900 Public Health Nurses 2,630 - 2,717 (3,848) 2,860 Health Promoters 262 - 416 Dental Hygienists/ Dental Assistants 289 - 286 - (167/DH) *PHO (Labs), MOHLTC, MCYS TOPHC––April April, 1, , 1,2014 2014 TOPHC Public Health Workforce Issues 1. Leadership and management 2. Career path 3. Opportunities/time for professional development 4. Lack of support for their profession 5. Undervalued within their organization. 6. Shortages TOPHC––April April, 1, , 1,2014 2014 TOPHC Synthesis of 8 Papers (CAN) … convergence of issues 1. Role scope and clarity 2. Leadership skills to support practice and provide voice 3. Professional development 4. Intra-professional collaboration 5. Stronger educational preparation in public health TOPHC––April April, 1, , 1,2014 2014 TOPHC Context Summary • public health professional - general • Public Health Professional – OPHA’s Identified • - who - common characteristics - unique contribution introduced public health workforce issues TOPHC––April April, 1, , 1,2014 2014 TOPHC Marlene Janzen Le Ber, BScN, MScN, PhD, CHE Assistant Professor, Epidemiology & Biostatistics Associate Director, Program Development Schulich Interfaculty Program in Public Health Schulich School of Medicine & Dentistry Cross Appointed to Faculty of Health Sciences (School of Health Studies) Cross Appointed to Interfaculty Program in Public Health Western University TOPHC––April April, 1, , 1,2014 2014 TOPHC Education of Health Professionals for the 21st Century • The Lancet Commission (Frenk, et al., 2010) • Transforming education to strengthen health systems in an interdependent world • 20 professional and academic leaders from diverse countries • Common strategy for PSE for public health, nursing and medicine TOPHC––April April, 1, , 1,2014 2014 TOPHC Three Generations of Educational Reform (Frenk et al., 2010) TOPHC––April April, 1, , 1,2014 2014 TOPHC Levels of Learning (Frenk et al., 2010) TOPHC––April April, 1, , 1,2014 2014 TOPHC Transformative Learning (Frenk et al., 2010) Fact Memorization Searching synthesis Analysis Synthesis Seeking Professional Credentials Achieving core competencies for effective teamwork Non-critical Adoption of Educational Models Creative adaptation of global resources to address local priorities TOPHC––April April, 1, , 1,2014 2014 TOPHC Models of interprofessional and transprofessional education TOPHC––April April, 1, , 1,2014 2014 TOPHC Health Professionals • Leaders who can address these issues • Scientists who understand the issues • Practitioners who set standards – All who understand complexity – Translate this to policy and practice – Learn to work in novel, and lead in transdisciplinary, and sustained ways (Fried et al. 2013) TOPHC––April April, 1, , 1,2014 2014 TOPHC Graduate Public Health Education (Fried et al., 2013) TOPHC––April April, 1, , 1,2014 2014 TOPHC Training Leaders in Public Health • Integrative action requires integrative learning • Systems problems require holistic analysis and holistic approach to actions • Beyond public health disciplines to collaboration among public health practice, academics, government and the private sector • Requires grounding in pragmatic approach that “builds a scientific foundation on the real-world needs of defining public health problems” (Fried et al., 2013, p. e4) • Team based learning TOPHC––April April, 1, , 1,2014 2014 TOPHC TOPHC––April April, 1, , 1,2014 2014 TOPHC Schulich Interfaculty Program in Public Health Our Distinction • Novel niche of the intersection of Leadership, Sustainability and Policy • Full-time one year (12 month) on site professional degree program (non thesis based program) • Experential Learning/ Case method learning TOPHC––April April, 1, , 1,2014 2014 TOPHC Schulich Interfaculty Program in Public Health Our Distinction • Cohort of students from diverse health professional and educational backgrounds • Special focus on health issues in Southwestern Ontario, First Nations across Canada and internationally • Interfaculty contribution to the program TOPHC––April April, 1, , 1,2014 2014 TOPHC What exactly is a case? • Mauffette-Leenders et al (2007) “A case is a description of an actual situation, commonly involving a decision, a challenge, an opportunity, a problem or an issue faced by a person or persons in an organization. The case requires the reader to step figuratively into the position of a particular decision maker.” (p. 3) • Ellet (2007) “A … case imitates or simulates a real situation. Cases are verbal representations of reality that put the reader in the role of a participant in the situation.” (p. 3) TOPHC––April April, 1, , 1,2014 2014 TOPHC What is NOT a case? • It is NOT just an interesting story • It is NOT investigative journalism • It is NOT research (which requires the truth, the whole truth, nothing but the truth, etc.) • It is NOT fiction (but some distortions, simplifications and omissions may be required in order to represent the situation so it can be taught in a typical 80 minute class) • It is NOT a news summary TOPHC––April April, 1, , 1,2014 2014 TOPHC Student Preferences • Current issue and situation • Issues and challenges are relevant to career interest • Can identify with protagonist (see self in the position of the decisionmaker in the near future) • Organization itself is well-known, respected and not disguised • Geographical area of the world where students expect to be working or are currently living • Issues in the case are urgent and important to the organization • Excitement over the issue; can personally relate to the issue/problem • Cases with an interesting dilemma, characters with personalities, and cases with compelling action requirements • Short, well organized TOPHC––April April, 1, , 1,2014 2014 TOPHC Attributes of a Good Case • Pedagogical usefulness – achieves learning goals and is “teachable” • Interesting, engaging and relevant to students • Poses a problem/decision with no obvious right answer • Requires the use of information in the case to figure out a reasonable answer/approach • Requires judgement, critical thinking and decision making skills • Is information rich – has numbers, industry information, insights into organization and has some complexity TOPHC––April April, 1, , 1,2014 2014 TOPHC Three Core Elements Reality • Realism makes a case an effective learning vehicle • Empiricism lends credibility to concepts learned in the classroom Theory • An underlying theory is essential for effective teaching • One person’s/ organization’s action is not necessarily a guide for practice Originality • What is new here? • concept? • context? • Novelty enhances scholarship and links well to research Charles Dhanaraj TOPHC––April April, 1, , 1,2014 2014 TOPHC Four Types of Cases Skills Practice Cases Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases TOPHC––April April, 1, , 1,2014 2014 TOPHC Four Types of Cases Skills Practice Cases Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases TOPHC––April April, 1, , 1,2014 2014 TOPHC Describe a situation facing a protagonist. Students must diagnose problem(s) and formulate possible solutions. Four Types of Cases Skills Practice Cases Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases TOPHC––April April, 1, , 1,2014 2014 TOPHC Describe a decision faced by the protagonist. Students must choose among a finite set of alternatives. Four Types of Cases Skills Practice Cases Illustrate organizational success or failure. Students synthesize policy lessons to be extracted from the situation. Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases TOPHC––April April, 1, , 1,2014 2014 TOPHC Four Types of Cases Describe situations requiring execution of specific technical skills in order to draw conclusions Skills Practice Cases Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases TOPHC––April April, 1, , 1,2014 2014 TOPHC Four Types of Cases Describe situations requiring execution of specific technical skills in order to draw conclusions Illustrate an organizational success or failure. Students synthesize policy lessons to be extracted from the situation. TOPHC––April April, 1, , 1,2014 2014 TOPHC Skills Practice Cases Evaluation/ Policy Cases Problem Defining Cases Decisionmaking Cases Describe a situation facing a protagonist. Students must diagnose problem(s) and formulate possible solutions. Describe a decision faced by the protagonist. Students must choose among a finite set of alternatives. Mauffette-Leenders et al., 2007, p. 19 TOPHC––April April, 1, , 1,2014 2014 TOPHC TOPHC––April April, 1, , 1,2014 2014 TOPHC John M Garcia, PhD Professor of Practice & Interim Director School of Public Health and Health Systems Faculty of Applied Health Sciences Burt Matthews Hall, Room 2311 University of Waterloo TOPHC––April April, 1, , 1,2014 2014 TOPHC Overview • UW School of Public Health and Health Systems • Master of Public Health • Other Academic Programs of UW SPHHS TOPHC––April April, 1, , 1,2014 2014 TOPHC 42 School of Public Health and Health Systems • Created in 2012 from Dept of Health Studies and Gerontology • More than 30 years of innovation and development • 9 academic programs, 5 new/planned – – – – BSc, MSc, PhD MPH BHP and MHI MHE, BPH, DrPH • Addition of 9 new faculty • recent review of four programs (1st listed) TOPHC––April April, 1, , 1,2014 2014 TOPHC MPH Program: Rationale and Mission Rationale: • need for greater #s and capacity of public health professionals • MPH degree recognized academic benchmark credential • Need for expanded access to public health training (hence blended curriculum/mainly on-line, regular tuition fees) • First intake, August 2006 Mission: • help produce new generation of public health leaders and managers Brand: • aspire, inspire, transform TOPHC––April April, 1, , 1,2014 2014 TOPHC 44 Public Health • "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations [public, non-profit and private], communities and individuals“ (Winslow, 2002) TOPHC––April April, 1, , 1,2014 2014 TOPHC 45 TOPHC––April April, 1, , 1,2014 2014 TOPHC 46 What are core competencies? • “…the set of cross-cutting skills, knowledge and abilities necessary for the broad practice of public health.” U.S. Council on Linkages Between Academia and Public Health Practice, 2004 TOPHC––April April, 1, , 1,2014 2014 TOPHC 47 Core competencies, PHAC • Public Health Sciences • Assessment and Analysis • Policy & Program Planning, Implementation and Evaluation • Partnerships, Collaboration & Advocacy • Diversity and Inclusiveness • Communication TOPHC––April April, 1, , 1,2014 2014 TOPHC 48 Example of a core competency – Public health sciences domain • A public health practitioner is able to… 1.1 Demonstrate knowledge about the following concepts: the health status of populations, inequities in health, the determinants of health and illness, strategies for health promotion, disease and injury prevention and health protection, as well as the factors that influence the delivery and use of health services. TOPHC––April April, 1, , 1,2014 2014 TOPHC Example of a core competency – Public health sciences domain (continued) 1.2 Demonstrate knowledge about the history, structure and interaction of public health and health care services at local, provincial/territorial, national, and international levels. 1.3 Apply the public health sciences to practice. 1.4 Use evidence and research to inform health policies and programs. 1.5 Demonstrate the ability to pursue lifelong learning opportunities in the field of public health. TOPHC––April April, 1, , 1,2014 2014 TOPHC MPH Admission criteria • year Honours Bachelor's degree (or equivalent) in a health-related field, from a recognized university • minimum 75% average in final two years of study (equivalent to last 20 half-credit courses) • minimum 1 year prior work experience in a public health setting or other relevant setting • personal essay, resume, and letter – the education, work and life experiences that have brought you to the decision to apply to the Master of Public Health program – how the Master of Public Health will help you in your future career • university-level course in basic statistics recommended TOPHC––April April, 1, , 1,2014 2014 TOPHC Program requirements General stream: • 9 core courses • 3 electives • practicum Socio-behavioural stream: • 9 core courses, 2 stream courses • 1 elective • Practicum Environmental stream: • In approval process, similar model TOPHC––April April, 1, , 1,2014 2014 TOPHC Competencies in curriculum development Competency domains 601/ 602 SCB Env Epi Comm Mgmt/ admin Policy Public Health Sciences + + ++ +++ + + + Analysis and Assessment + ++ +++ +++ + + +++ Policy/Program Planning/ Implement/ Evaluation + + + + ++ +++ +++ +++ ++ + + +++ +++ +++ + + + + +++ ++ ++ Diversity/ Inclusiveness +++ +++ + + +++ +++ +++ Leadership +++ + + + +++ +++ +++ Partnerships Collaboration Advocacy Communication TOPHC––April April, 1, , 1,2014 2014 TOPHC The MPH “Building” – Core courses S-2 Capstone (PHS 602) W-2 Practicum (PHS 641) S-1/F-2 W-1 F-1 Health Policy (PHS 603) Stream courses Electives Principles of Epidemiology for Public Health (PHS 606) Health and Risk Communication in Public Health (PHS 608) Management and Administration of Public Health Services (PHS 609) Biostatistics in Public Health (PHS 605) Social Cultural and Behavioural Aspects of Public Health (PHS 607) Public Health and the Environment (PHS 604) Foundations of Public Health (PHS 601) TOPHC––April April, 1, , 1,2014 2014 TOPHC Elective course offerings – beyond core • PHS 614 Evaluation of Public Health Programs (stream requirement) • PHS 617 Population Intervention for Health Promotion and Disease Prevention (stream requirement) • PHS 623 Risk and Exposure Assessment (stream requirement) • PHS 624 Environmental Toxicology (stream requirement) • PHS 632 Health Economics & Public Health • PHS 635 Public Health, Environment and Planning • PHS 636 Applied Epidemiology • PHS 637 Public Health Informatics • PHS 638 Selected Topics in Public Health – Social Justice and Public Health • PHS 661 GIS and Public Health • PHS 662 Global Health • PHS 663 Human Development and Health TOPHC––April April, 1, , 1,2014 2014 TOPHC MPH Student Numbers by Year 300 250 239 236 215 200 185 159 150 134 98 100 94 86 77 63 45 65 62 55 50 76 48 45 40 30 19 0 1 0 15 10 8 4 40 12 11 8 0 2006 2007 2008 Incoming Students ₁ TOPHC––April April, 1, , 1,2014 2014 TOPHC 2009 Graduating Students ₂ 2010 2011 Total # of Students ₃ 2012 Withdrawals ₄ 2013 Students • Working at federal, provincial and local level, some international • Government, non-governmental, private sectors • MDs, nurses, dentists, public health inspectors, health educators and promoters, psychologists, social workers, engineers, community activists, computer professionals, statistics, planning, etc. • Range of substantive interests – chronic disease prevention, healthy growth and development, healthy environment, disaster planning/management, environmental health, infectious disease control, social determinants of health • Aspire to be future leaders in public health – policy, management, director level TOPHC––April April, 1, , 1,2014 2014 TOPHC Graduating Class, October 2014 TOPHC––April April, 1, , 1,2014 2014 TOPHC MPH Alumni Survey (spring 2012) • 81% employed (76% fulltime), 8% studying further, 8% homemaker/caregiver, 4% looking for employment/unemployed • Employed by: PHA/RHA (33%), provincial/territorial government (26%), federal government (19%), NGO/health charity (11%), other including communitybased organizations and international agencies • Range of roles: MOH, policy and program analysts, public health inspection/environmental health, health promotion, epidemiology, health communications etc. TOPHC––April April, 1, , 1,2014 2014 TOPHC Other UW SPHHS Programs • Master of Health Informatics – Public Health and Health Systems Field, complementing Cheriton School of Computer Science program – to identify, design and manage informatics solutions relevant to health and health systems – Competencies adapted from COACH • Bachelor of Health Promotion • Master of Health Evaluation – Preparation of professional evaluators – Competencies for evaluation practice established by the Canadian Evaluation Society • Future – BPH, DrPH?? TOPHC––April April, 1, , 1,2014 2014 TOPHC André La Prairie, Manager Skills Enhancement for Public Health Health Security and Infrastructure Branch Public Health Agency of Canada TOPHC––April April, 1, , 1,2014 2014 TOPHC Skills Enhancement for Public Health Centre for Public Health Capacity Development Health Security Infrastructure Branch Building a Solid Foundation for Public Health Practice TOPHC––April April, 1, , 1,2014 2014 TOPHC 62 Flexible (online) learning options to build knowledge, skills and competencies in public health www.phac-aspc.gc.ca/php-psp/ccph-cesp/about_so-apropos_cd-eng.php TOPHC––April April, 1, , 1,2014 2014 TOPHC “Nurses new to the north need opportunities to develop the breadth of skills and depth of knowledge needed to practice independently.” “Most public health nurses today are baccalaureatetrained, and further specific training in public health is no longer mandatory. Instead, public health nurses learn on the job through formal and informal inservice training.” “A thorough review of public health training programs is also needed—new entrants to the public health workforce should be appropriately qualified, and existing public health workers should be provided with opportunities to acquire additional skills if necessary.” “It has also been argued that short courses in infectious disease epidemiology are an essential part of capacity building for many aspects of public health practice and leadership, but are not widely available..” “Health Canada’s Skills Enhancement for Health Surveillance program is a webbased distance education program aimed at front-line and supervisory workers in local health departments. While not intended to substitute for master’s level training, and still under development, it aims to provide basic, high-quality training in epidemiology, surveillance and information management..” TOPHC––April April, 1, , 1,2014 2014 TOPHC Skills Online •Online continuing professional development program for front-line public health professionals • 10 online facilitated modules, 2 self-directed modules; English and French • Content mapped to the Core Competencies for Public Health in Canada TOPHC––April April, 1, , 1,2014 2014 TOPHC 65 Modules Currently Available Facilitated modules Selfdirected modules TOPHC––April April, 1, , 1,2014 2014 TOPHC • Basic Epidemiological Concepts • Measurement of Health Status • Epidemiologic Methods • Outbreak Investigation & Management • Epidemiology of Chronic Diseases • Introduction to Surveillance • Applied Epidemiology: Injuries • Communicating Data Effectively • Introduction to Biostatistics • Evidence-based Public Health Practice (English only) • Introduction to Public Health in Canada • Introduction to Literature Searching Modules Under Development • Privacy and Confidentiality • Core Competency Toolkit • Health Literacy • Introduction to Core Competencies • Introduction to Program Evaluation • International Health Regulations TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Challenges TOPHC––April April, 1, , 1,2014 2014 TOPHC Our Future • be a leader in new online module production National Schools and Programs of Public Health • links with CPHA (network and professional designation) • offer module content to schools and other programs • expand to alternate learning formats, including MOOCs TOPHC––April April, 1, , 1,2014 2014 TOPHC Future considerations • Need for a pan-Canadian and provincial public health human resources strategy – – – • Is this possible and if so, what would it include? How does this related to plans for public health organizational and system capacity building strategies? Role of Public Health Network? Increasing number and diversity of MPH programs – do they address demand? Do MPH program address front line practitioner and management needs? Evolving “National Network of Schools and Programs of Public and Population Health” (NNSPPPH) – – – Credentialing of public health professionals? Accreditation of schools and academic programs? Requirement for public health practitioner participation in planning? • In-service professional development programs, human resources changes local public health agencies? Uptake, dissemination • Role of MPH Programs in developing expert leaders for public health • MOOCs and free access to educational content TOPHC––April April, 1, , 1,2014 2014 TOPHC Jennifer L Chu, MD, MPH, FRCPC Staff Physician, Department of Emergency Medicine, St. Michael’s Lecturer, Department of Medicine, University of Toronto Director of Basic and Clinical Sciences, NextGenU TOPHC––April April, 1, , 1,2014 2014 TOPHC Overview • Overview of distance learning and MOOCs • Introduction to NextGenU • Future direction of public health and MOOCs/NextGenU TOPHC––April April, 1, , 1,2014 2014 TOPHC 81 Distance Learning 2000s 1930s 1800s 1996 2010s TOPHC––April April, 1, , 1,2014 2014 TOPHC 82 Internet Usage TOPHC––April April, 1, , 1,2014 2014 TOPHC What are MOOCs? TOPHC––April April, 1, , 1,2014 2014 TOPHC MOOCs • Coursera, EdX, Udacity largest MOOCs in the US • ALISON (Advanced Learning Interactive Systems Online) one of largest MOOCs mostly used in developing countries • MOOCs being developed globally TOPHC––April April, 1, , 1,2014 2014 TOPHC 85 MOOCs PROS CONS • Free or low cost for learners • Credit for courses often costs money • Self-directed/paced • Lack of direct human interaction • Less barriers than traditional • May lack prestige/acceptability education compared with traditional education • Computerized interactions globally • Sustainability • Limitless scalability • Quality control • Financial efficiency for institutions • High drop-out rates TOPHC––April April, 1, , 1,2014 2014 TOPHC 86 Kampala Declaration • WHO identified a need for 12.9 million more trained health workers by 2035 • WHO also stated this will require greater use of training innovation especially information and communication technologies TOPHC––April April, 1, , 1,2014 2014 TOPHC 87 NextGenU • Not a MOOC – a DOOHICHE Democratically Open, Outstanding Hybrid of Internet-aided, Computer-aided, and Human-aided Education TOPHC––April April, 1, , 1,2014 2014 TOPHC 88 TOPHC––April April, 1, , 1,2014 2014 TOPHC Course Development • Identify existing expert-derived core competencies • Organize competencies into modules • Match competencies with existing internet resources from highly reputable sources • All resources must be freely available and advertisement-free • Develop peer and mentor-based activities • Evaluation • Review from advisory committee • Sponsorship from accredited organizations TOPHC––April April, 1, , 1,2014 2014 TOPHC 90 Current Courses • Alcohol, Tobacco Use and Other Substance Use Disorders • Climate Change and Health • Emergency Medicine • Environmental Health • War and Health TOPHC––April April, 1, , 1,2014 2014 TOPHC 91 Upcoming Courses TOPHC––April April, 1, , 1,2014 2014 TOPHC 92 Pilot Tests • Emergency Medicine course piloted at the Uniformed Service University of the Health Sciences and University of Missouri with senior medical students • Environmental Health piloted with MPH students at Simon Fraser University (BC) • No significant difference found in standardized testing between control students and NextGenU students TOPHC––April April, 1, , 1,2014 2014 TOPHC 93 Countries Using NextGenU • Climate Change and Health – • Environmental Health – • Argentina, Australia, Bangladesh, Belgium, Canada, El Salvador, Germany, Great Britain, Hrvatska/Croatia, Hungary, India, Italy, Kenya, Nigeria, Pakistan, Philippines, Russian Federation, Saudi Arabia, Singapore, Sri Lanka, Thailand, United Arab Emirates, United States War and Health – • Brazil, Bulgaria, Canada, Christmas Island, Denmark, Egypt, Great Britain, Hrvatska/Croatia, Hong Kong, India, Nigeria, Pakistan, Saudi Arabia, Turkey, United States Canada, Ecuador, Malaysia, Switzerland, United States Emergency Medicine – Afghanistan, Australia, Bangladesh, Belgium, Bahrain, Brazil, Canada, Columbia, Czech Republic, Germany, Denmark, Ecuador, El Salvador, Estonia, Egypt, Spain, France, Great Britain, Greece, Hong Kong, Hrvatska/Croatia, Hungary, Indonesia, Ireland, India, British Indian Ocean Territory, Italy, Kenya, Latvia, Malaysia, Nigeria, Netherlands, Philippines, Portugal, Romania, Qatar, Saudi Arabia, Spain, Sri Lanka, Sudan, Sweden, Switzerland, Singapore, Trinidad and Tobago, Taiwan, US Minor Outlying Islands, United Arab Emirates, United States, Venezuela, South Africa TOPHC––April April, 1, , 1,2014 2014 TOPHC 94 Emergency Medicine TOPHC––April April, 1, , 1,2014 2014 TOPHC 95 Future Direction • Continue to develop courses in basic sciences, clinical medicine and public health • Preventative medicine residency curriculum currently under development • Goal to create a free MPH TOPHC––April April, 1, , 1,2014 2014 TOPHC 96 TOPHC––April April, 1, , 1,2014 2014 TOPHC 97 GROUP DISCUSSION TOPHC––April April, 1, , 1,2014 2014 TOPHC Discussion at Tables • After introducing each other, choose one person to record • Where do you see the challenges for the future? • What would be needed – To build on existing strengths (strongest collective capacities) at your place of work? – To build additional capacities (greatest area of collective improvement needed) at your place of work? • How would you go about enabling collective capacity building to happen at your workplace? In the future? TOPHC––April April, 1, , 1,2014 2014 TOPHC Thank you TOPHC––April April, 1, , 1,2014 2014 TOPHC