Partnering with communities
Published in the Spring 2015 UNC at Chapel Hill Gillings School of Global Public Health Carolina Public Health Magazine
Students use capstone projects to improve public health
By Whitney L.J. Howell
Throughout North Carolina, Master of Public Health students from the UNC Gillings School of Global Public Health are hard at work in communities — designing, reviewing and improving community-based programs to improve health outcomes statewide. They’re doing it for course credit — and they’re loving the learning process.
Caitlyn Snider, Adébukola Oni and Hyun Namkoong meet with potential capstone community partners. (Photo by Linda Kastleman)
Since 2009, instead of writing lengthy theses, health behavior master’s students participate in the capstone program, an initiative that embeds them within a community project, giving them opportunity to gather new skills while they apply in their neighborhoods what they’ve learned in the classroom. The capstone course was the result of a comprehensive review of the Master of Public Health program, led by Laura Linnan, ScD, professor of health behavior at the Gillings School.
Now in its sixth year, capstone accomplishes something its community partners had long wanted, says Megan Landfried, MPH, capstone program manager and health behavior lecturer.
“A program evaluation revealed that many stakeholders were ready for a new form of field training,” Landfried says. “We really wanted to strike an optimal balance between student learning and service to our community partners.”
Landfried, who participated as a student in Action-Oriented Community Diagnosis, a
Students in spring 2013 display their capstone accomplishments at a poster exhibition. (Photo by Branson Moore)
prior iteration of the year-long field experience, says the current program affects real change in communities while preparing students for their own careers. That students work on projects proposed by community partners ensures that their efforts truly benefit the communities in which they work.
Each year, capstone invites 15 to 17 community partners to the School for a “pitch day,” when program leaders present their project ideas to students. Students rank the five programs in which they are most interested, and capstone leaders assign between four and six students to each of 10-12 selected projects. On average, 80 percent of students are assigned to their first choices.
Student Impact
According to Landfried, students spend about 7.5 hours each week with their projects, working alongside program leaders and learning from these real-world mentors.
Dr. Geni Eng (center), professor and capstone adviser, attends a planning session with students and their community partners. (Photo by Linda Kastleman)
For example, PORCH (porchnc.org), a Chapel Hill-based, all-volunteer, hunger-relief organization, has worked with capstone to evaluate the efficacy of its food distribution and referral process, says program founder Debbie Horowitz. Without capstone students, the group could not have obtained that information.
“The students have provided us with a lot of data that we would have had to do without otherwise,” Horowitz says. “Are we helping the right people? Is the food we provide being used? Are we providing enough? As an all-volunteer organization, we just don’t have the time and expertise to go after that research.”
Based on capstone work, for example, PORCH leaders learned that 50 percent of the Hispanic families served by the organization don’t use peanut butter. That’s useful information, Horowitz says, because historically, volunteers have worried about not having enough of what they considered a basic nutritious food for every family. Now, they can distribute the product more efficiently.
Next year, she says, she hopes capstone students will help redesign PORCH’s referral process, improving communication and making it more seamless for social workers to help connect families to the service.
Safe Teens Think First, a program based in Cleveland County (N.C.), engaged capstone students to re-invigorate their efforts to teach safe driving skills to teens. Sharon Schiro, PhD, program leader and UNC assistant professor of general and acute care surgery at the UNC School of Medicine, says the program initially presented lectures about driving to between 30 and 60 teens.
Dr. Laura Linnan, professor and adviser (far right) listens to a community partner describe a project and invite capstone students to be part of it. (Photo by Linda Kastleman)
Being closer to the young drivers’ ages (15 and 16 years old), she says, capstone students were able to identify ways to keep teens more engaged. Not only were the teens divided into smaller groups for direct interaction, but they also were given more activities.
In the future, Schiro says, she hopes capstone students will help expand the program and take Safe Teens Think First beyond Cleveland County to the rest of North Carolina.
Program benefits
Although capstone is the culminating academic element of the Master of Public Health degree, its benefits are far-reaching, both for student and community partner.
“For the community organizations, capstone students offer a fresh perspective on how each program runs,” Horowitz says. “It certainly forces us to change and improve. When you have people asking questions and thinking outside the box, it will inform the changes that we make to our own programs.”
Master’s candidates also benefit from the capstone experience. Although
Meg Landfried (left) poses with capstone teaching assistants Melissa Cox (center) and Christine Agnew-Brune during a final presentation of team projects. (Photo by Linda Kastleman)
time spent in Gillings School classrooms gives students a solid foundation for meeting public health needs, working with capstone partners gives them first-hand experience and a taste of what to expect in their future jobs.
An added benefit, Schiro says, is that the program exposes students to potential employers and provides students with work references outside academia.
“Capstone is a fusion of academic instruction and real-world endeavors that prepares MPH candidates to better meet the public health needs they will encounter in their careers,” Landfried says. “The program is a unique opportunity to carry out important field work while having a wonderful, supportive safety net.”
To read the story at its original location: http://sph.unc.edu/cphm/partnering-with-communities/
Dilshad Jaff
Published in the Spring 2015 UNC at Chapel Hill Gillings School of Global Public Health’s Carolina Public Health’s Magazine
Passionate about the safety of patients and health-care providers during war
By Whitney L.J. Howell
For Master of Public Health candidate Dilshad Jaff, MBChB, war-zone health crises are more than 10-second sound bites on the evening news. As a Baghdad-trained physician, he was neck-deep in those crises and found them to be complicated and very real. Now solving them is his mission.
“The nature of conflict has changed, and things have become more complex,” says Jaff, who worked as primary health district manager under the Iraqi Ministry of Health from 2003 to 2008. “We can’t improve global health without looking at conflict and resolution.”
Between 2010 and 2013, Dr. Jaff regularly visited primary health-care centers in disputed areas of Iraq to support staff members. Here, at a rural center low on supplies, he devises a disposal box for used needles from an empty medicine box. (Contributed photo)
Jaff pairs his public health training with conflict-zone experiences — both as physician and as Rotary World Peace Fellow (sponsored by the Rotary Club in Cary, N.C.) — to determine how to safeguard soldiers’ and civilians’ health needs during times of war.
Jaff ’s path has been winding. After the 2003 war in Iraq, he managed the emergency room as a volunteer in a hospital without power or water. He led mental health care, health education and vaccination programs at a primary health care center in Iraq, supervising nurses and other health professionals. There, he witnessed an undeniable truth — that the lack of wartime medical infrastructure compromises public health needs. Victims of violence — the wounded and displaced — remain vulnerable, and health workers also are endangered, he says.
He discovered a serious lack of training among in-field health professionals. As a physician with the International Committee of the Red Cross, he taught triage procedures, pharmacy management, waste management and infection control to nurses and other staff members — but he also had to educate about the most basic hygiene practices. He trained emergency workers to use ambulances properly.
After studying conflict management and peace through a Rotary Club scholarship in Thailand and Cambodia and returning to the field with the Red Cross, Jaff found that it was impossible to track attacks, kidnappings
Dr. Jaff (standing) delivered a lecture in 2010 to a group of medical doctors and nurses in Iraq as part of a program to strengthen emergency services through training in communication and teamwork, infection control, waste management and other topics. (Contributed photo)
and other incidents that put health-care workers in danger. Without that information, improving safety and infrastructure is unlikely.
“There is a big gap in knowledge because people aren’t communicating or sharing, and no one is looking at the problem,” he says. “We don’t know the number of people affected because we can’t collect the data. What we see, believe me, is the tiny tip of the iceberg.”
Jaff had the necessary negotiation, facilitation and communication skills to navigate conflict zones, but if he were to affect change, he knew he needed to improve his credentials in public health. With additional Rotary Club support, he came to the Gillings School in 2013 to focus on women’s and children’s health. The specialization is important, he says, because violence now so often catches civilians in the crossfire.
His goal is to unite the objectives of public health and conflict resolution through education. Colleges of law, medicine and military science, he says, must teach students that medical missions are protected during war. Ultimately, he wants to teach local communities how to handle emergency cases, displacements and epidemic threats, as well as how to ensure that women and children have access to health care that is equal to access by men.
Jaff (second from left) and other members of the 2014-2015 Student Global Health Committee presented at the GillingsX talks in April. (Contributed photo)
“This is part of my dream for the future,” Jaff says. “I would love to be involved in teaching or building a connection between UNC and other organizations to address these issues. I want to use the university’s considerable educational resources to bring people together. It’s unacceptable to ignore the problem. Physically, we can’t be everywhere, but we still can do something.”
For now, Jaff, who is co-chair of the School’s Student Global Health Committee, is focused upon learning all he can and informing all who will listen about the plight of those who live and provide health care in conflict zones. In spring 2014, for example, he presented a GillingsX talk on health-care delivery in war zones.
Jaff poses with his wife and daughter at his 2009 graduation from the Rotary peace and conflict resolution program at Thailand’s Chulalongkorn University. (Contributed photo)
There’s no doubt that his earnestness, dedication and courage will play a big part in the change to come.
To read the story at its original location: http://sph.unc.edu/cphm/dilshad-jaff/
Medical Schools Taking Active Role in Helping Students Manage Debt
Published in the AAMC Reporter July/August 2015 issue
By Whitney L.J. Howell
The incoming student’s strategy for covering his costs at Drexel University College of Medicine was a financial disaster waiting to happen, said Michael Clancy, the school’s director of financial planning. The student planned for a parent to cover most of the bill through a broker loan, while the remainder was charged to a credit card. A consistently paid minimum balance would avoid any interest charges, the student believed.
Clancy recognized the flawed reasoning and knew he had to speak up. “I calmly explained that wasn’t how credit cards worked and asked if his parent understood how broker loans—margin loans based on the value of a securities account—[functioned],” he said. “Based on that interaction and another consultative meeting, they changed their approach.”
While most financial planning conversations focus more on loan repayment details than avoiding potential catastrophe, this scenario underscores the need for medical schools to help students navigate tuition and repayment of debt. A 2014 AAMC report revealed that 84 percent of medical students graduated with an average debt of $180,000.
Many repayment options exist, such as loans linked to income level and the federal Pay As You Earn program that establishes monthly payments equal to 10 percent of discretionary income. Other loan forgiveness options, including the Public Service Loan Forgiveness Program and National Health Service Corps, also are available. But the existence of these programs does not mean that students understand the financing of their education. Increasingly, the onus of clarifying the process falls to medical schools, and many are adopting creative strategies tailored to each student’s circumstances. Cookie-cutter approaches to managing medical education debt usually don’t work because each student’s financial situation is unique.
Oregon Health & Science University (OHSU) and Drexel both hired certified financial planners to provide personalized guidance for their students. Kribs and Clancy make presentations during student orientation and at mandatory meetings. Often, the planners work with students for all four years and offer one-on-one sessions. “It’s taking their personal puzzle and putting the pieces together with them,” said Justin Kribs, OHSU’s certified financial planner, who has created webinars on financial topics for students as well. “What’s great is we’re starting students at square one and getting to ask them what they want to accomplish, how they will get there, and what things are in their way.”
Since joining OHSU, Kribs said he has advised more than 1,000 students. Third- and fourth-year students are required to meet with him at least once. Many students want to know how to minimize the amount of money they borrow, he said. Others want advice on managing the financial aspects of getting married or having a child while in school.
Julie Fresne, AAMC student financial planning director, acknowledges that the debt the typical medical student incurs is high, but noted that after controlling for inflation, the figure has remained relatively constant for roughly six years. And it is a burden worth assuming, she added. “The AAMC believes a career in medicine is an excellent investment with very good job security and excellent income potential. There are enough flexible ways to repay student loans and provide a secure living and retirement,” Fresne said.
Improving financial literacy
Financial aid professionals at Tufts University School of Medicine begin early during the admissions process to engage students in discussions about the intricacies of loans, debt management, and repayment. Launched in 2010, Tufts’ Planning for $uccess program provides students with “financial literacy education that dives much deeper than typical debt management and loan repayment,” said Tara Olsen, Tufts director of financial aid.
Workshops and lunch-and-learn sessions teach Tufts students about credit, mortgages, contract negotiations, and taxes. The financial aid office also publishes quarterly newsletters with spending tips, student discounts, and low-cost local activities.
The University of Missouri (MU) School of Medicine introduced its financial literacy program in the 2009–10 school year. Available to all students, the initiative addresses financial topics in 30-minute sessions that are posted online as well. Students receive incentives to attend the sessions, too, explained Cheri Marks, MU’s student financial aid and records coordinator. When they show up or complete a task such as submitting a budget sheet, they are entered into a $500 scholarship drawing.
“It takes a while for this new language to sink in because [it uses] terms students are unfamiliar with,” Marks continued. “In the past, they might have thought about [their financial situation] when they got their financial aid package and not again until after they got their money.”
The MU initiative incorporates the AAMC’s FIRST (Financial Information, Resources, Services, and Tools) program, which is available to medical students around the country seeking support to manage finances, understand loan repayment options, and learn about various types of loans. FIRST provides access to the MedLoans® Organizer and Calculator, helping students track loans and test sample repayment scenarios, and $ALT®, a money-management skills program. The program also offers loan and debt management webinars.
At Michigan State University College of Human Medicine, fourth-year medical student Joseph Meleca proposed a one-credit business and finance elective inspired by his front-office experience at his uncle’s private cardiology practice. He got the idea from observing that he and his peers had little understanding of how to finance their education or manage their living expenses. Approved by school administrators, the 11-week program invites financial experts to speak at all of the school’s campuses to elevate students’ understanding of medical school financing, debt management, billing and coding, and practice management.
After the first year, 85 percent of students reported that they benefited from the course and believed it would be helpful for incoming students. Thirty percent said it should be in the permanent curriculum. In fact, this elective, now in its third year, is the basis for a potential 60-credit MD/MBA program at Michigan State University’s Eli Broad College of Business.
It’s imperative for medical students to understand how their financing choices will affect their future decisions in practice, Meleca said. “If medical students don’t have this knowledge, they go into residency without it, and then they have even less time to learn it.”
To read the article at its original location: https://www.aamc.org/newsroom/reporter/julyaugust2015/439854/medicalschoolstakingactiveroleinhelpingstudentsmanagedebt.html
Medical Schools Put Radiology in the Spotlight
Published on the July 23, 2015 DiagnosticImaging.com website
By Whitney L.J. Howell
Although radiology stands as one of the most technologically forward-moving specialties, it has suffered a drop-off in interest over the past 15 years in the National Residency Match Program. Residency programs, though, are now learning more about what’s keeping medical students away and are implementing strategies to reverse this trend.
According to radiology faculty currently or previously involved with residency programs nationwide, turning the tide to increase radiology residency numbers requires changing how medical schools approach introducing students to the specialty. Residency programs must also participate in the process for appeal in radiology to rebound.
There are a variety of reasons medical students give for avoiding radiology as a residency choice, these faculty said. Waning attraction seems to stem from misunderstanding radiology, perceptions about lack of job opportunities, beliefs about little patient contact, and the increased use of computer technology. As it turns out, these perspectives are misplaced or inaccurate.
“The question is how much of what medical students see is real or fictitious,” said Saurabh Jha, MD, MS, assistant professor of radiology at the Hospital of the University of Pennsylvania who also participated in residency interviews in the past. “I’m not sure, to a large extent, that the distinction is important from their position.”
In an environment where medical schools are more focused on producing primary care or internal medicine practitioners, the onus of enticing students to choose radiology lies with current radiologists. To be successful, Jha said, the industry must exude more confidence in literature, blogs, and in teaching.
“It’s not simply saying ‘Look at the pretty pictures we can take.’ It’s going and telling them about diagnostic radiology and revealing to them how the radiologist – not the CT – made the difference,” he said. “We have to make sure medical students understand that it’s people who make the difference.”
To read the remainder of the article at its original location: http://www.diagnosticimaging.com/residents/medical-schools-put-radiology-spotlight?cid=top
Who am I?
I’m a seasoned reporter, writer, freelancer and public relations specialist with a master’s degree in international print journalism from The American University in Washington, D.C.
I launched my journalism career as a stringer for UPI on Sept. 11, 2001, on Capitol Hill. That day led to a two-year stint as a daily political reporter in Montgomery County, Md. As a staff writer for the Association of American Medical Colleges, a public relations specialist for the Duke University Medical Center and the public relations director for the UNC-Chapel Hill School of Nursing, I’ve earned in-depth experience in covering health care, including academic medicine, health care reform, women’s health, pediatrics, radiology, and Medicare.
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