# Presentation: 423161

## Knowledge, Application, and Synthesis:  Internet-Based Public Health Preparedness Training Options 

## Session Learning Objectives:

- Describe the ways in which NCCPHP developed and implemented three public health preparedness Internet-based training options to address a range of preparedness learning outcomes.
- Identify advantages of using an Internet-based format to deliver public health preparedness training for public health professionals.
- Identify lessons learned in developing Internet-based training options.

## Overview of Session Talk

- NCCPHP Mission
- NCCPHP distance learning strategy
- Discussion of  three public health preparedness Internet-based training options
- Lessons learned

## NCCPHP Mission

*	**“**To improve the capacity of the public health workforce to prepare for and respond to terrorism and other emerging public health threats”*

## Why Distance Learning?

- Technical and instructional design expertise already in place at UNC SPH
- Just in time response to emerging issues
- Mixed audiences
- On-the-job learning
- Local, regional and national audience

## NCCPHP Distance Learning Strategy

- Develop trainings to meet different learning outcomes*
- Knowledge
- Application
- Synthesis
- Dependent on
- Need
- Time
- Audience

- *Bloom et al's Taxonomy of Educational Objectives (1956)

## NCCPHP Distance Learning Strategy

- Core Public Health Competencies
- The Public Health Foundation and the Council on Linkages
- Bioterrorism & Emergency Readiness
- CDC and the Columbia School of Nursing Center for Health Policy
- Public Health Epidemiology Competencies
- Northwest Center for Public Health Practice @ University of Washington

## NCCPHP Distance Learning Strategy

- Re-useable Learning Objects
- Learning objects are much smaller chunks of learning than courses, modules, or units.  30-60 minute
- Are **self-contained** – each learning object can be taken independently
- Are **reusable** – a single learning object may be used in multiple contexts for multiple purposes
**Can be aggregated **– learning objects can be grouped into larger collections of content, including traditional course structures

- Wisconsin Online Resource Center

## Public Health Preparedness Training Options

- Short (30-60 minute) trainings on our training website
- 14 week continuing education online course on communicable disease surveillance and outbreak investigation
- 16 month graduate level online certificate in field epidemiology

## Internet-based Public Health Training Site for Public Health Professionals 

**Public Health Preparedness Training Option 1**

## Goals of Training Website

- Training needs which were identified in assessments and surveys
- Just in time response to emerging issues
- Mixed audiences
- Local, regional and national audience
- On-the-job learning
- Address core competencies
- Bioterrorism and Emergency Readiness
- Core Public Health
- Epidemiology
- Training website was launched in February 2003

## Trainings in the Following Topic Areas:

**Notes:**
137 trainnings

## Training Website Faculty

- Center, SPH and UNC faculty to create original trainings
- Guest experts from local, state and federal public health to create original trainings
- Used existing online course material where applicable

## Participant Profile

## Audio Training Module Contents

- Each audio training consists of:
- PowerPointTM slides
- Streaming audio via Macromedia BreezeTM 5
- Printable transcript and slides
- Links to references and additional resources
- Interactive quiz questions
- Evaluation and certificate of completion

## Non-Audio Training Module Contents

- Each non-audio training consists of:
- FOCUS on Field Epidemiology periodical
- Interactive quiz questions
- Links to references and additional resources
- Evaluation and certificate of completion

## Evaluation 

- Complete the post-test
- Multiple choice with immediate feedback on correct and incorrect answers
- Complete online evaluation
- Timeliness
- Relevance
- Practicality
- Provide information to receive free Continuing Education Units from UNC CH

## Slide 18

## Slide 20

## Slide 21

## Slide 22

## Slide 26

## NCCPHP Training Web Site Registrations and Completions

**Count**

-          Total Registrations
-          Total Completions

**Date**

## Modules Competed Most

| Incident Command Systems (ICS) for Public Health  | 304 |
| --- | --- |
| Recognition and Management of Bioterrorist Agents:  | 246 |
| Chemical Terrorism: Introduction & Classification/  | 201 |
| Forensic Epidemiology | 183 |
| Introduction to Communicable Disease Law /Title VI--Cultural Competency | 142 |

## Evaluation of Trainings

- 	Nearly 100% of all trainees report that materials presented in online modules meet the educational objectives stated

## Satisfaction with Online Modules

## Educational Strategy

- Highest learning outcome: knowledge
- In and out quickly
- No interaction with faculty
- No interaction with other students
- Students are passive learners
- Standardized/organized website design
- Technical support provided

**Any Questions?**

## A Hybrid Internet/Classroom-Based Continuing Education Communicable Disease Course for North Carolina Public Health Nurses (Fall 2004 Pilot Course)

**Public Health Preparedness Training Option 2**

## Training Need

- 41% of public health nurses (n=1935) indicated that recognizing a disease outbreak in their community or nearby communities was of high importance to their job,
- They indicated a high need for training in this area.

## State Health Department –NCCPHP Partnership

- The General Communicable Disease Control Branch (GCDCB) in the Epidemiology Section of the North Carolina Division of Public Health
- NCCPHP

## Course Goal

- Enhance public health capacity and response of local health departments in North Carolina by
- Enhancing communicable disease nurses skills in recognizing communicable disease in their communities
- Enhancing communicable disease nurses skills in reporting communicable disease in their communities
- Improve accuracy of completing disease report cards and supplemental surveillance forms submitted to NC Division of Public Health
- Improve basic computer and Internet skills

## Faculty from GCDCB

- Kathy Dail, RN, BSN, MEd Nurse Epidemiologist (Course Director and Lecturer)
- Other Lecturers
- Jean-Marie Maillard, MD, MSc
- Jeffrey P. Engel, MD
- Megan Davies, MD, MPH
- George Ghneim, DVM
- Lee Hunter, DVM, MPH
- Pam Jenkins, RN, BSN, EdD
- Patti Poole, RN
- Krissy Simeonsson, MD, MPH
- Carl Williams, DVM, MS

## Faculty from NCCPHP 

- Faculty:
- Anjum Hajat, MPH, Epidemiologist (Lecturer)
- Lorraine Alexander, DrPH (Instructional Design)
- Teaching Assistant:
- Aaron Kipp, BS, Graduate Research Assistant Epidemiology

## Course Participants

- 80 enrolled from 47 local health departments
- 58 completed the course from 36 local health departments

## Participant Profile

**Job Title**

## Graduates of the Introduction to Communicable Disease Surveillance and Investigation in NC by County 

**Fall 2004 Pilot**

**CD Course**

**Graduate(s)**

**YES**

**NO**

## Course Structure

- 5 modules
- Four Internet-based modules delivered via BlackboardTM Course Management System (14 Weeks)
- Two-day face-to-face classroom based session

## Course Content

- Module 1 (Week 1) 3 units
- Overview of Epidemiology, global public health, state level surveillance activities
- Module 2 (Week 2) 2 units
- North Carolina Communicable Disease Laws
- Module 3 (Week 3-13) 11 units
- Case definitions for reportable diseases, methods of case investigation
- Module 4 (Week 14) 3 units
- Steps of an outbreak investigation, working with outbreak data, risk communication
- Module 5
- Skills demonstration in exercise, including creation of line listings and epidemic curves

## Contents of a Typical Module

- Multiple-choice knowledge pre-test
- Instructions on how to complete module
- Two or more units
- Module feedback mechanism
- Multiple-choice knowledge post-test

## Contents of a Typical Unit  

- Audio lecture
- PowerPointTM slides
- Streaming audio via Macromedia BreezeTM 5
- Printable transcript and slides
- Links to references and additional resources
- Activities handed in for evaluation of student learning
- North Carolina disease report cards and surveillance forms
- Laboratory results
- Disease scenarios

## Learner Satisfaction                                          n=55

## Educational Strategy

- Highest learning outcome: application
- Interaction with faculty
- No interaction with other students
- Students are still passive learners
- More time commitment
- Flexible course schedule
- Standardized/organized course design
- Technical support provided

**Any Questions?**

## A Graduate Online Certificate in Field Epidemiology    

**Public Health Preparedness Training Option 3**

## Goals of the Certificate Program

- Training needs which were identified in assessments and surveys (locally and nationally)
- Local, regional and national audience
- Address core competencies
- Bioterrorism and Emergency Readiness
- Core Public Health
- Epidemiology

## Field Epidemiology Certificate Program

- 12 credit hour program
- 4 graduate level courses
- 13 weeks each
- Faculty from the Department of Epidemiology
- Internet-based
- Launched Fall 2005
- 90 students

## Field Epidemiology Certificate Program

## 

	This course allows students to learn epidemiology as the basic science of public health by applying epidemiology concepts to current public health concerns. 

- 	This course allows students to learn epidemiology as the basic science of public health by applying epidemiology concepts to current public health concerns.

## 

	This course focuses on methodology, public health concerns, patterns of transmission, and “newly” discovered infections.  Will focus on diseases in developed countries, especially the United States. 

- 	This course focuses on methodology, public health concerns, patterns of transmission, and “newly” discovered infections.  Will focus on diseases in developed countries, especially the United States.

## 

This course provides conceptual foundations and
practical skills for designing, implementing and
evaluating surveillance systems and using data to
conduct and evaluate public health programs or
research. 

- This course provides conceptual foundations and
- practical skills for designing, implementing and
- evaluating surveillance systems and using data to
- conduct and evaluate public health programs or
- research.

## 

	This course will focus on the practical hands-on aspects of field epidemiology including computer applications in field epidemiology, questionnaire design, interviewing techniques and data analysis. 

**	**
**	**This course will focus on the practical hands-on aspects of field epidemiology including computer applications in field epidemiology, questionnaire design, interviewing techniques and data analysis.

## Faculty

- Faculty:
- Pia D. M. MacDonald, PhD, MPH,
- Karin Yeatts, PhD
- Lorraine Alexander, DrPH
- Teaching Assistant:
- Sandi McCoy, MPH

## Pilot Participants (Spring 2005)

- UNC CH graduate students
- Continuing education students
- UNC CH employee
- Public Health Epidemiologists

## Course Structure

- 11 modules
- Internet-based modules delivered via BlackboardTM Course Management System
- One module per week
- Students are assigned to learning teams
- 8-10 students per team
- A graduate student teaching assistant (TA)  served as consultant for two teams.

## Modules

- Overview
- Outbreak detection
- Generating hypotheses
- Testing hypotheses
- Data collection and entry
- Data analysis 1
- Data analysis 2
- Communication during crisis
- Laboratory studies
- Environmental health studies
- Forensic epidemiology

## Contents of a Typical Module

- Instructions
- Learning Objectives
- Audio lecture
- PowerPointTM slides
- Streaming audio via Macromedia BreezeTM 5
- Printable transcript and slides
- Epi Info folder
- Lecture with screen motion capture
- Activity

## Contents of a Typical Module

- Readings (required and additional)
- Case study questions
- Group discussion forum question or activity
- Ask The Faculty! link
- Module feedback mechanism

## Evaluation of Student Preformance

- Course participation grade
- Weekly case studies
- Weekly group discussion forum
- Project I and II
- Group project
- Peer evaluation

## Learner Satisfaction                                          n= 11

## Educational Strategy

- Highest learning outcome: synthesis
- Interaction with faculty
- Interaction with other students
-  small group discussions each week
- Students are active learners
- Large time commitment
- Scheduled activities
- Standardized/organized course design
- Technical support provided

## Overall Lessons Learned

- Know your target audience
-  Training needs
-  Time commitment
-  Technical capabilities
- Partner with someone who knows the target audience
- Commitment and flexibility from both instructors and participants

## Overall Lessons Learned

- Website should have a standard look and feel
- Website should be well organized
- In an online course, it is critical that instructions and activities be clearly presented
- lecture materials should be available both electronically and via hard copy
- Build training packages, courses and certificate programs on modular foundation

## Overall Lessons Learned

- Technical support or lack there of makes or breaks a training, a course, a program
- Prompt responses to email
- Email etiquette
- Student to faculty ratio
- FEEDBACK, FEEDBACK, FEEDBACK !

## Conclusion

- 	The NCCPHP has worked to create a made-to-order, flexible and expandable distance learning training program to fit the ever changing needs of public health professionals

- Pia D. M. MacDonald
- Jennifer Horney
- Mary Davis
- Anjum Hajat
- John Wallace
- Lisa Macon Harrison
- Kim Brunette
- Victor Schoenbach

- Edward Baker
- David Weber
- Karin Yeatts

- Instruction and Information Systems’
- Todd Nicolet
- Andrew Ochs

## Questions?

- Lorraine K. Alexander
- Director of Distance Education
- Department of Epidemiology and the North Carolina Center for Public Health Preparedness
- University of North Carolina at Chapel Hill School of Public Health
- CB #7435
- Chapel Hill, NC 27599
- 919-966-7423
- Lorraine_Alexander@unc.edu