Abstract
Universities offering undergraduate degrees in health promotion or health education and/or graduate degrees in public health typically require an internship, practicum, or fieldwork experience. This type of mentored experience is an important aspect of career development for the next generation of public health professionals and benefits not only the students but also the profession and the communities in which they work. This article provides perspectives from four public health professionals who have recently graduated from designated minority-serving institutions and highlights the ways in which internship, practicum, or fieldwork experiences have contributed to their career development. From a career development perspective, internships provide unique opportunities to develop professional networks, practice competencies learned in the classroom, gain experience in different environments, and share lessons learned with others in our field. The diversification of the public health research and practice workforce is increasingly recognized as crucial in building health equity. Internship programs that focus specifically on the academic and professional development of students underrepresented in public health provide experiences that meet or supplement academic requirements, and provide students with real-world experience and an expanded network of mentors and role models.
Introduction from the Coeditors
Recommendations from the first National Institutes of Health Summit on the science of eliminating health disparities included the need to focus on building capacity for health disparities research through tailored career development, with an emphasis on diversifying the health disparities research workforce (Dankwa-Mullan et al., 2010). This article focuses on the ways in which internship experiences in public health contribute to career development, especially among students underrepresented in the public health profession. The coeditors hope that the perspectives of the authors provide helpful information to students pursuing their academic internships and that faculty, students, and practitioners will share the article with their colleagues and networks.
Universities offering undergraduate degrees in health promotion or health education and/or graduate degrees in public health typically require an internship, a practicum, or a fieldwork experience. Although definitions vary slightly by degree program, all three terms are commonly used to refer to “work or service experiences related to a students major or career goal . . . that involve working in a professional setting under the supervision and monitoring of practicing professionals” (National Association of Colleges and Employers, 2013). This type of mentored experience is an important aspect of career development for the next generation of public health professionals and benefits not only the students but also the profession and the communities in which they work.
In the context of health promotion and public health programs, these experiences are typically a
planned, supervised and evaluated practice experience . . . [that includes] supervision by a preceptor qualified to evaluate the professional competence of the student . . . [as well as] well-defined learning objectives, procedures and criteria for evaluation of the practice experience. (Council on Education for Public Health [CEPH], 2011, p. 15)
In this article, the terms internships, practicums, and fieldwork are used interchangeably to refer to work experience designed to provide experience in the areas of responsibility for health education specialists (National Commission for Health Education Credentialing, 2010) and/or the core competencies of public health (CEPH, 2011)
This article provides perspectives from four public health professionals who have recently graduated from designated minority-serving institutions and highlights the ways in which their internship, practicum, or fieldwork experiences have contributed to their career development. These experiences took place in diverse sites including Cancer Prevention & Research Institute of Texas, a Minority Health International Research Training Program, a local nonprofit health plan, and a medical clinic serving mostly Hispanic/Latino patients who may be undocumented or have no other health care access. Several of the authors also interned with the Hispanic Health Disparities Research Center (HHDRC; http://hhdrc.utep.edu) and local health departments, and benefited from a stipend and an additional layer of mentoring support through the Directors of Health Promotion and Education (DHPE, 2013) Health Equity Internship Program.
Perspectives on the Benefits of Internship Experiences
From a career development perspective, internships provide unique opportunities to develop professional networks, practice competencies learned in the classroom, gain experience in different environments, and share lessons learned with others in the field. For example, as part of internships in their undergraduate programs, the authors had the opportunity to develop, implement, and evaluate health education programs, which provided confidence in their abilities as health educators and reinforced the value of their skills to the community. They also developed strong networks with public health professionals in the community and have sustained these relationships in subsequent projects, as volunteers and/or as paid employees.
Common Experiences and Lessons Learned
The value of our internship projects became evident to us throughout our studies, as we frequently have had the opportunity to share our findings and lessons learned. Communicating with other health professionals enhances our ability to connect with diverse stakeholders, and in turn provides us with new perspectives that inform our own career development. This exposure enhances our careers through several mechanisms. First, we gain opportunities to promote the profession through planning committee membership and student/new professional organizations. For example through the Society for Public Health Education (2013), what started with scholarships to attend a conference and present our practicum projects became multiple opportunities to join local chapters, serve on committees, and plan and implement a preconference workshop for students and new professionals. These experiences enhanced our understanding of the diverse roles of health education professionals and broadened our networks by connecting us with colleagues around the country.
Individual Perspectives
Kristen Hernandez, MPH, The University of Texas at El Paso
I am the first of my family to graduate from college and continue my education, so the majority of my academic guidance was deeply rooted in what I heard during my coursework. In my sophomore year, a graduate student spoke to my health promotion class about health disparities and research she did in the community. I introduced myself after class and asked how I could get involved in health disparities research. Making this one connection led to many others, including those who supervised my first internship experience.
My first opportunity to practice outside the classroom was as part of a research team that collected data on nutrition and physical activity among children. This provided much-needed experience and confidence and made me competitive for future internships. I kept in touch with the graduate student I met sophomore year, who later supervised my undergraduate community health practicum experience and encouraged me to pursue graduate school. Through her and through other faculty and students, I began to realize the benefits of reciprocal mentoring (Mata, Latham, & Ransome, 2010) in that I discovered that I had much to share with my own mentors, as well as with student colleagues. For example, in one of my internships I did a lot of data management and program evaluation, learning new approaches that I have shared within my network. Surrounding yourself with others who share a passion for the role of health education in public health provides many opportunities for your own growth and for you to help others grow and learn. In addition to the importance of participating in internships, my mentors taught us to apply for stipends, to submit our work for publication and presentation at conferences, and to participate in professional organizations. We have collaborated on many community health education projects and have shared results and lessons learned regionally and nationally.
Like many MPH programs, my current school requires a service learning practicum experience. This was also very important to my career development. In addition to my required practicum, I participated in the DHPE health equity internship program and benefited from the exposure to other students around the country as well as the mentoring and financial support. Through my practicum site I helped evaluate state health programs’ communication strategies, was part of a workgroup collaborating with other agency departments, and received a crash course in managed care health services. Once again, I gained valuable experience that influenced my career plans, and motivated me to pursue doctoral education in health policy once I have a few years of work experience.
Sandra Bejarano, MPH(c), CHES, The University of Texas at El Paso
As a Certified Health Education Specialist (CHES) in the U.S.–Mexico border region, I have experience in community health education, health disparities research, and community/academic partnerships. Much of this experience I gained through internships. I have seen firsthand the benefit of increasing the diversity of public health researchers and practitioners. I have presented my work related to mentoring and collaborations between community and academic partners at national public health conferences, campus and community forums, and health organization trainings. Sharing our work to contribute to improved public health practice is an important part of being a health education specialist (Mata & Davis, 2012).
As an undergraduate interning with the HHDRC, I gained experience in most of the areas of responsibility for health education specialists and later became a CHES. As part of my practicum, I joined a binational STI/HIV coalition. As a team we assessed social, environmental, and political conditions that may affect health education, and prioritized community health education needs. We mobilized community partners for National HIV Testing Day, and I developed an evaluation tool to improve subsequent events. I also developed educational materials tailored to Hispanic women that are still used by several agencies and were recently updated for our 2013 National HIV Testing Day event.
Serving as a resource person and communicating and advocating for health and health education also allowed me to mentor fellow students through their own practicum experiences, as my mentors constantly encouraged me to mentor others. This gave me even more experience and confidence, which in turn helped me to apply for DHPE funding and then a graduate research assistant position. In my practicum I received mentoring from my faculty mentor, my preceptor at the health department, and DHPE staff. I also continued to volunteer with the HHDRC, which enabled me to maintain established mentoring relationships and nourish community/academic partnerships. My practicum provided experience in the five core areas of public health (CEPH, 2011) as well as in Hispanic health disparities and border health.
As a first-generation college student and a single parent, I am particularly aware of the benefits of paid internships and research positions through which we gain experience while earning a paycheck. Although paid internships are uncommon in our field and are very competitive, I believe the high quality of my undergraduate practicum gave me the confidence to apply and the experience to be selected for paid internships and other positions. They also prepared me well for my first full-time job in the field, and my new employer is particularly impressed with the coalition-building experience I gained through internships.
Margarita Chavez, MS (Health Education), University of New Mexico
Fieldwork experience was an extremely important part of my education. After multiple courses in community health, including hundreds of lectures and many hours reading and researching, I was anxious to get out into the community. My fieldwork experience showed me that I had more learning to do! Being able to sit and talk with people from my community and let them tell me the best ways to educate about health was an experience I could not get from a textbook. I would talk with patients about chronic disease prevention and they would tell me, “I will never make changes like that” or “That will never work for me.” I was then able to learn what would work for them and how to help them make changes. This practical application showed me that each patient, each community, each priority population is unique and any prevention or intervention program must be tailored to their needs. Without this humbling and practical experience, I would have been unprepared for the health education profession or my graduate studies.
My graduate studies included fieldwork at a breast cancer education and advocacy community organization. I helped analyze 15 years of program data, provided program evaluation, advocated for women in the program, and provided direct patient education. Learning the inner workings of a community-based organization was an eye-opener. I now understand the critical role of data collection in the overall success of a program. As an external program evaluator I was also able to see how every staff member, volunteer, and dollar spent is critical to every program.
Because I continued to volunteer with both of my fieldwork sites, I continued to grow as a health educator. I also linked with local congressmen and county commissioners through the clinic and continue to work closely with them to advocate for health in my community. Many providers and physicians from the clinic have been great references as I grow in my professional career.
The experience gained through these internships motivated me to apply for the Exito! Latino Cancer Research Leadership Training. This paid internship involves qualitative and quantitative data collection and analysis with the Susan G. Komen Foundation and focuses on women being treated for breast cancer. I believe that fieldwork or internship experiences, as a part of health education curriculum, should not be an option. Practical application of coursework before being thrust into the professional world provides the knowledge and skills every student needs. Fieldwork gave me credibility as a public health educator. It also showed me that the people we work with do not always fit neatly into the theories or perspectives we learn in school. The exposure to my community members was just as beneficial as the exposure to mentors and researchers in the field.
Francis J. Reyes, MPH, Health Communications Fellow, National Cancer Institute
Throughout my college career, I had many opportunities to learn new skills, network, and perform at the professional level as a health educator. As an undergraduate, I interned with the HHDRC, learning public speaking, curriculum development, supervision, collaboration, and networking. I worked with several community-based organizations, such as the Boys and Girls Clubs of El Paso, and with state and local health departments. My practicum experience led to a paid position as a research assistant, as well as a summer consulting job with an international public health organization.
My internship experiences gave me confidence to pursue my MPH degree, and to apply for additional internships. Like several of my coauthors, I received a stipend from DHPE that greatly enhanced not only my finances but my professional network as well. During that practicum at our local health department, I worked mostly in public health preparedness and epidemiology. DHPE helped me connect the dots between my academic practicum, health policy, and health equity. I learned more about the importance of culturally and linguistically appropriate services, and the role that health educators play in providing them. My practicum experience also gave me the qualifications and references that helped me obtain a paid research associate position that lasted throughout my graduate program, and gave me yet another mentored opportunity to develop skills and strengthen professional networks.
I believe it was because of the experience I gained through my internships that I was hired upon graduation as a Health Communications Fellow at the National Cancer Institute, National Institutes of Health in Washington, D.C. As I near the end of my 18-month fellowship, I realize just how much the experience and confidence gained in my internships have contributed to my career development.
Recommendations
The diversification of the public health research and practice workforce is increasingly recognized as crucial in building health equity (Hernandez, Arredondo, Bejarano, Mata, & Tomaka, 2012; Kreuter et al., 2011). Internship programs that focus specifically on the academic and professional development of students underrepresented in public health provide experiences that meet or supplement academic requirements, and provide students with real-world experience and an expanded network of mentors and role models. Interns also enhance the capacity of agencies to serve their communities, often providing a new service or a comprehensive evaluation of an existing program in addition to new perspectives and ideas. Whether an internship includes a stipend or not, the most beneficial in our experience were those in which we had responsibility for a particular project, frequent opportunities to contribute ideas and innovation, and dedicated mentoring time from both agency and university supervisors.
From a health equity standpoint, we have the ability and responsibility to advocate for and provide culturally and linguistically appropriate services, and to promote policies that improve community health. Internships give us more opportunities in more places to do so! We encourage all future public health professionals to take advantage of internships offered both within and in addition to your academic programs. Your careers and our communities will benefit from the experience! To find internship opportunities, use networks within your academic program and talk with your advisors, mentors, and student colleagues. Just as important from our experience is connecting with professional organizations in our field that offer special memberships, conference scholarships, networking, and tailored career development opportunities for students. Here are a few to get you started!
Society for Public Health Education: http://www.sophe.org
Directors of Health Promotion and Education: http://dhpe.site-ym.com
American Public Health Association: http://www.apha.org
