Teaching Graduate Students to Evaluate Public Health Programs Through Community-Based Learning

Abstract

Public health professionals are increasingly called on to demonstrate program evaluation skills, a core competency for the field. Learning opportunities that are connected to community organizations with identified evaluation needs give students meaningful opportunities to build and test new skills. When thoughtfully implemented, community-based learning benefits both the student and the community, yet there are several important considerations for designing a course that incorporates this feature. This article describes one approach for teaching graduate public health students how to conceptualize and write a comprehensive program evaluation plan for a community agency, based on the needs, priorities, and capacity of that agency. Lessons learned and recommendations for adopting this model are discussed.

Keywords

evaluation teaching community-based projects

Introduction

Program evaluation has long been recognized as an important component of public health, and it has been featured in prominent planning models (Green & Kreuter, 1991), the core public health competency framework (Council on Linkages between Academia and Public Health Practice, 2010, 2014), the 10 Essential Public Health Services (Centers for Disease Control and Prevention [CDC], 2018), and national public health agency accreditation standards (Public Health Accreditation Board, 2019). Recently, public health professionals have placed additional attention on the role of program evaluation and identified this work as one of the critical skills public health practitioners of the future will need (Erwin & Brownson, 2017). Efforts by the CDC have underscored program evaluation efforts as “essential” and, increasingly, organizations have been encouraged to adopt policies and practices to support this work (Kidder & Chapel, 2018, p. 356). Now, more than ever, funders are requesting evaluation plans that involve stakeholders and maximize improvement opportunities (CDC, 2012).

Teaching students how to build evaluation skills is a common feature of most graduate public health programs. Based on recently revised criteria, accredited public health schools and programs in the United States are required to demonstrate the ways in which they assess student evaluation competencies (Council on Education for Public Health, 2016), and attention has been placed on teaching students practical evaluation methods (Davis, 2006).

One teaching approach that has gained momentum and proven successful is the application of community-based coursework focused on real projects (Bentley & Swan, 2017; Comeau et al., 2019; Florence & Behringer, 2011; Greece, Dejong, Schonfeld, Sun, & McGrath, 2018; McIntire & DiVito, 2017). The literature indicates that this approach has many benefits including enhanced retention and application of key concepts (Chupp & Joseph, 2010), as well as the development of skills linked to critical thinking, problem-solving, communication, and cultural awareness (O’Connor, McEwen, Owen, Lynch, & Hill, 2011).

The purpose of this article is to share a structured approach for engaging community partners in a team-based class assignment focused on developing a comprehensive program evaluation plan. This article provides instructors with details about the assignment, grading, content covered, and a reflection of lessons learned and recommendations for facilitating an effective student learning experience.

Course Assignment

Assignment and Key Audience

The evaluation plan assignment was originally developed and used in 2013, and it has been adapted and implemented in a public health graduate-level applied research and evaluation course annually. This assignment can be adopted by other master’s-level health-related programs seeking to provide students with community-based practice opportunities to build program evaluation skills and confidence in applying those skills.

The assignment reflects three learning objectives. On completion of the course, students should be able to

Write a comprehensive program evaluation plan that is responsive to the needs of a community partner,

Create a data collection tool that is aligned with best practices for qualitative and quantitative protocol development, and

Present evaluation ideas and approaches with confidence to community partners.

Given the stated objectives, the assignment includes three components.

A written evaluation plan. The plan should be comprehensive and written as a “stand-alone” document that not only provides details about the evaluation approach, framework, methods, and proposed dissemination efforts but also includes sufficient background information for potential external audiences to understand the initiative, the purpose of the plan, and any additional context that warrants consideration. The plan needs to be submitted as a formal technical report based on best practices. The expectation is that all evaluation plans will include the following key features: a cover page, table of contents, clear headers and subheaders used to organize the plan, the use of figures and charts, and the inclusion of appendices.

A data collection tool. Students are required to develop and submit (in an appendix) one tool that could be administrative (e.g., for record keeping), qualitative, or quantitative. This tool can reflect a new strategy for collecting data or enhancements to an existing tool/protocol currently used by the community organization. The proposed tool needs to be (1) aligned with the evaluation priorities, (2) designed to add value, and (3) complete and ready for adoption. In other words, submitting three new survey items measuring a specific construct would not be sufficient.

An evaluation presentation. On completion of the evaluation plan, each team is required to present their ideas in a graded and timed (20 minute) presentation to a mock review panel that includes the community partner and the instructor. The purpose of the presentation is to share the team’s plan and essentially “sell” their evaluation approach and services as though they were external consultants asked to bid on an evaluation contract.

Rubrics

The written components of the assignment were graded on the quality, comprehensiveness, and responsiveness of the evaluation plan and accompanying tool. Figure 1 includes a grading rubrics with each component rated on a scale of one to four. This assignment represents 25% of the student grade, 15% for the written submission, and 10% for the presentation.

Figure 1.

Rubrics for written assignment.

In addition to the grading rubrics, an instructor checklist was developed to ensure consistency in the review process and to record additional constructive feedback that could be shared with each team. As seen in Figure 2, the checklist includes a list of characteristics discussed as part of the course and expected to be demonstrated as part of the written assignment. A separate evaluation form was used to grade the student presentations, assessing both the content (e.g., key elements of the plan) and delivery (e.g., organization) of the presentation.

Figure 2.

Instructor checklist and feedback form.

Class Structure and Content

The class is set up as a 15-week semester face-to-face course that is taken by students who are in their second year of study in the MPH program. While there are no prerequisites, most students have taken the core course requirements for the program and have therefore been exposed to logic models, budget and resource planning, and team building. In the event that a student has not been exposed to one or more of these topics, special arrangements are made as part of the course, with the instructor, depending on student needs.

As seen in Table 1, the evaluation plan assignment is linked to 13 of the class sessions allowing flexibility for two additional sessions on topics of interest or based on student or program curriculum needs. The content areas for the class sessions are described below. Table 1 provides a list of student learning objectives and lesson plan considerations for each session.

Table 1.

Weekly Course Sessions, Student Learning Objectives, and Instructor Considerations.

Course sessions and student learning objectives	Lesson planning considerations
Session 1. Evaluation: The Basics
• Describe evaluation terms, tools, and approaches	Use standard textbook language and share examples with different designs
• Compare and contrast common research designs
Session 2. Evaluation in Practice
• Apply frameworks to help guide an evaluation	Highlight the CDC program evaluation framework and RE-AIM, with examples
• Explain the application of one framework given a case example
Session 3. The Evaluator
• Describe the role of an evaluator and share facilitator tips	Distinguish between internal/external evaluators, teach facilitation strategies
• Discuss solutions to address problem-based scenarios
Session 4. Evaluation Planning, Writing, and Presenting
• Write a comprehensive, responsive, realistic evaluation plan	Share an evaluation plan outline only; this will encourage critical thinking and prevent duplication
• Format a professional looking plan and data collection tool
• Present a plan to clients and stakeholders
Session 5. Evaluation Disseminating
• Identify strengths and weaknesses of various approaches	Engage students in a discussion about innovative approaches, give examples
• Propose one dissemination approach given case examples
Session 6. Engaging Partners and Negotiating a Scope of Work
• Identify strategies for communicating effectively	Teach students how to listen and probe for key information that is relevant
• Demonstrate advanced preparation prior to meeting a client
Session 7. Community Partner Presentation
• Listen to the partners to determine evaluation needs	Consider setting up a mock bidder’s conference with the partners or require students to ask partners questions to help shape the evaluation plan
• Ask meaningful questions to help shape the evaluation
• Identify priorities, given resources and needs of partners
• Articulate the key evaluation questions
Session 8. Human Subjects Research
• Receive CITI certification^a	Work with the IRB office to create videos; this session can be online and the sequencing and timing is flexible
• Describe the IRB submission process
• Create an informed consent form
Sessions 9 and 10. Qualitative Data Collection
• Determine when and how to use qualitative data	Require students to develop a Moderator Focus Group Guide, have each student lead a mock session in class using the guide they developed
• Develop a qualitative data collection tool^a
• Prepare recruitment and consent material^a
• Moderate a focus group or lead an interview^a
Sessions 11. Quantitative Data Collection
• Determine when and how to use quantitative data	Have students critique existing survey tools and create a scenario that allows students to generate new survey items
• Identify the ways by which to improve example surveys (content/format)
• Develop good survey questions and response options
Sessions 12. Working With Administrative Data
• Determine when and how to use administrative data	Share examples of administrative data and summary charts, matrices, and visuals
• Identify strategies for collecting/synthesizing this data
Sessions 13. Evaluation Plan Presentations
• Present an evaluation plan with confidence to partners	Have all panelists provide written feedback
Sessions 14 and 15. Additional Content Areas—To Be Determined
• Develop an evaluation abstract and poster presentation	Determine student needs and interests and cover additional topics, as needed, based on curriculum gaps
• Conduct a thematic analysis using qualitative data
• Analyze survey data from an existing dataset

Note. CITI = Collaborative Institutional Training Initiative; CDC = Centers for Disease Control and Prevention; RE-AIM = Reach, Effectiveness, Adoption, Implementation, Maintenance framework; IRB = institutional review board.

Indicates separate class assignment.

Evaluation 101

This content is covered in three class sessions that are held at the beginning of the semester, and they focus on the fundamentals of program evaluation, the application of frameworks, practical approaches for evaluating public health initiatives, and the role of an evaluator. Key evaluation terms are defined, common evaluation designs (e.g., mixed methods) and their advantages/disadvantages are discussed, logic models are reviewed,¹ the types of evaluation (e.g., context, implementation, outcome, impact, cost-effectiveness) are described and compared, and the various roles and skills of an evaluator are highlighted. The class is introduced to the CDC’s Framework for Program Evaluation in Public Health (CDC, 1999) and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework (Glasgow, Vogt, & Boles, 1999). Examples of their application are reviewed and discussed based on local, relevant evaluations. Principles of community-based participatory research (Minkler & Wallerstein, 2003) are also introduced. Additionally, a series of seven problem-based scenarios are presented to students to generate discussion on “how to handle” a variety of situations that may arise when negotiating, planning, or implementing an evaluation.

Evaluation Planning, Writing, and Presenting

This session teaches students how to write an effective and comprehensive evaluation plan. An outline of the key elements of a plan is provided to students, and an instructor-led discussion about how to organize, format, and write the plan is held. The discussion is based, in large part, on the characteristics listed in Figure 2, and examples for structuring the report, writing sections, and developing visuals (including a Gantt chart) are provided. In addition, this session provides instruction on how to develop a plan that is responsive and realistic. A final component includes a reflective piece designed to prepare the student teams to present their work. If done well, this part of the session should help students identify ways to connect with the community partner to “sell” their plan, and it should challenge them to critically think about what to share and how to best share it during their team presentation.

Evaluation Dissemination

This session introduces students to traditional and nontraditional approaches for disseminating evaluation results. Students are exposed to evaluation technical reports, evaluation briefs, posters, and presentations tailored to different audiences. In addition, recent examples of more innovative approaches drawn from the instructor’s work are presented including evaluation-based infographics, profiles, dashboards, and online chartbooks. Data visualization techniques are discussed as are the ways in which evaluators can “add value” by creating and disseminating a range of evaluation products that reflect the needs of different partners.

Engaging Community Partners and Negotiating a Scope of Work

This session is devoted to coaching students on how to appropriately interact with community partners to help inform an evaluation. Examples of common mistakes are discussed as are key strategies for facilitating a productive conversation that leads to a common understanding about the community partner’s evaluation needs, priorities, and capacity. The session prepares students to develop questions they can pose to a community partner, through their lens as potential external evaluation consultants. The discussion includes ideas for reaching agreement, negotiating and focusing the evaluation efforts, and steering the conversation to ensure a productive use of everyone’s time.

Community Partner Presentation

This session is typically a highlight of the class for students. It occurs after students have received instruction in evaluation fundamentals, planning, writing, and disseminating to ensure that students understand their task and role. Ideally, the community presentation follows the weekly session coaching students on how to engage partners and negotiate a scope of work. This allows students to have sufficient background knowledge and to come prepared to actively listen, ask good questions, and formulate a plan of action that reflects what they have learned. The community presentation generally last 90 minutes and begins with the community partner providing a 20- to 30-minute review of their organization and the work they do, a description of the program to be evaluated, and a discussion focused on priorities or existing evaluation efforts that have been in place. The community partner is asked to share material in advance of the class, including any resources, existing data collections tools, program records, or reports that may be useful in helping create an evaluation plan. Students are expected to review this material prior to the session and to generate a list of questions they may ask the community partner. Once the presentation is complete, the instructor facilitates a question and answer period designed to address student questions, until all questions are addressed or the allotted time is reached. The instructor asks any final questions that are deemed necessary to help plan the evaluation before the community partner departs. The remaining class time is used by the instructor to debrief with students, help guide their initial efforts, and allow teams to begin planning.

Human Subjects Research

This session provides important historical and background information on the protection of human subjects. Students are required to take the Collaborative Institutional Train-ing Initiative’s (2017) Social-Behavioral-Educational basic course, and they are graded on the score they receive, as a separate assignment. Students are also given a “walk-through” of the university’s online institutional review board protocol submission process, and they are directed to additional resources, including approved templates for informed consent forms that are in compliance with all federal requirements. This material is presented through a series of videos created by the university institutional review board staff, and the session is held online.

Qualitative Data Collection

This content is covered in two sessions that introduce students to a range of qualitative approaches and help build their skills. The first session includes a discussion on (1) when and how these approaches can effectively be used in applied research and evaluation, (2) how to create good open-ended questions for key informant interviews and focus groups, (3) how to develop a focus group moderator guide that includes recruitment and informed consent material, and (4) how to facilitate a focus group. The second session includes a mock-focus group facilitation exercise, in class, where each student is expected to facilitate up to 10 minutes of a focus group based on a section (identified by the instructor) of the Moderator Focus Group Guide they prepared as a class requirement, based on a topic of their choice. The guide and mock facilitation exercise are graded as separate assignments.

Quantitative Data Collection

The focus of this session is to teach students the steps in survey design and to reflect on best practices. Examples of poorly designed surveys and common pitfalls are reviewed as are good “real-world” examples from the field. This session also provides instruction on the use of primary and secondary data collection, including when and how it can be used in an evaluation.

Working With Administrative Data

Students are exposed to a range of program or administrative-level data in this session, and the advantages and disadvantages of these data. Students learn strategies for when and how to incorporate programmatic information, records, summary documents, and other material in an evaluation. Students are also taught about the ways in which they can capture, analyze, and disseminate administrative data to help program staff monitor and showcase their efforts.

Evaluation Plan Presentation

During this session, each team has 20 minutes to present their plan to the panelists, which includes the instructor and community partner. During the presentation, the panelists complete an evaluation form, previously mentioned, assessing the presentation (e.g., organization, approach) and the content (e.g., responsiveness and feasibility of plan). Panelists also include comments and questions on this form. Following each presentation, there is a 15- to 20-minute question and answer period, facilitated by the instructor. Once all presentations are complete, the instructor and panelists debrief in a separate room, and then the instructor returns and provides overall feedback on the presentations to the class, prior to submitting the formal graded feedback on each presentation.

Lessons Learned and Recommendations

Selecting the Community Partner

Finding a community partner that has an ideal program well suited to evaluation is critical, as is their interest in participating. Recruiting a partner 3 months prior to the start of the course is generally helpful, and having a potential backup agency may be worthwhile if efforts to meet prove challenging. When engaging a potential community partner, it is important to discuss the class needs and to covey this as a learning experience, reinforcing the role of students. The work products are not designed by professional evaluation consultants but by students learning and applying new skills. Reinforcing this message at the onset has been shown to be helpful in setting realistic expectations. Additionally, discussing the organization’s evaluation needs and ideas openly, in order to assess the match, is important. Most community partners are enthusiastic about having “free” evaluation plans developed by students they can use to support their work, so this is an important benefit to discuss. Efforts also suggest that it is helpful to have a commitment from at least two staff from the partner organization who are committed to participating in the two class sessions, to introduce their organization and needs, and to evaluate the team presentations. Having more than one perspective provides an important learning opportunity, particularly when those perspectives may differ. Other factors for considerations include a community partner with

Clear process evaluation needs, not just outcome;

The availability of, access to, or interest in collecting administrative data;

Interest in mixed-methods (both qualitative and quantitative) approaches; and

A willingness to participate in two 90-minute class sessions.

Having the Community Partner in the Classroom

It is important to adequately prepare both the students and the community partner for the initial class discussion. Students may view this as a networking opportunity, and they want to make a good impression. Therefore, the instructor should be prepared to coach the students on how to ask good questions that can inform their work and how to take good notes on the things that matter. Community representatives need to know what to prepare, what to bring, what to focus on, and the preferred approach (formal/informal) for their visit. The instructor sets the tone, models the role of an evaluator, introduces the community members, facilitates the question and answer period, and serves as the fallback to ensure that all necessary questions are asked while partners are present. Helpful tips include the following:

Build in enough time (at least 30 minutes) for the question and answer period.

Be prepared, as the instructor, to take good notes since your perspective will be invaluable. Your notes can help students prioritize their work based on what you heard, and interpreted, given your experience.

Make a list of all outcomes and data sources identified during the discussion; this helps with the prioritization process.

Organizing and Supporting Student Team

In order to create balanced teams, the task of strategically assigning students to a group is important; it requires the instructor to have sufficient background information on each student’s level of experience with evaluation, professional practice, and to understand the strengths each student can bring to a team. Generally, four to five students are selected per team, and class time is designated for each group to work together and to receive timely feedback from the instructor. Given past experience, the instructor may want to establish mechanisms for each team to communicate and share resources, outside of class.

Designing and Evaluating the Assignment

While providing students with a modifiable template or an example “gold standard” evaluation plan may be tempting, experience with this course suggests that this approach diminishes innovation and critical thinking, and it often results in an exercise that reflects replication more than application. Students will likely push back and request examples they can draw from. Therefore, it is helpful to share components of various plans (both good and bad) as part of the didactic classroom learning, while also encouraging creativity. Additional considerations include the following:

Provide the teams with opportunities to receive feedback on their efforts throughout the process. Students want reassurance, and they want to make sure that they have not forgotten something important that would reflect poorly on their team.

Allow students to provide feedback on their experiences with the assignment and with the team, and create mechanisms to ensure that students are held accountable for their level of effort and contributions.

Presenting the Final Evaluation Plan

Students want to perform well in front of community partners, and they are generally well prepared for delivering the details of their evaluation plan. Yet many students may lack the experience and confidence to effectively deliver this type of presentation, which, in many ways, is quite different than a typical academic presentation. Frequently, students make the mistake of trying to share every detail in the evaluation plan to the community partner, and experience has shown that this is not the ideal approach. Many students need to be taught what to share and the importance of connecting with the community members and conveying that they genuinely respect and value their work. In terms of the community members, sharing a copy of the plans in advance of the presentation is helpful, as is having a standard evaluation form they can complete as part of the panel review process to provide feedback on each team’s presentation and plan. A confidential debrief with the community partner immediately following the team presentations is also useful and recommended.

Additional Considerations and Opportunities

There are several enhancements that could be considered including more class instruction and attention to logic models, budget and resource planning, and team building. Given that separate courses in the curriculum focused more closely on these topics, less attention was placed on building competencies in these areas. As mentioned previously, students were expected to have demonstrated these skills in prior coursework and the instructor worked independently with students needing more guidance, yet the prior work was not evaluation-focused. In addition, there was limited classroom instruction on research design to assess impact, as well as qualitative and quantitative data analysis, due in large part to time constraints. Students would likely benefit from additional coursework in these areas. Given the course sessions outlined in Table 1, there is some flexibility to include more instruction on these content areas, albeit limited. Finally, while evaluation implementation was not a key feature of this assignment, several students have opted to continue working with community partners as part of a capstone project to implement evaluation activities proposed by students in the class. Serving as a liaison and preceptor to support this student work with the community partners is an important role.

While the course was offered in a typical semester-long format, there may be opportunities to modify this curriculum to a blended or online approach. Some sessions (e.g., human subjects projection) lend themselves well to online learning, and more work is needed to fully understand which components of the course are well suited to this approach. However, given the role and engagement of the community partners in this course, special attention would be needed to ensure that students are able to directly connect with the partner and participate in a simulation of a typical client-evaluator discussion and team-based presentation, since both serve as core features of the course.

Conclusions

Engaging community partners in the classroom can provide students with a rich learning experience and an opportunity to build their professional network. Unlike more conventional evaluation courses, this curriculum requires application of fundamental concepts taught in class through a real project that forces students to directly engage with community partners. Balancing traditional classroom instruction with real-world examples, based on real needs and conversations, increases the stakes, allows students to directly apply new skills, and fosters a learning experience that more closely simulates practice. Yet this approach needs to be thoughtfully integrated in a manner that supports and benefits community partners and students alike.

Footnotes

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

Notes

ORCID iD

Brenda M. Joly

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