Pedagogy in Health Promotion

Specifications grading is an alternative approach designed to establish assessment criteria aligned with well-defined learning outcomes while giving students autonomy and choice with respect to their level of achievement in a course and focus on the act of learning instead of earning points. Degrees in public health are based on the development of discipline-specific competencies, making them prime candidates for a specifications grading design. This study presents the implementation process and evaluation of specifications grading applied to three graduate health promotion courses, including a comparison of final letter grade distribution as well as student and instructor perceptions of the grading scheme implementation. We hypothesized that although the grading scheme may take some adjustment by students, overall students would feel more control over their letter grade and therefore less stress. The process of revising requirements for assignments and maintaining alignment with competencies is discussed. There were no differences in the distribution of final letter grades between traditional points-based grading and specifications grading. However, students were overwhelmingly favorable toward the specifications grading scheme, with a majority reporting reduced stress, more flexibility, a clearer understanding of the learning objectives and grading standards, greater engagement with the course content, and the perception of greater control over final grades. Using a grading scheme based on displaying competencies is logical in the public health education context. This study supports the application of specifications grading for meeting student and instructor needs, and contributing to an equitable learning environment.

The practice of assigning grades is a universal quality of educational institutions, but the effects of biases in grading as well as its potential to distract from actual learning can make grading particularly problematic in the context of global health education. Ungrading is an anti-oppressive strategy to teaching which seeks to promote students as the experts of their own learning. It de-emphasizes grades and focuses on improved student engagement over time facilitated through thoughtful instructor comments and ongoing conversations. We implemented ungrading in two graduate-level global health courses at the Johns Hopkins Bloomberg School of Public Health; this manuscript documents the implementation process, the teaching teams’ experience, and student evaluations related to ungrading. Overall, quantitative course reviews were much improved from previous year(s). Qualitative responses revealed that students across both courses felt that ungrading improved their ability to focus on learning course material without anxiety about GPAs. Ungrading also encouraged students to embrace comments for learning, take risks, and leverage their lived experiences in responses. The teaching team felt students put in more effort, not less, and enjoyed a transformation in interactions with students—away from grades and toward content. Ungrading is a promising approach in graduate global health education that can facilitate inclusive and reflexive learning spaces.

Metaphor is essential to human cognition and central to teaching and learning. In this case study, the author documents the use of metaphor in a senior-level course as a strategy to build community, provide a sense of direction, and unite the class around a shared experience. Students who experienced the metaphor as a teaching tool were invited to share their memories and reflect on the impact (N = 395). Through content analysis, three themes were identified in the responses: (1) Appreciating the Journey, (2) Building and Supporting a Classroom Community, and (3) Finding Motivation, Purpose, and Willingness to Face the Unknown. Overall, most respondents remembered and valued the metaphor immediately and, in the months, and years following the course. The use of metaphors is recommended in public health teaching and learning.

Critical thinking is an important skill in all academic disciplines, but it can be difficult to develop assessments that adequately evaluate how critical thinking has changed over the period of a semester. In the context of health promotion, it is essential to prepare learners to appraise health information and misinformation, identify health disparities and work to address them, engage in health promotion practices that are culturally sensitive, theoretically driven, evidence-based, and acknowledge the role of social determinants of health and health behaviors. Health Behavior Theory is a fundamental subject taught in health promotion programs. While a large part of this subject matter involves the learning of health behavior theory, it presents an opportunity where critical thinking can be fostered through embodied pedagogy. Since students have had years of exposure to health information, as well as personal and observed experiences with health behavior, students come with many preconceived notions about the subject matter. In this article, we describe the use of a scaffolded experience of embodied behavior change and self-reflection, culminating in the creation of an autoethnography as a pedagogical experience which can support critical thinking in learners. We describe the development, implementation, and evaluation of the autoethnography assignment. As an embodied pedagogy, the autoethnography experience provides students with valuable insight into the difficulties of behavior change on an individual level while connecting individual experiences with social discourses that influence diverse meanings related to health behavior.

Modern public health practice includes planning, implementation, and evaluation of programs targeting the structural and social determinants of health. To prepare graduate students to engage with theory in complex, practical, and innovative ways, a new model of course delivery was created to focus on developing and applying theorizing skills to the social ecological model. Throughout the semester, students engage in collaborative learning to apply theory to real-world public health interventions focused on high-profile public health issues. Data were gleaned from three course sections (N = 80) using a pre-post study design to evaluate students’ ability to apply theory at various levels of the social ecological model and confidence to meet course objectives. The post-course survey also included questions about the helpfulness of specific course elements and asked for recommendations for improvement. Descriptive statistics were calculated and differences between pre- and post-ratings were tested with paired samples t-tests and Wilcoxon signed rank tests. Students improved in their ability to apply theory by the end of the semester (p < .001) and in their confidence in meeting all learning objectives (p < .001). Most students found that this new format of engaging with theory in complex, applied, and innovative ways by working in teams, completing in-class activities, and open poster presentations beneficial. Engaging students in a new course format led to critical reflection about various levels of influence on health and enhanced students’ ability to apply theory at multiple levels of influence. Further refinement and course development will continue to facilitate developing theorizing skills.

Since 2020, graduate public health students have been living through the intersecting pandemics of COVID-19 and structural racism while simultaneously experiencing classroom lessons on these topics. In this paper, we analyze 14 oral history interviews exploring these experiences, and identify needed shifts in public health pedagogy that these interviews illuminate. Interviews were produced through a participatory oral history project called Public Health Education Now, which was led by a team of faculty and MPH students based at the City University of New York Graduate School of Public Health and Health Policy. We analyzed the interviews using reflexive thematic analysis. In these interviews, students described lived experiences of trauma, isolation, and tensions in public health (Theme 1), as well as a desire for public health education anchored in their lived experiences that activates hope (Theme 2), and public health education that nourishes and sustains them (Theme 3). Our analysis advances a view of public health students of this era as survivor-learners whose lived experiences can be a rich resource for informing the future of public health education, provided appropriate supports are in place. We discuss the ways that trauma-informed teaching and learning responds to these findings. Finally, we suggest action steps toward incorporating trauma-informed public health pedagogy drawing on lived experiences into public health classrooms, programs, and schools.

As public health aims to improve health outcomes of all populations, social justice is argued to be the philosophy on which public health is based. A social justice approach to population health requires the field to recognize that the inequities in society have negative consequences for health. The purpose of this work is to develop a framework for integrating social justice into a public health curriculum. We used an interprofessional approach to create a definition of social justice, and develop a training program and evaluation plan. The program weaves social justice throughout the core MPH curriculum. The social justice definition is the foundation of the curriculum which is composed of eight key social justice domains with competencies directly aligned with each of the domains. Our evaluation plan focuses on students’ change in understanding of social justice in public health. The overarching goal is to explicitly integrate social justice into an MPH curriculum such that students can work toward health equity and justice in their careers.