Guidelines for MPH Programs in Canada

Criteria

Public Health Program

1. Mission The program shall have a clearly formulated and publicly stated mission with supporting goals and objectives. The program shall foster the development of professional public health values, concepts and ethical practice.

• The program shall be guided by the broad mission of public health (e.g. enhancing health in human populations through organized community effort).
• It shall comprise a consortium of disciplines, together addressing the health of the community through instruction, research and community service.
• It shall equip public health practitioners with the skills and knowledge required to identify and assess the needs of populations; to plan, implement and evaluate policies and programs that will address those needs; and to otherwise assure conditions that protect and promote the health of populations.

2. Organization The program shall provide an organizational setting conducive to teaching and learning, research and service. The organizational setting shall facilitate interdisciplinary communication, cooperation and collaboration.

• The administrative structure and resources should allow the program to carry out the majority of its teaching, research and service functions.
• One faculty/department should assume responsibility for the MPH program and have an identifiable program director to ensure internal consistency and coherence.
• Core courses will normally be delivered by the home department faculty to ensure a relevant public health orientation and socialization to public health culture.
• Where programs are structured as a consortium of two or more academic institutions, a lead institution must be identified and the roles and responsibilities of the partners clearly articulated.

3. Governance The program administration and faculty shall have clearly defined rights and responsibilities concerning program governance and academic policies.

• Faculty should have sufficient rights and privileges to assure integrity of the program and to allow accomplishment of the program's stated mission, goals and objectives.
• Program faculty should have formal opportunities for input in decisions affecting admissions and progress, resource allocation, faculty recruitment and promotion, curriculum design and evaluation, research and service activities, and degree requirements.
• Faculty recognition and incentive mechanisms should support a practice-focused professional degree program.

4. Quality Management The program shall have a quality management system to evaluate and monitor its overall efforts against its mission, goals and objectives; to assess the program's effectiveness in serving its various constituencies; and to contribute to the achievement of its mission.

• The program should demonstrate how evaluation and planning contribute to quality enhancement of its programs and activities.
• An ongoing system should be in place to oversee and monitor the quality of the program over time so that changes can be made in response to the evolving needs in public health and the requirements of students.
• The quality management system should include a set of quality indicators regarding teaching staff, research, teaching programs, and student careers in order to assess program effectiveness.

Public Health Program Capacity

5. Strategic Linkages with the Public Health System The program shall demonstrate a successful relationship with the public health community.

• The program should be focused on the present and future needs of employment in the field of public health (i.e. focused on developing competencies for public health practice).
• The program should demonstrate close cooperation in various sectors of public health, particularly health authorities at national, provincial/territorial, regional and/or local levels.
• The program should have formal cooperation with the public health system for service and applied research (e.g. evidence of contractual agreement and/or consultancy appointments or services).
• The program should have formal cooperation with the public health system for training (e.g. joint curriculum development and course delivery opportunities, involvement in providing students with opportunities to exercise their competency through relevant practicum opportunities).
• The program should provide advice on public health implications of government policies.
• The program should demonstrate a definite promotion of quality in public health and of evidence-informed public health practice.

6. Resources The program shall have adequate resources to fulfill the stated mission and goals, including instructional, research and service objectives.

• The program should have a clearly defined faculty which, by virtue of its size, multidisciplinary nature and complement, educational preparation, practice experience, and teaching and research competence, is able to fully support the program's mission, goals and objectives. Specifically, the program should:
  • require faculty to have professional experience and demonstrated competence in public health practice and pedagogical skills; and
  • reflect a balance within faculty members' workload between:
    • direct teaching and tutoring;
    • service to the profession and the broader public health community;
    • program administration;
    • innovation, course development and production of teaching materials; and,
    • research and publication.
• The program must have a central core of faculty to sustain curricular requirements.
  • This includes at least three full-time faculty who are trained and experienced in public health (including an associated sub-discipline) and who devote the majority of their time to the MPH program. At least one of these full-time core members should have current or previous public health practice experience.^{Footnote 3} 
  • To assure a broad ecological perspective, the faculty complement will need to draw on various disciplines, regardless of the size of the student body. Teaching public health is labour-intensive and will generally require low student/faculty ratios.
  • Programs should be aware of the additional faculty requirements for specialty streams. A supplementary set of core faculty is required for each specialty MPH program offered.
• Programs should have sufficient academically linked practica supervisors and learning experiences in order to provide a range of structured practica appropriate to the size and focus of the program.

Public Health Program Content

7. Competency-Based Learning MPH programs must address core content areas and competencies basic to public health.

• The content of the program should reflect the needs for knowledge, skills and abilities (i.e. competencies) for practice in public health, addressing the core functions of public health:
  • population health assessment;
  • public health surveillance;
  • disease and injury prevention;
  • health promotion; and
  • health protection (including public health emergency preparedness).
  • With respect to identifying the necessary competencies for MPH graduates:^{Footnote 4} 
    • Programs should be informed by the recently developed Canadian set of public health workforce core competencies.^{Footnote 5}  Based on the above core public health functions, the competency set has 36 competency statements clustered into seven domains (see Appendix 1 for a complete list of competencies):
      • public health sciences;
      • assessment and analysis;
      • policy and program planning, implementation and evaluation;
      • partnerships, collaboration and advocacy;
      • diversity and inclusiveness;
      • communication; and
      • leadership.
    • Programs may also find it useful to consider the list of competencies for MPH graduates that have been developed by the U.S. Association of Schools of Public Health. See Appendix 2 for further details.
    • Recognizing that there are a variety of ways in which competencies can be acquired, programs will need to map out how the competencies will be achieved by graduation (e.g. courses, projects, practicum, seminar series).
    • In order to address the identified set of competencies, programs will need to strike a practical balance between breadth and depth.

8. Duration An MPH degree program must be at least 42 semester credit units^{Footnote 6}  and include an appropriate practicum experience supervised by a qualified preceptor.

• If participating full time, students enrolled in such a program would typically require 16 or more months of study. Many MPH students study on a part-time basis, which obviously extends the completion time. Some students may take a combination of full- and part-time study (e.g. one year of full-time study completing required courses and practicum, and completing the remaining requirements on a part-time basis).
• A program is expected to provide the equivalent of two semesters of courses, one semester of practicum, and one semester of additional learning experiences (e.g. additional courses, guided study, practicum, project, culminating experience). See Appendix 3 for more detailed examples.
• Prior professional degrees or substantial public health work experience may offset a limited number of credit units. That said, this must be assessed on an individual basis and must be competency-based and specific to the requirements in the MPH curriculum.^{Footnote 7} 
• All students must develop practice-based skills in public health (see Criteria - MPH Practicum, below).
  • A practicum is a planned, supervised and evaluated practice experience with welldefined learning objectives, procedures and evaluation criteria, usually involving a learning contract with the on-site preceptor, student and academic program.
  • A practicum needs to be of sufficient duration and be taken for earned credit (12 weeks minimum, 16 or more weeks ideally) to allow meaningful exposure to public health practice and opportunity to develop/apply public health competencies.
  • Supervision must be carried out by a qualified preceptor who is a public health practitioner.
  • A practicum must be different from an existing job and preferably take place in a separate organization.
  • A practicum ideally takes place in a local, provincial/territorial or national formal public health setting.
• Also to be included is a culminating experience that requires synthesis and integration of theory, principles, knowledge and experiences applied to a situation approximating some aspect of professional practice.
  • Many different models are possible, such as written or oral comprehensive examinations, supervised practice experiences, a major written paper, an applied research project, or the development of case studies.
• If part of the program is provided through distance education, it must:
  • be consistent with the mission of the program and within the program's established areas of expertise;
  • be guided by clearly articulated student learning outcomes that are rigorously evaluated;
  • be subject to the same quality control processes that apply to other degree programs in the university;
  • provide planned and evaluated learning experiences that take into consideration and are responsive to the characteristics of adult learners; and
  • provide some structured opportunity for face-to-face interactions with students.

MPH Practicum

9. Overview of the Practicum

• Purpose Public health practice is an integral part of the MPH degree. The practicum provides the opportunity to integrate classroom learning and practise in a public health work environment. The student contributes to a community's resources and to addressing a public health problem while developing personal confidence and skills as a public health professional.
• Goals An MPH practicum aims to provide students with an opportunity to:
  • integrate, synthesize and apply public health knowledge and skills (i.e. competencies) acquired in preliminary MPH courses to a real-world public health situation (see Appendix 1 for a description of competencies expected of MPH graduates);
  • enhance and develop skills needed to function in a professional public health setting including:
    • problem identification, analysis and solving;
    • interpersonal skills, including working as part of an interdisciplinary public health team;
    • oral and written communication; and
    • understanding the mission, structure and functioning of the public health organization.
  • work on a substantive public health problem or issue relevant to the sponsoring organization;
  • engage in professional self-assessment and critical reflection; and
  • explore areas of concentration that interest them.
• Duration and Waivers The practicum is to be a full-time practice experience, 12 to 16 weeks in duration. The MPH program should have a mechanism in place to address situations where an alternative schedule (i.e. part-time) may be more suitable. There needs to be alignment between the practicum learning objectives and the type of engagement expected with the practicum setting. The practicum's goal is to enhance and develop skills needed to function in a professional public health setting, which typically requires the student to be based primarily within the practicum setting. The purpose of the practicum is to support the application of new knowledge and skills acquired in the MPH program in a supervised setting. As such, it is a mandatory component of the program; there are no provisions for waiving the requirements of the practicum.
• Prerequisites Students should participate in the practicum only after sufficient knowledge and skill development has occurred to allow their application during the practicum. The MPH program should clearly identify mandatory and elective courses that need to have been successfully completed prior to participating in the practicum.
• Selection of Practicum Settings
  • The program will provide a list of potential placements that are interested and capable of supervising an MPH practicum student. Practice placements should:
    • require the student to apply graduate-level competencies acquired in the MPH program to date;
    • address a practical public health problem/ issue;
    • advance the student's knowledge and skills;
    • have a field-based practicum supervisor with the appropriate interest, education and experience to supervise, support and mentor the student; and
    • provide the necessary organizational environment and support.
  • The placement must be able to provide a practice environment that will allow the application of the student's public health knowledge and skills. Settings should include, but not be limited to, organizations that are part of the formal governmental public health system.
  • The existence of a pre-approved list of practicum settings should not preclude students from identifying a potential practicum in another institution or area of specific interest. In these circumstances, it is the responsibility of the student and the field-based practicum supervisor to demonstrate to the program that the experience will meet the program's expectations. A practicum not based in a specific public health agency/organization needs to be justified in relation to how the practicum will support the student's development as a public health professional.
  • Interest in a new project or practicum location may also come from a potential host organization. See Appendix 4 for an example of a proposal form for this scenario.
  • Establishing and maintaining a relationship between the MPH program and the organization sponsoring the practicum is the best means of ensuring a quality student experience. Doing so may be more difficult over long distances. Practicum placements in international settings pose particular challenges and have at times presented considerable logistical and quality challenges for students and programs. Program directors need to carefully assess the planning and stability of such placements.
  • The practicum should occur in an organization separate from the student's employer. This may not always be possible. If there are no alternatives and the practicum must be conducted in the student's regular work-place, the responsibilities should be decidedly different from those involved in his or her regular job. The practicum is part of a professional degree program in which newly acquired knowledge and skills are put into practice; academic credit is not earned for fulfilling the responsibilities of the student's regular job. In addition, the student's learning must be paramount; job responsibilities cannot overtake the learning objectives of the practicum. Program directors should ensure that there are adequate safeguards in place to protect the academic rigour of the placement.
• Qualifications of Field-Based Practicum Supervisors
  • The practicum is the main opportunity within an MPH program for the student to gain practice experience in applying newly learned competencies in a supervised public health setting. The field-based practicum supervisor needs to have expertise in the project area, experience and status within the organization, and an interest and competence in supervising and mentoring. Just as course instructors need to have adequate preparation to teach and evaluate students, the field-based practicum supervisor needs to have the necessary competencies to be able to guide, support and supervise the student's practice and learning at a graduate level.
  • In some instances, particularly in highly focused areas of practice, the academic and/or professional credentialing of the fieldbased practicum supervisor will address, to a significant degree, the adequacy of his or her competencies. In other circumstances, the extensive experience of a field-based practicum supervisor in an area of public health practice may be sufficient to provide a quality practicum experience for a graduatelevel student. In either instance, it is the program's responsibility to ensure that the field-based practicum supervisor has the necessary competencies to supervise a master's level practicum.
• Student Stipend and Costs
  • The primary purpose of the practicum is to develop practice-based competencies. Nevertheless, with a full-time commitment over a 12- to 16-week period, the practicum student is expected to make a contribution to the operation of the host organization.
  • Hosting students is also a key recruitment strategy for organizations. The organization in which the practicum takes place will normally be expected to provide a financial stipend. Some programs strive to have stipend amounts comparable to those determined for graduate student research assistants. It is recognized, however, that not all organizations may be able to offer a stipend.
  • Students should be expected to cover their travel costs to the practicum location and their living costs while there. Where extensive travel is required to attend a practicum (e.g. international location, travel across North America), students should ensure that they have sufficient funds to cover expected costs well in advance of the practicum. An exception would be any travel and additional costs required to conduct practicum-related duties that are the responsibility of the hosting organization (e.g. practicum student asked to assist with investigating an outbreak in an outlying community).

10. Responsibilities of MPH Program Actors

• Program Director
  • The program director is responsible for establishing the necessary structures and processes for the practicum component, which is a key component of the MPH program. This includes:
    • establishing a range of quality practicum placements that will meet the learning needs of the students. This involves: * ensuring that field-based practicum supervisors have the necessary qualifications to supervise MPH students; * supporting quality practices of supervisors (e.g. tools, workshops, library access, existing training sessions for supervisors); and * ensuring that organizations can provide the necessary learning environment for professional practice.
    • reviewing and approving additional practicum sites proposed by students, faculty and public health organizations;
    • making available a list of potential practicum placements to facilitate student decision making; and
    • reviewing and providing final approval for: * learning contracts; * students' mid-term evaluations; * students' final evaluations; and * students' practica evaluations.
• University-Based Practicum Supervisor
  • The university-based practicum supervisor is a member of the Program's Department who has responsibility for overseeing the academic aspects of the student's practicum to ensure that it will meet the learning needs of the student and the academic requirements of the program. In some programs, the duties of the university-based practicum supervisor may be assumed by the program director.
  • The university-based practicum supervisor is expected to:
    • assist the student, as needed, to identify realistic goals and specific learning objectives for the practicum and possibly assist with the identification of potential practica;
    • advise on the development of a learning contract;
    • review and approve the learning contract, ensuring that it meets academic and quality expectations;
    • address any concerns or difficulties experienced during the practicum; may attend the interim and/or final evaluation (e.g. at the request of the student or field-based practicum supervisor);
    • review, evaluate and provide feedback on any project that is part of the evaluation of the student;
    • review and sign off on the interim and final evaluations of the student by the field-based practicum supervisor; and
    • review and sign off on the student's evaluation of the practicum experience.
• Field-Based Practicum Supervisor
  • The field-based practicum supervisor ensures the necessary practice and learning environment for the student and provides ongoing guidance, support and supervision. He or she is expected to:
    • identify potential projects and/or learning experiences in his/her organization;
    • negotiate with the student the details of the learning contract. Ideally, this should be done in person, which would provide an opportunity to discuss the educational and practice needs of the student, expectations and needs of the host organization, expected activities and responsibilities, project deliverables, any relevant policies or procedures related to the practicum site, and stipend-related issues;
    • review and sign off on the learning contract prepared by the student (which typically would have been developed in collaboration with the field-based practicum supervisor);
    • make necessary arrangements to provide for space, computer, phone, supplies, etc.;
    • provide orientation to the workplace, organizational structure and functions;
    • provide access to individuals and work teams, and support opportunities for exposure to ongoing activities (e.g. board and other relevant meetings, field visits, investigations, seminars), as well as identify additional opportunities for public health practice;
    • meet with the student regularly (i.e. weekly) to review progress and provide feedback and direction. Ideally this would be in person, but communication by phone or other electronic means can be used when a face-to-face meeting is not logistically feasible;
    • suggest supplementary readings or projects to enhance the experience;
    • discuss student needs with the universitybased practicum supervisor as necessary;
    • discuss with the student a mid-placement interim evaluation; and
    • discuss with the student a final practicum evaluation.
• Student Responsibilities
  • The student needs to actively engage in finding and negotiating an appropriate practicum to meet his/her learning and career development needs.
  • The student is expected to:
    • work with his/her university-based practicum supervisor, as necessary, to clarify personal and professional learning needs;
    • choose/develop a practicum of interest and make contact with the field-based practicum supervisor;
    • work with the field-based practicum supervisor to establish a learning contract prior to the start of practicum;
    • seek ethics approval, if required, for any of the practicum-related projects;
    • once agreed to by the field-based practicum supervisor, submit the learning contract to the university-based practicum supervisor for review and approval;
    • conduct activities to meet learning objectives, service expectations and other deliverables of the learning contract. Identify, if applicable, where practicum is not meeting learning needs;
    • meet professional standards of conduct, including * having respect for the confidentiality of health or other information related to individuals that they may encounter as part of their practicum experience; * having respect for the confidentiality of agency information; and * behaving responsibly regarding attendance and interest in agency activities.
  • participate in the mid-placement and final evaluation interviews with the field-based practicum supervisor; and
  • prepare an evaluation of the placement and provide it to the university-based practicum supervisor.

11. Practicum Processes and Forms

• Identifying Learning Objectives
  • The learning objectives are the foundation of the practicum and the core element of the learning contract. They should build on the knowledge and skills acquired during the coursework and reflect the goals of the practicum placement (listed earlier in these guidelines). The objectives should also be informed by the student's overall training needs, interests and career goals. The university-based practicum supervisor and field-based practicum supervisor are key resources to advise the student in developing the objectives. It is critically important that the expectations of the student and fieldbased practicum supervisor are realistic, explicit and agreed upon prior to the onset of the practicum.
  • The learning objectives should be:
    • linked to the goals of the practicum placement;
    • clear and specific statements about the learners' expected competencies (e.g. knowledge, skill, attitude changes as a result of the learning experiences);
    • statements that will help guide the student's assessment of the experience, in addition to helping the university-based practicum supervisor and field-based practicum supervisor improve the practice-based teaching process;
    • linked to behaviourally based, measurable statements of the learner's desired outcomes (i.e. to provide a way for the practicum mentor and agency field-based practicum supervisor to know whether a student understands or knows the subject matter);
    • statements that begin with action verbs (e.g. list, explain, apply, predict, analyze, compare, contrast); and
    • statements that convey the service or benefit to the agency and/or community.
    Appendix 5 provides a series of questions to help formulate learning objectives, which has been used at a number of U.S. schools of public health, as well as an example from a Canadian MPH program.
• Learning Contract
  • The learning contract is an indispensable tool for communicating, monitoring and evaluating the practicum. Misunderstandings related to practica can be avoided by making explicit the expectations of the various parties involved. The student has the lead responsibility for developing the contract in collaboration with the field-based practicum supervisor prior to the onset of the practicum.
  • Learning contracts should include:
    • a clear description of the practicum setting (name, address, field-based practicum supervisor name and contact info);
    • the project title, dates, hours of work, stipend (if any);
    • the learning objectives;
    • methods and timetable to accomplish objectives;
    • deliverables; the deliverable itself may involve a more detailed project plan that is developed with the field-based practicum supervisor;
    • the need for ethics review, as required;
    • the responsibilities of each party; these may be described in more detail in a separate affiliation agreement between the host organization and university;
    • signatures: * student; * field-based practicum supervisor; * university-based practicum supervisor; and * program director.
  • The Association of Schools of Public Health (ASPH) document supplies the following checklist for learning contracts and includes a sample contract:
    • provide the complete name, title, address and phone number of the field-based practicum supervisor from the sponsoring organization and the university-based practicum supervisor.
    • briefly describe the sponsoring organization and divisions with which the student will be most closely affiliated.
    • describe the specific work the student will be performing, as well as the student's responsibilities and expected outcomes designating individual student responsibilities if possible.
    • identify the issues and problems the student will be addressing.
    • describe any data to be gathered or used in completing the project and affirm that the field-based practicum supervisor will make these data available to the student as needed.
    • list the skills and knowledge that the student will use for the project.
    • describe the new knowledge and skills that the student should expect to gain and apply.
    • describe technical needs of the project, including copying and computer time, and define how these needs will be met.
    • other issues: (e.g. remuneration, time flexibility). (See reference document 3).
  • A sample learning contract is provided in Appendix 6.
• Evaluation
  • There are two aspects to the evaluation of a practicum: an evaluation of the student; and an evaluation of the practicum experience. Evaluation of the student is based on the expectations set out in the learning contract. The mid-practicum interim evaluation assesses the progress achieved to date, assesses whether there is any need to adjust overall deliverables, and addresses any major performance concerns. Appendix 7 provides a sample form for this evaluation. The final evaluation needs to be more detailed than the interim evaluation and should explicitly refer to the learning objectives for the practicum and the fulfillment of the deliverables. Any gaps in the student's preparation for the practicum should be noted, since this provides important feedback on the adequacy of the coursework component of the program. Typically, a recommendation for credit/no credit is provided by the field-based practicum supervisor. The university-based practicum supervisor assigns credit based on the assessment by the field-based practicum supervisor and the review of any practicum products. Both the interim and final evaluations are signed off by the student acknowledging receipt of the evaluation. They are approval steps taken by the university-based practicum supervisor and program director in recognizing the student's completion of the practicum and the recommendation for credit. See Appendix 8 for examples of final evaluation forms. Programs have a choice of options for practicum deliverables (i.e. what to expect from the practicum) that may include, but not be limited to, the following: presentation to the staff of the practicum host organization; presentation to other students and faculty at the Program Department; preparation of a poster summarizing the major project conducted; preparation of a written report for the practicum host organization; and interview/defence of a completed project before a faculty panel. Programs should choose the combination of options that complements the overall evaluation scheme for the program and considers the needs of the host organization.
  • Evaluation of the practicum experience by the student is critically important as it provides important feedback to the program director regarding the suitability of the practicum experience at that site.

To ensure receipt of all of the evaluations, the program director should consider withholding a mark/assessment for the practicum until all required documents have been received.