Public Health Services Research, Moving to the Mainstream: Recent Experiences

with Performance Measures, Quality Improvement, Accreditation and

Certification Sunday June 26, 2005

Harrison C. Spencer, MD, MPH

President and CEO

Association of Schools of Public Health

ASPH Member SchoolsASPH Member Schools

Historical Goals of Credentialing

• Make public health a recognized public health profession;

• Raise the visibility of public health; and

• Measure and improve the competency and standards set for public health workers nationwide.

Past Efforts:

• Both ASPH and APHA established task forces on the credentialing of public health workers in the late 1980’s, stimulated, in part, by the call from the U. S. Surgeon General for such an effort.

• ASPH commissioned a formal study of public health worker credentialing in 1989, which recommended that if ASPH did decide to undertake credentialing that it should pursue it independently and in a “pro-active, reformist role.”

Past Efforts (cont.)

• A survey of the opinions of public health leaders on the issue of credentialing public health workers was published in 1995. Of those who participated in the survey 45% supported a national certification effort with an additional 30% undecided on the issue.

• In 1999, the APHA/ASPH Task Force on Public Health Workforce Credentialing was formed. After receiving encouragement from both the APHA and ASPH Executive Boards, the Task Force reached out to other stakeholders in the credentialing process and became the Steering Committee on Public Health Workforce Credentialing.

The Current Plan: In January of 2002, ASPH’s Executive Committee approved moving forward to develop an independent National Board of Public Health Examiners to issue examinations and provide those that pass the exam with a public health credential.ASPH Credentialing Taskforce created:

      Dean Bernard Goldstein (Pittsburgh) -- Chair      Dean James Curran (Emory)      Dean James Kyle (Loma Linda)      Dean Donna Richter (South Carolina)      Dean Steven Shortell (Berkeley)      Dean Alfred Sommer (JHU)

Consultant: Dr. Charles Mahan (USF)

Priority:

• Address that SPH and accredited program graduates are competent to serve as public health professionals through:

Competency development

Voluntary exam

Core MPH Competency Development Project

• Why now?

• Aims

• Process

• Deliverables

• Working model

• Recent input

Why now?

• Increasing accountability in higher education• Proliferation of competency-based training• Challenges of 21st century practice• Recommendations by IOM, etc. • Increasing incorporation of competencies into

accreditation criteria• Development of a voluntary credentialing exam

Aims• Version 1.1 incorporates two sets of core MPH

competencies: The first set represents each of the five core areas

plus public health biology, and The second set aims to serve as an interdisciplinary,

cross-cutting set• The sets are intended to serve as a resource and guide • ASPH will not prescribe the methods nor processes for

achievement

Process

• Guided by 6 discipline-specific workgroups• Direction from an expert consultant (J. Calhoun)• Total of 135 academic (both SPH and program reps)

and practice participants• Nominal group processes (Delphi Technique)• Integration by an expert panel consisting of

academic and practice partners• Oversight by the ASPH Education Committee

Deliverables

• Two consensus lists of core MPH competencies:(a) discipline-specific set, and (b) interdisciplinary/cross-cutting set

• Background documents

• Dissemination plan

Working Model

Blue = interdisciplinary/ cross-cutting comps

Purple = discipline-specific comps

Recent Input* From the ASPH membership:

-- “Town-hall” presentation of the sets in May by the Education Committee -- Review by ASPH’s associate deans in June-- Review by the ASPH deans in July-- Ratification by the board in November

* From external stakeholders:-- “Town-hall” input from partners in May-- From November 2004 to date at “competency@asph.org”

Review & Comments Welcome

• See current and previous draft lists at: http://www.asph.org/document.cfm?page=851

• Send a response to competency@asph.org

National Board of Public Health Examiners

• Purpose: Ensure the competence of public health graduates from public health schools and programs, accredited by the Council on Education of Public Health (CEPH) through developing, preparing, administering and evaluating certification examinations for students and graduates from CEPH accredited schools and programs of public health.

National Board (cont.) “Representative members” will nominate individuals:• ASPH• APHA• ATPM• ASTHO• NACCHO• Private sector representatives

These committee members will then form a nominating committee to complete the 24-member board. Board members will be required to hold a degree from an accredited SPH or program.

Exam

• Based on competencies

• Inexpensive

• Voluntary

• Cumulative

Degrees offeredDegrees offeredMaster’s Degrees• MPH• MS• MHA

Doctoral Degrees• DrPH• PhD• ScD

Joint degrees• MPH/MBA• MPH/MD• MPH/JD

Timeline

• Board Nominations Completed Summer‘05 • 1st Board Meeting (12 members) Fall ‘05•  • Competency Process Finalized Fall ‘05•  • 2nd Board Meeting Fall ‘06•  • 1st Exam Delivered Spring ‘07

1101 15th Street, NW, Suite 910, Washington, DC 20005

voice: (202) 296-1099 fax: (202) 296-1252

e-mail: khelsing@asph.orgwebsite: www.asph.org

For further information, contact: