Change

by Jay E. Maddock, PhD, FAAHB


The Dean’s Perspective focuses on issues pertinent to the relationship between academic public health and the practice community.

“Life is a series of natural and spontaneous changes. Don’t resist them; that only creates sorrow.  Let reality be reality.  Let things flow naturally in whatever way they like.” –Lao Tzu

Jay E. Maddock, PhD, FAAHB

The end of summer and the start of the fall semester brings along change for many of us in academia. For most, it is planned change. August graduation gives way to new student orientation, students return to campus, and football seasons begins.  For many of us, this is comforting change. It is cyclical and expected. Small changes occur always, like different class sizes and compositions and the competitiveness of our football teams, but these are comforting and the spice of life. Life, of course, is not a simple cyclical cycle or a straightforward path. At some points we face disruptive change, a true change in the way we do things and how we think, learn, and work. In this column, I will explore this type of change and how we can address it in academic public health.

On my vacation this summer, I was chatting with my friend Michelle about her job in a large online e-learning company. She mentioned that they had just been acquired by a venture capital firm and then went on to discuss the number of CEOs, mergers and acquisitions, moves and other changes that had occurred in this company over the past fifteen years.  I was dumbfounded at the amount of change she had endured, but she took it in stride. It was just part of corporate culture and remaining competitive. Her company has been incredibly successful and is seen as the one of the leaders in this space. This led me to think about the speed of change in academic and public health practice. In Hawaii, the group I worked closely with at the state department of health was going through a reorganization from a special project to a permanent division. Talk of this change started in 2012. When I left Hawaii in 2015, it was still not complete.  This past spring, I got a call from the former project director, now chief of the new division. She informed me the reorganization was finally complete and that she was doing a reference check on one of my former colleagues because they all had to reapply for the jobs they had been doing because they were classified differently!  The state government policy and procedures seemed almost to have been developed to avoid change. Every year on the last day of the fiscal year, our contract would be hand-carried from office to office to make sure it was executed before the end of the day even though we had written and agreed on the contract six months earlier. I often wondered aloud how work ever got done in the state and many of my colleagues have assured me that this is not a problem that is unique to the state of Hawaii.

The change of pace in academia is equally leisurely. In medieval universities, the “sage on the stage” model of a professor lecturing while the student took notes was the preferred method of teaching. While much has been made about flipped classrooms and new methods of pedagogy, the standard in most universities is still lecturing, most often with PowerPoint slides. Michelle’s experience in corporate America led me to think about how we are training our students. If the corporate world changes so fast, how do we train students to be effective and prepared for the workforce of tomorrow? Michelle noted that resiliency and flexibility are essential for her being able to thrive in the organization and that many people left because they could not adapt to change.

As we celebrated the 100th anniversary of the Welch-Rose Report in 2015, it became very clear that the MPH degree, which had remained largely unchanged for 100 years, needed to be revamped. I served as a member of the Association of Schools and Programs of Public Health (ASPPH) task force of the 21st Century MPH degree. As we examined critical content and design features, it was clear that the old five-class core curriculum was not meeting current workforce needs. We argued for the core to consist of no more than a third of MPH content and encouraged a set of integrated learning experiences rather than distinct courses. This change across schools and programs of public health to a more integrated core has been uneven across institutions. The three-credit, 16-week stand-alone class has been the cornerstone of academia for decades, and thinking outside this box is challenging.

Our team here at Texas A&M led by Amy Fairchild has developed an innovative, interdisciplinary core that will launch in the fall of 2018. The change is large, but the excitement of bringing in faculty across disciplines to think through what public health is and what it should do is exhilarating. They have built a series of case studies that do not follow the traditional academic semester and require studio time. I have not seen this level of change in my 18-year career in academia. It is exciting but also scary. We are expecting unforeseen problems, unexpected consequences, and a whole host of issues, but it is something that needs to be done. It will not be 100 years before we need to change the degree contents again. As we look at the field of public health, we need to be ready to embrace change. Our world is changing and we need to be able to adapt to it. The speed of information dissemination and the extent of travel of humans and products is unprecedented. We’ve seen ebbs and flows of both infectious diseases (eg, SARS, Zika, H1N1, West Nile) and behavioral ones (smoking, obesity, opiate addiction) in the last decade. We have no idea what our world and our future public health professionals will face in the coming decades. We need to do our best to prepare them for success in this ever-changing environment because we know that the only thing that is constant is change.


Jay E. Maddock, PhD is the Dean of the School of Public Health at Texas A&M University. He is internationally recognized for his research in social ecological approaches to increasing physical activity. He has served as principal investigator on over $18 million in extramural funding and authored over 100 scientific articles. [Full Bio]

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