New criteria for accreditation to chart updated course for public health education: Bolstering students
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* Kim Krisberg

With a goal of graduating public health students ready to practice from day one, the Council on Education for Public Health recently announced revised accreditation criteria that represent the biggest change to public health curricula since the 1940s.

Officially rolled out in conjunction with APHA’s 2016 Annual Meeting and Expo in Denver in October, “Accreditation Criteria for Schools of Public Health and Public Health Programs, Amended October 2016” introduces a new framework for assessing the quality of public health education, shifting the traditional accreditation focus from core curricula to core competencies.

Laura Rasar King, MPH, MCHES, executive director at CEPH, noted that while the U.S. Department of Education requires accrediting agencies such as CEPH to regularly assess and revise their criteria, the 2016 revision marks a major turning point in public health education. In particular, King said the revision addresses a reoccurring thread that she and her colleagues had been hearing from stakeholders and employers — that public health students are graduating with excellent technical knowledge, but without the competencies to translate that knowledge into effective day-to-day practice.

“Students want to be practice-ready, they want to be able to provide value to employers right away — and employers want the same thing,” said King, an APHA member. “Our goal really was to start making graduates more practice-ready right out of the gate.”

Highlights of the revised criteria include moving curricular expectations from a course-based topical framework to a framework built around knowledge and practice skills, eliminating a number of requirements to make room for greater flexibility and innovation and reducing accreditation reporting requirements to enable a greater focus on student achievements and outcomes, rather than on curricula inputs. Previously, for example, every accredited public health school and program had a curriculum built around five core areas: biostatistics, epidemiology, health services administration, social and behavioral science and environmental health. Those topics will still be key ingredients in public health education, King said. However, the revised accreditation criteria shifts the focus from how schools and programs deliver that knowledge to whether they are graduating students who can readily translate that knowledge into practice.

The desired result, King said, will be a less siloed, more integrated education that delivers public health knowledge through a lens of real-life public health practice. At the ground level, it means schools and programs can forgo the typical five-course model and teach the topics in any combination of classes as long as students can successfully demonstrate nearly two-dozen competencies.

“This is definitely a dramatic change,” King told *The Nation’s Health,* noting that all accredited schools and programs of public health must have the curricular components in place to comply with the new criteria by Dec. 31, 2018.

The revised accreditation criteria will require all MPH students to attain 22 competencies across eight domains: evidence-based approaches to public health, public health and health care systems, planning and management to promote health, policy in public health, leadership, communication, interprofessional practice and systems thinking. Within those domains are competencies such as analyzing quantitative and qualitative data using biostatistics, informatics, computer-based programming and software; explaining basic principles and tools of budget and resource management; evaluating policies for their impact on public health and health equity; and selecting communication strategies for different audiences and sectors. Under the revised criteria, every MPH student must be assessed on each of the 22 competencies at least once.

According to APHA member Donna Petersen, ScD, MHS, CPH, dean of the University of South Florida College of Public Health, such a change is critical to the future of public health.

“There’s been a big chasm between public health practice and public health schools,” said Petersen, who also serves as CEPH president. “But we need to shift from input to output. It’s not just about the curriculum. We need to know that we’re producing people who can do this work because we don’t have time anymore to train people on the job.”

Petersen helped lead the charge to reform public health schooling in 2011 as chair of the Association of Schools and Programs of Public Health’s Framing the Future Task Force, which was charged with re-envisioning the future of public health education. From the beginning, Petersen said, CEPH was engaged in all of the task force’s activities, as any recommendations would have to be translated into accreditation criteria. Over a three-year period, the task force held dozens of town halls around the country, hearing from stakeholders.

The task force’s final reports and recommendations, released in 2014, laid the foundation for CEPH’s revised accreditation criteria. Petersen said she expects the 2016 criteria to inspire a variety of innovative curricula models. For example, she said the University of South Florida College of Public Health has already adopted a fully transformed MPH curriculum after piloting changes in 2014 and 2015. The new, more integrated curriculum centers learning around application and translation, giving students the opportunity to apply their newly gained knowledge to real-life scenarios and job demands from the start.

“This (change) is more critical than ever,” Petersen told *The Nation’s Health.* “Our collective ability to produce people who can engage communities in addressing their own health needs is absolutely critical to the future of this country.”

From a practice perspective, Joyce Gaufin, a member of the CEPH board, said the revised criteria offers academic programs a chance to “look inside the actual processes that are taking place in today’s work environment” and design curricula that align with workforce needs. Gaufin, an APHA member, noted that during her tenure as executive director of the Great Basin Public Health Leadership Institute in Utah, she consistently heard from employers who said that graduates were entering the field with great knowledge, but often lacked competencies in systems thinking, management skills, communication and leadership.

Gaufin also noted that with workforce surveys reporting that many public health leaders are either leaving the field or retiring, the traditional way of learning leadership competencies through on-the-job mentorship is becoming less feasible.

“Public health workers are required to do more today than ever before,” Gaufin told *The Nation’s Health.* “We need to make sure we have a workforce not only prepared for today, but capable of being prepared for tomorrow. These are fundamental skills they will rely on the first day of the job and throughout their careers.”

For more information on the new accreditation criteria, visit [www.ceph.org/criteria-revision](http://www.ceph.org/criteria-revision).

*   Copyright The Nation’s Health, American Public Health Association