through a practice experience that is relevant to the students’ areas of specialization. 2.4.a. Description of the program’s policies and procedures regarding practice placements, including selection of sites; methods for approving preceptors; opportunities for
orientation and support for preceptors; approaches for faculty supervision of students; means of evaluating student performance; means of evaluating practice placement sites and preceptor qualifications; and criteria for waiving, altering, or reducing the experience.
For a full description of the program’s policies and procedures regarding practice placements for the MPH internship, please see ERF 2.4.a. All MPH students must complete an internship course (a practice placement) as part of their degree requirements. It is typically completed in the final term (spring quarter), although much of the work leading up to the final term’s on-site placement is conducted in the summer, fall, and winter terms. The Internship is overseen by the Internship Co-Directors and a team of internship advisors who work with students and preceptors.
Selection of sites
Students may select from a list of available sites and internship projects or they can develop their own internships, both options with oversight from the Internship Co-Course Directors and the student’s assigned Internship advisor. Below is a flow chart of the internship selection process. See Figure 2.4.a for an overview of the internship selection process.
84
Figure 2.4.a: MPH Internship Selection Process
Students’ exposure to various preceptors and possible projects
Information Sessions Small group meetings Individual Meetings
Students narrow their interests to top 3-5 sites.
Students prepare and submit cover letters and resumes for these 3-5 sites.
Independent Process Match Selection
Process
Student contacts Internship faculty to let them know that s/he has an organization that s/he are interested in working with for the internship.
Students interview with the site preceptors.
Site preceptors review applications, conduct interviews, and select their top 3 candidates.
Students and preceptors submit their top three choices for the match process.
Internship teaching team completes the matching process.
Students and preceptors are notified about the match placement.
The scope of work and deliverables are developed and finalized by the students and preceptor, with final approval by the Internship team.
Legend:
Green = Summer term Yellow = Fall term Blue = Winter term
MPH Internship Selection Process for Summer, Fall, Winter terms
The Internship Teaching Team contacts the site and the preceptor to learn more about the site and the preceptor’s capabilities.
The student submits an Independent Internship Proposal that is reviewed by two members of the teaching team.
The scope of work and deliverables are developed and finalized by the student and preceptor, with final approval by the Internship team.
85 Methods for approving preceptors
Preceptors are identified through several sources: 1) past work with Dartmouth’s MPH students and program; 2) availability of research or program projects for students; 3) connection with their respective community and with Dartmouth; and/or 4) student identification of potential preceptors and internship sites.
Opportunities for orientation and support for preceptors
For new preceptors, preceptor materials are provided, and phone and in-person meetings are arranged with the preceptor. Internship Course Directors or Internship advisors discuss the Internship process, roles and responsibilities of preceptors, and support provided to the preceptor and student by the Internship team.
Approaches for faculty supervision of students
The Internship Course Directors have a cadre of faculty members and teaching assistants who are part of the Internship advising team who work closely with the students and preceptor site
throughout the Internship process. Students are assigned to small advisory groups with one member of the Internship team assigned as their primary advisor which brings the
advisor/student ratio to approximately 1 advisor per 12 students. The Internship team
communicates and meets regularly regarding the status of the students to monitor the students’ work and resolve any issues.
Means of evaluating student performance
Students’ performances are monitored by the Internship team and preceptors throughout the Internship experience. Students are required to complete interim deliverables throughout the academic year and a final deliverable upon completion of the internship. Using a grading rubric that is readily available to the students, the deliverables are graded by the student’s Internship advisor, and the Course Directors review the grades for all students. Internship advisors contact the preceptors at three points in time: 1) at the point of selection, 2) at the mid-point check in, and 3) at the end of the internship for the preceptor to complete a final evaluation survey on the student. Preceptors’ evaluations of students are included in ERF 2.4 (with names of students and preceptors redacted to protect the confidentiality of students and preceptors).
Students also report on their performance by completing two Progress Reports and a final
evaluation survey for the Internship experience. The Progress Reports and evaluation surveys are submitted to the Internship Course Directors at several points during the 10-week term.
Follow-up with the site preceptors by the Course Directors or the Internship advisors is performed as needed, based on the submitted evaluations and other communications. Final grades are assigned by the Internship Course Directors and Internship advisors, based on academic assignments, final site-specific deliverables, and on the feedback from the preceptor and the self-reported performance evaluations by the student.
Means of evaluating practice placement sites and preceptor qualifications
Our evaluation system allows for students to evaluate the practice placement site by completing two Progress Reports and a final evaluation form that assesses their work and their placement
86 site for the internship site. The reports and evaluation forms are submitted to the Internship Course Directors in the middle of the term and close to the end of the spring term.
As noted earlier, students are assigned Internship advisors to provide oversight during the internship process, including communicating about issues that might be occurring at the
placement site. Weekly office hours are also held to allow for in-person feedback from students and to provide an opportunity for students to voice any concerns or issues.
In terms of assessing preceptor qualifications, we prefer that our preceptors have advanced degrees and substantial experience in the field and as mentors. We have a stable inventory of preceptors with whom we have long-standing relationships. The majority of preceptors hold advanced degrees in public health or medicine, and many are affiliated with the Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, or the Veterans Administration Medical Center in White River Junction, VT. Some preceptors are faculty members or
collaborators on research or teaching projects. A growing number of preceptors are graduates of the MPH program at Dartmouth.
Criteria for waiving, altering, or reducing the experience
The public health internship is a required set of courses and is not waived for any student. As described further in section 2.4.c, Leadership Preventive Medicine Residents (LPMR) who are enrolled in the MPH program are required to complete a local, governmental public health placement, and they follow those specific processes and guidelines as required for the LPMR program. This public health placement serves as their required internship for the MPH program.
2.4.b. Identification of agencies and preceptors used for practice experiences for students, by specialty area, for the last two academic years.
See ERF 2.4.b. for a list of internship sites for 2013-14 and 2014-15.
2.4.c. Data on the number of students receiving a waiver of the practice experience for each of the last three years.
Practice experience or internship waivers are not allowed; therefore, no waivers have been requested or granted for the practice experience over the last three years.
Although this is not considered a waiver, the only exception to the MPH curriculum is for MPH students who are also part of the Leadership Preventive Medicine Residency (LPMR) at
Dartmouth-Hitchcock Medical Center. This residency program is accredited by the ACGME (Accreditation Council for Graduate Medical Education). Because part of their preventive medicine residency requires a public health governmental field placement, separate course numbers have been developed specifically for these projects so the LPMR students meet the required internship experience for the MPH degree:
ECS 163: Governmental Public Health Experience for Leadership Preventive Medicine Residents: Part 1 (4 cr)
87 ECS 164: Governmental Public Health Experience for Leadership Preventive Medicine
Residents: Part 2 (6 cr)
These students receive more credit for their internship experience because the length of the governmental experience is longer than the one for the non-LPMR MPH students.
2.4.d. Data on the number of preventive medicine, occupational medicine, aerospace medicine, and general preventive medicine and public health residents completing the academic program for each of the last three years, along with information on their practicum rotations.
Table 2.4.d.: Leadership Preventive Medicine Residents Completing the MPH Degree
Academic Year # of MPH Graduates in LPMR Program
2012-2013 11
2013-2014 3
2014-2015 8
Note: The data above are also counted in our total enrollment and graduation figures in other tables in this document.
See ERF 2.4.d. for a list of internship sites for our Leadership Preventive Medicine Residents over the last three years.
2.4.e. Assessment of the extent to which this criterion is met and an analysis of the program’s strengths, weaknesses, and plans related to this criterion.
This criterion is met.
Strengths:
All students are required to complete an internship for the MPH degree.Dartmouth has a number of long-term relationships with various community service, public health, and health care-related organizations across the region, nation, and the globe. These
relationships are further enhanced through the internships that are completed by the MPH students. The variety of internship opportunities guarantees that students are able to select or create field placements which meet their needs and interests. The internships are a field-based mechanism in which students apply knowledge and skills gained from their classroom-based learning and provide relevant and appropriate competencies for the students’ next career steps.
The MPH Internship Luncheon, held during the last week of classes in the spring term, brings together the students and a number of the preceptors, teaching faculty, and
program leaders for students to share their internship experiences. This provides students with the opportunity to showcase their internship work and network with preceptors. The luncheon also provides an opportunity for the relationships between the MPH program and the site preceptors to be strengthen further.
88
Weaknesses:
It is a challenge to expose students to the variety of mission-driven internship projects and potential preceptors, other than through a directory made available in Canvas.
We need to further streamline internship selection process.
In the internship course evaluations, students noted that the internship assignments needed to be more streamlined and more connected with the internship itself. Oftentimes, some of the assignments felt like busywork to the students.
Some students and faculty believe there could be better connections between the capstone and the internship to create a more integrated learning experience.
Plans for Improvement:
Specific to an internship site where many of our students work each year, we are recruiting a physician liaison to serve as the connector between the internship/capstone projects and
Dartmouth-Hitchcock Medical Center, which is a site where a number of our students complete their internships and has multiple population health projects which could use student
contributions. DHMC could then serve as the “learning lab” for the internships and capstones, and these projects will be more TDI-mission driven.
For the development of the online MPH, we plan to pilot a newly designed “Practicum” for the MPH online program that will combine the current Capstone and Internship experience that exists in the residential program. This experience will be integrated with coursework and with career planning across the two-year period of the online program.
The Internship-equivalent period will meet the standards for the residential program and students will be immersed in a practice setting. Many students will be able to complete their practicum projects within their home organizations, but will be required that the work for the practicum be above and beyond what they would normally do in the course of their jobs.
During each week of the online program, a period of educational time will be dedicated to the practicum. The allotment will vary, generally building over the two years as the project develops and is implemented. The month of July between the two years of the online MPH program will be dedicated to the practicum, so that they can be immersed in their project. Students will have assignments and consult with their mentors, but will have no additional class responsibilities during this time.At each residential period during the MPH online program, students will have the opportunity to present the current state of their project to classmates, faculty, and other mentors.
These revisions will begin initially in the online program, but we will carry the successful efforts related to process and evaluation over to the residential program as is feasible.
89
2.5 Culminating Experience. All graduate professional degree programs identified in the