Health Policy Class Emphasizes Teamwork, Leadership, and Advocacy

December 9, 2015

“I didn’t expect policy to be this interesting,” said PhD student Jennel Osborne.  “I didn’t think I liked policy, but now I’m considering it as a career.”

Osborne took Columbia Nursing’s required master’s course “Health and Social Policy in the Context of Practice” during the summer and now serves as a teaching assistant (TA) for the fall class.  Osborne plans to attend a health policy conference this March in Washington, DC, something she said she’d never considered before taking this class.                    

This type of response is music to the ears of Assistant Professor Andrew Phillips '12 who teaches the course with Associate Professor Jacqueline Merrill, PhD, his former doctoral advisor  The pair refocused the curriculum to give students experience creating policies that address real-life health care issues.   

“Policymaking involves collaboration and engagement, so we revamped the main project so students work in groups to create policies addressing real health problems in specific states,” said Phillips.  

The course focuses on the social, legal, and political contexts in which health care systems exist and adapt, with emphasis on the U.S. system.  One goal of the class is to help students understand how nurses can participate in developing and implementing policies on institutional, local, state, and federal levels.

“When we thought about updating the course, we considered several questions,” Phillips said. “What do students need to know about policy? How can they best learn those things? What tactics can we use to better engage them?” The latter question provided no easy answer — some 300 plus students enroll in the class each year with more than 200 planned for the fall .  

This semester, Phillips and Merrill, accompanied by a team of nine TAs, divided the class into groups of 30 students. Each group, led by a TA, focuses on a health issue identified using Centers for Disease Control (CDC) data as underperforming in a particular state.  Then each group is divided into subgroups, which approach that health issue focusing on a different element in the spectrum of prevention: influencing policy and legislation, changing organizational practices, fostering coalitions and networks, educating providers, promoting community education and strengthening individual knowledge and skills.

The basis of their project is the CDC’s Prevention Status Reports, which evaluate public policies pertinent to 10 health problems faced by every state: excessive alcohol use, food safety, teen pregnancy, health care-associated infections, HIV, prescription drug overdose, heart disease and stroke, motor vehicle injuries, tobacco use, and nutrition, physical activity and obesity.  The CDC gives each state a red, yellow, or green rating on each topic, depending on the success of their policies and programs in dealing with that specific issue.  Green means that the policy is established in agreement with recommendations or expert recommendations, yellow means that the policy is established with partial accordance, and red means that the policy has not been established.

“These are real-life problems and policies we’re dealing with,” said Minru Hwang,  a Family Nurse practitioner student who took the course during the summer and now serves as a class TA.  “After taking the class, I felt more equipped to work in policy on any level, including affecting hospital policy where I work.  The class gives you a sense of how to approach policymaking from different angles within the context of your practice.”  

The groups pick state issues identified as underperforming, for example, prescription drug overdose in Vermont. Then, each of the six subgroups researches and proposes policy regarding the topic. The entire effort culminates in a group presentation and a comprehensive policy brief, which compose the bulk of the group’s grade.  States this term include New Mexico, North Dakota, Ohio, Vermont, Alaska, California, Georgia, Illinois, and Kentucky. 

“The group project is a team effort with a lot of give and take, coordination, exchange of ideas, and debate about tactics,” said Hwang.  “Some students feel uncomfortable working in groups at first, but I tell them that policy is made by working on committees.”

Like Obsorne, other students have decided to become more policy-focused due to his course, Phillips noted. “I think they are all realizing that advocacy is an integral part of nursing, and they are seeing how policy will affect their own practices in the future.”