Date Published: March 23, 2017
Publisher: Public Library of Science
Author(s): Carey Roth Bayer, L. Lerissa Smith, Renée Volny Darko, Marissa McKool, Fengxia Yan, Harry Heiman, Jacobus P. van Wouwe.
We assessed the training needs of health policy leaders and practitioners across career stages; identified areas of core content for health policy training programs; and, identified training modalities for health policy leaders.
We convened a focus group of health policy leaders at varying career stages to inform the development of the Health Policy Leaders’ Training Needs Assessment tool. We piloted and distributed the tool electronically. We used descriptive statistics and thematic coding for analysis.
Seventy participants varying in age and stage of career completed the tool. “Cost implications of health policies” ranked highest for personal knowledge development and “intersection of policy and politics” ranked highest for health policy leaders in general. “Effective communication skills” ranked as the highest skill element and “integrity” as the highest attribute element. Format for training varied based on age and career stage.
This study highlighted the training needs of health policy leaders personally as well as their perceptions of the needs for training health policy leaders in general. The findings are applicable for current health policy leadership training programs as well as those in development.
Health and health care leaders are increasingly recognizing the importance of health policy and health policy training. This growing consensus has also been reflected in a number of reports over the past 10-15 years. The Institute of Medicine in its 2003 report, Who Will Keep the Public Healthy? Educating Health Professionals for the 21st Century, stressed the importance of both politics and policy to the future of public health and health care. In their 2010 report, the Commission on Education of Health Professionals for the 21st Century noted the importance of planning, policy, and management for future health leaders. As the interest and importance continues to grow, so does the opportunity for adding health policy into existing training structures.
We received Institutional Review Board (IRB) approval from the Morehouse School of Medicine (MSM) IRB to conduct this work. In February and March, 2013, we recruited health policy leaders and practitioners across career stages to assist in the development of the health policy leaders’ training needs assessment tool. We recruited through electronic invitation and word of mouth and indicated that the purpose of the group was to identify the content to include in a health policy leadership training needs assessment tool. We used purposive sampling to insure the group would have relevant background and experience with health policy. The multidisciplinary group consisted of graduates from two of MSM Satcher Health Leadership Institute’s (SHLI) training programs, the Health Policy Leadership Fellowship Program and Community Health Leadership Program, and professionals working in public health, health advocacy, and health policy. The group included nine individuals (five women, four men, one transgender man) from four states and the District of Columbia with a racial/ethnic breakdown of six Black/African-American and three White/Caucasian individuals. Educationally, they ranged from college graduate to doctoral graduate as well as from recent graduate/early career professional to late career professional.
We had 70 diverse individuals complete the health policy leaders’ training needs assessment tool. (Table 1) Participants ranged in age from 25 years to greater than 65 years and included slightly more females than males or transgender individuals. The participants were predominantly either Caucasian/White or African American/Black. The demographic outcomes that were most surprising included the education levels (75%, n = 46 with earned doctoral degrees) and income levels (50%, n = 30 with a household income over $100,000/year) of the participants.
To the best of our knowledge, this is the first study specifically designed to begin assessing health policy leaders’ training needs. It is clear that many factors need to be considered, including training content and delivery, learner age and stage of career, financial capacity, self-perceptions of training needs, and career motivations. While there was clear overlap in perceived self needs compared to perceptions of the broader needs of health policy leaders in general, in this sample, there were also notable differences. “Effective communication skills” ranked highest for the participants’ personal skill development as well as for health policy leaders on the whole, implying recognition of the critical role of communication in health policy. Similarly, “integrity” and “professionalism” were ranked highest as both personal needs and needs in general. Participants ranked “cost implications of health policies” as most critical for personal knowledge development, yet this same item did not appear among the top 5 as a critical element for health policy leaders in general. It is not clear why this group of participants viewed cost implications as less of a priority for health policy leaders in general. Participants also ranked “presentation skills” and “advocacy skills” in the top 10 skills as personal needs; yet, neither of those made the top 10 for health policy leaders in general. Participants ranked “assessing strengths and weaknesses of various policies” and “networking skills” in the top 10 skills for health policy leaders in general; yet, neither of those made the top 10 for personal development. Given that our sample contained a large portion of doctorally-prepared participants, it is possible that formal training and stage of career impacted their rankings.
We intentionally did not define “health policy leader” and “leadership,” which may have influenced potential participants’ decisions to participate in the study. Since we wanted to understand health policy leaders’ training needs and perceptions, we intentionally did not go into exhaustive operational definitions for most elements in the tool, which may also have influenced participants’ responses. In spite of widespread electronic marketing and recruitment efforts, the final sample remained small. Our sample included a large number of doctorally-prepared participants and a third of participants were 65 years or older, which may indicate that having the word “leader” in the title and tool did not resonate with those at earlier stages of their careers. It is not clear at what point one self-labels as a “leader” or “expert” and those who are not comfortable embracing those labels may have self-selected not to participate. Understanding at what career stage an individual self-identifies as a “leader” or “expert” in health policy may help explain our sample size. It is possible that many professionals who work on health policy do not self-identify as “leaders” despite engaging in leadership roles. Though we organized the tool to better understand knowledge, skill, attribute, and training format needs, as one participant noted, “I’m not sure how you ‘train’ integrity or selflessness or humility,” which raises the question of how feasible it is to measure attributes in health policy leadership training. The findings represent the perspectives of the study group and their specific health policy interest and career experiences.
Based on the findings from this study, our next steps include deeper analyses to determine further distinctions in knowledge, skill, and attribute needs related to career stage. We also plan to map the top knowledge, skill, and attribute items to the SHLI Health Policy Leadership Fellowship Program curriculum to assess overlap and gaps in training health policy leaders. As disciplines across healthcare (e.g. medical, public health, nursing) have cited a need for health policy leadership[3–8,12], our assessment helps to begin building a foundation of evidence to inform the development of such trainings.