Core coursework in the on-campus MPH program focuses on the development of essential quantitative and analytic skills, foundational knowledge about how health care systems function (or malfunction) and how they can work better. In short, students gain the knowledge and training they need to improve health system performance through quality improvement, leadership, health policy and research.
Applied Practice Experience (APE) and Integrative Learning Experience (ILE)
The opportunities for students to put their skills and knowledge immediately to practice abound throughout the on-campus MPH curriculum. The competencies that the Council on Education for Public Health (CEPH) requires students to meet for the Applied Practice Experience (APE) and the Integrative Learning Experience (ILE) are directly incorporated into designated courses such as Community Health: Needs Assessment, Program Design & Evaluation for the APE, and Advance Health Services Research or Advanced Topics in Health Care Improvement (among additional course topics) for the ILE. Additionally, students can apply to take the Practicum Intensive, which includes two culminating electives – an independent APE and independent ILE working closely with faculty mentors.
Course descriptions by term are provided below. Elective courses are available in Fall-Spring terms.
To see the days and times that courses are offered by term, view the full academic calendar here
Foundations of Population Health
This online course introduces 1) the factors of human health that affect individuals and communities and 2) the two systems in the United States that use these factors to improve population health – public health and health care. Students will explore fundamentals of each system and its impact on population health. The Foundations course is 0.25 units with an additional 0.10 unit of course work on responsible and ethical conduct of research
Inferential Epidemiology 1
Students will learn to recognize the purpose, structure, strengths and weaknesses of common study designs: randomized controlled trials and observational studies (cohort and case-control). Weekly journal clubs establish a critical assessment framework to determine the relevance and validity of published studies. Students apply this knowledge through collaboratively writing a systematic review proposal, which includes developing a research question, conducting a preliminary literature search, and considering appropriate inclusion/exclusion criteria.
This course will develop strong foundations in introductory analytic epidemiology and cultivate the ability to communicate epidemiologic concepts in plain language. Analytic epidemiology, the science of investigating patterns and determinants of disease and its consequences in populations, is foundational to any effort to improve health or healthcare. Through published studies and hands-on data analysis, students will examine, derive, and interpret measures of disease, its determinants and consequences, and the role of chance in interpreting these relationships.
Determinants of Health Inequities
This course will explore the root causes of population health -- including social, economic, and political inequities -- and the pathways by which they influence choices, behavior, and decision-making that lead to poor health outcomes. We will also explore the role of structural determinants such as structural bias and racism and the challenges in addressing these through public health action. Students will research evidence-based strategies in addressing health inequities for a particular health issue.
Health Systems & Policy
Improving population health requires understanding of health systems and health policy. This course identifies the challenges facing health systems and how different countries address them (or not) through their specific approaches to the financing, organization, delivery and oversight of their health systems, emphasizing systems thinking and payment systems. The policy-making process is introduced with an emphasis on how policy proposals can be moved forward and to evaluating their potential impact on health and equity.
Introduction to Qualitative Methods for Public Health & Healthcare Studies
This course introduces students to qualitative design and methods in public health and health care as a stand-alone approach and in combination with quantitative approaches (mixed methods) for research, evaluation, and needs assessment. Topics include an overview of qualitative traditions, distinguishing between qualitative and quantitative approaches, when to use qualitative or mixed methods designs, how to design a qualitative study including quality standards, common qualitative methods, data collection, qualitative analysis, and presenting results.
Inferential Epidemiology 2
As a continuation of PH100, students learn to recognize the purpose, structure, strengths and weaknesses of common study designs: decision and cost-effectiveness analysis, before-after, cross-sectional, qualitative and mixed-methods studies. Weekly journal clubs establish a critical assessment framework to determine the relevance and validity of published studies. Students apply this knowledge through continued collaborative writing of a systematic review proposal, which includes refinement of a search strategy and selection of three studies that fulfill inclusion criteria.
Applying Health Statistics
Students will critically appraise studies of analytic epidemiology. After classifying a study’s design and acknowledging its inherent limitations, students will trace what outcome measures (e.g., risks) and effect measures (e.g., risk ratios) were used to describe the problem and assess impact. Students will appraise the choice of these numbers, how the authors explained them, and whether their conclusions were justified. Weekly laboratory sessions allow students to conduct their own analyses with Stata® on real-world datasets.
Finance and Strategy in Value-based Public Health and Healthcare
Changing U.S. health policy has shifted the focus from volume to value, increased revenue and cost pressures, and pushed leaders to do more with less. Managing for program outcomes and financial soundness requires making value enhancing decisions. Students will interpret and analyze financial statements (financial accounting), develop skills in operational, capital, and project budgeting (managerial accounting), appreciate principles of shared decision-making and coproduction, and apply principles of leadership, including creating a vision and guiding decision-making.
Medical Care Epidemiology
Students will learn to see how their own and others’ mental models have acted as a barrier to addressing racial, socioeconomic and geographic disparities in health and health care and how applying curiosity, healthy skepticism, systems thinking, and basic epidemiologic principles to both public health and medical care have contributed to advancing our understanding of how to improve health system performance.
Intro to Quality Improvement
This course develops systems thinking in health care and public health. Students explore various perspectives on healthcare services, including coproduction of health and health care, connections between communities and health systems, and making change in complex system. Students will learn and apply basic improvement skills and will be exposed to a variety of approaches and examples. Implications of health care systems on social inequities and structural bias are a central focus.
Medical Care and the Corporation (elective)
This course is intended to 1) illustrate the applicability of management concepts and techniques to the health care and biotechnology industries; 2) enhance the ability of managers to serve as trustees of health care organizations; and 3) demonstrate how corporate managers can exercise judgment and control over expenditures for health care benefits while protecting the health of their employees. The characteristics and components of the health care system and their interactions and determinants will be analyzed. The history of corporate and governmental intervention in health care will be reviewed. The importance of understanding the medical market dynamics and the options for data-driven strategies for market reform will be stressed. Case examples will highlight the use of new analytic techniques for understanding and managing the medical markets.
This course is cross-listed with Tuck School of Business in their MBA program.
This highly interactive, short course is designed to give students an overview of health care ethics, including recognizing and responding to contemporary clinical, research, and organizational ethical conflicts in health care. The students will become familiar with the application of ethics principles to today’s health care ethics challenges faced by health care professionals. Through the discussion of case studies, students will build practical ethical reasoning skills and strategies for dealing with frequently encountered ethics issues, as well as approaches for anticipating and decreasing the presence of ethics conflicts. Students will also gain an understanding of the structure and function of a Hospital Ethics Committees and an Institutional Review Board/Committee for the Protection of Human Subjects. Emphasis throughout the short course will be on critical thinking, real-world application and ethical decision-making in a professional environment.
Winterim Seminar Electives
New Topics in Health Care Variation: Research and Policy Dimensions (seminar elective)
Almost a half century after John Wennberg’s seminal Science paper, health care variation is still with us! Students in this seminar will assess the prospects and challenges of health care variation studies through eight recent publications from the U.S. and Europe. The research and policy dimensions of four specific topics will be examined: descriptions of health care variation; inferential studies investigating the causes and consequences of variation intended to inform public policy; the growth of research in study populations under age 65; and communicating findings, including controversies in public reporting of variation in health system performance.
The Patient Revolution: Capturing the Patient Voice in Healthcare Policy and Research (seminar elective)
This seminar will interweave the need for a Patient Revolution in healthcare, and strategies to achieve it. Sessions will begin with a discussion of patient stories from ‘Why We Revolt – a patient revolution for careful and kind care’ by Victor Montori (book provided). Students will learn practical strategies and tools by which we can create change including: 1) how to engage patients and other stakeholders in health system design and research, 2) the importance of patient reported outcome measures (PROMs), giving patients a voice in healthcare policy and research, and 3) how to critically appraise patient engagement and PROM quality.
Policy for Clinicians: Influencing Formulation to Lead in Implementation (seminar elective)
Drawing upon lessons from implementation of reform policy in the US (ACA, 2010) and UK (HSCA, 2012), this seminar will prepare students with clinical backgrounds or interests to influence policy formulation. Students will critique five design principles for reform at the frontlines of care and identify capabilities needed for system-wide implementation of policy reforms that improve health and wellbeing of vulnerable populations. Their application and synthesis of these principles and capabilities will serve as a framework for consolidating and expanding TDI learnings while acquiring the skills that will equip them to lead in health policy as well as clinical practice.
Recording clinical encounters: what are the implications and the potential benefits? (seminar elective)
People are recording their visits to health professionals: sometimes they ask permission, sometimes they do not. These four seminars will examine the emotions generated, the arguments for and against, and the fast-moving technological developments that will take advantage of digital recordings of clinical encounters.
Systems Thinking (seminar elective)
This course provides a hands-on introduction to systems thinking and modeling. We live, work, and play embedded within physical, social, and cyber systems of systems. Students will develop systems thinking skills as they model natural, technical and, socio-technical systems at various scales and scope, from the home to a national public health system. Topics include: Why do we need systems thinking?, what is a system?, types of systems, key system concepts, modeling the graphical architecture of a system, and a brief description of system tools.
Strategies to Pursue Personal Health and Create a Culture of Wellbeing (seminar elective)
This seminar aims to advance health professionals capacity to model evidence-based wellbeing strategies and to collaborate with colleagues in leading change and creating cultures of wellness. We will examine wellbeing through individual and population-based lens, explore current and complex health challenges and apply evidence-based solutions to foster personal and community wellbeing. Students will participate in case-based readings, self-reflection, in-depth discussion and application of evidence-based wellbeing strategies, tools and skills. The course is grounded in an experiential learning approach and draws on principles of prevention, personal health practices, and processes of improvement.
Ethics & Health Policy During the Covid-19 Pandemic (seminar elective)
This course explores the relationship between public health ethics and Covid-19 policymaking. Through interactive presentations and discussions, students will identify state and institutional pandemic policy issues that create a conflict between population health and individual rights. Students will review an ethical framework including an ethical justification process for addressing the moral considerations of creating policy that may deprive an individual of their traditional personal rights for the benefit of the population. Understanding how an ethical framework relates to Covid-19 policymaking will provide students with practical knowledge and skills of how the framework can be applied to all health policymaking situations.
Community Health: Needs Assessment, Program Design, and Evaluation
This course develops defining skills in public health: assessing a community’s needs, designing programs to address those needs, and evaluating the effectiveness of those programs. Students will learn the principles of these processes. Working in teams, students will evaluate a non-profit hospital’s Community Health Needs Assessment, the programs the hospital designed in response, and the evaluation process the hospital employs. Students will report the strengths and opportunities for improvement they identify to hospital staff.
The Applied Practice Experience (APE) component is met in this course.
Statistical Measurement and Analysis for Healthcare Quality Improvement (elective)
This course explores the history, theory, and application of Statistical Process Control (SPC) in health care improvement. Topics include development of measures; data collection; graphical display of data; the selection and generation of SPC analyses for continuous measures, proportions, counts and rare events; for both longitudinal and cross-sectional analyses. Benchmarking, organizational approaches, and multicenter collaborative approaches to improvement measurement are discussed and research study designs for improvement and implementation science are explored. The course emphasizes application of theories and principles through the use of case studies based on ongoing work in the field, individual and small group exercises and interactive discussions with guest presenters. Individual lab exercises, a small group project and an in class final exam are required elements of the course.
Patient Centered Health Communications (elective)
Health care decisions are complicated – really complicated – and frequently lack evidence to determine a ‘one best’ course of treatment. As such, patient‐centered health communications increasingly are recognized as a critical means to facilitate health care decisions that provide patients with “the care they need, and no less; and the care they want and no more” (Al Mulley, The Dartmouth Center for Health Care Delivery Science). Shared decision making is on strategy to promote better communication with patients and has been described as “the pinnacle” of patient centered care (Barry, Mass General Hospital)
The objectives of this course are to 1) engage you to think broadly about the impact of communication at the patient, institutional, and population level, with a focus on shared decision making; 2) to gain skills and experience related to the design and development of decision support tools and methods; 3) to understand the challenges involved in implementing decision support into practice at the clinical and policy level.
Health Coproduction (elective)
Coproduction has been defined as the interdependent work of users and professionals to design, create, develop, deliver, assess and improve the health of individuals and populations, through mutual respect and partnership, that invites participants’ strengths and expertise. At the core, coproduction relies on shared decision making, and to operationalize the approach, a learning health system approach is advocated.
From Observational Data to Valid Inference: Regression and Other Approaches (elective)
In the quest to understand and improve population health and healthcare, observation is essential – and yet when we observe the world, the true nature of cause, effect, and association can be obscured. To see beyond influences that disguise the truth, investigators need expertise and ingenuity – to use multivariable statistics, and understand when their use is indicated, and adequate, to address a question. In PH 141, students will gain proficiency – in study design and analysis, interpretation and communication – to capably address threats to inferential validity in epidemiologic and other observational data, and apply these capabilities to questions about health, disease, and healthcare.
Environmental Health Sciences and Policy (elective)
In this course students explore major environmental and occupational health issues by applying basic tools of environmental science including epidemiologic methods, toxicology and risk assessment. Students examine the relationship between environmental and occupational exposures and human disease, emphasizing the interface of science and policy, the role of regulatory agencies and environmental risk communication. Topics include air and water quality, hazardous waste, radiation, heavy metals, food safety, environmental pathogens, and clinical occupational medicine. Teaching tools include lectures, audiovisual media, case studies, guest experts, and assigned readings/exercises.
U.S. Maternal and Child Health Care (elective)
The health of mothers, infants, and children is dependent upon accessible and effective health care. In this course, we will critically examine the provision of health care through public and private systems to U.S. women of reproductive age, infants, and young children. The course will first provide an overview of health and social issues in this population, and then students will explore the unique funding, structure, processes, and outcomes of U.S maternal and child health care with an emphasis on current critical issues. This is a hands-on evidence and data driven course that builds upon many of the courses and topics from the summer and fall and connects with winter and spring term courses. The course includes a virtual lab where previously acquired epidemiologic and Stata skills will be applied to examine perinatal risk, care, and outcomes. In-class time (via Zoom) will be used primarily for discussion and hands on learning.
Independent Internship 1 (elective)
Part 1 of the Independent Internship. The public health field internship provides students with an opportunity to apply principles and skills learned in the classroom - the measurement, organization, and improvement of population health - to real situations in the field. The placement site can be an agency or organization in any sector – government, non-profit, or for-profit – but any university-affiliated settings must be focused primarily on community engagement, typically with external partners. Students will be provided a selection of TDI-sourced Internship offerings but students may also opt to identify a self-sourced internship site. The project should be scoped such that a minimum of 120 hours will be spent at the placement site. Activities of the internship should be mutually beneficial to both the site and the student, with the student specifying five learning objectives for their learning experience. Students will spend the Winter term contacting internship sites and applying for an internship position. By the end of the term each student will be matched and have developed a mutually agreed upon contract with their Internship Site preceptor that will require approval from the course directors before the start of the Spring term. Typically, the internship series occurs in the winter and spring terms of the year, but other arrangements are possible with permission of the course director(s).
Advanced Topics in Healthcare Improvement (elective)
Participants will work in partnership with selected managed care settings throughout the United States. Specifically, this course will offer participants an opportunity to identify the processes involved in managing a panel of patients, learn the knowledge and skills providers need to manage panels and provide optimal patient care, identify approaches for taking costs out of the care while maintaining or improving quality and enhancing customer satisfaction, understand the difference between the efforts for improvement of care at the front line and in the front office and how they may be related, and identify some of the barriers to making the health of a population better.
The Integrative Learning Experience (ILE) component can be met in this course.
Advanced Health Services Research (elective)
This course will develop student analytic competencies to the level necessary to conceptualize, plan, carry out, and effectively communicate small research projects in patient care, epidemiology, or health services. Lectures, demonstrations, and labs will be used to integrate and extend methods introduced in other TDI courses. The course will also cover new methods in epidemiology, health services and data science. The students will use national publicly available data and synthetic research datasets resembling Medicare claims and electronic health record data in classroom lab exercises and course assignments. Course topics focus on key aspects observational research including cohort derivation, multilevel analyses, small area analysis, and network analysis. Practical skill areas will include programming in STATA and/or R, developing an analytic workflow, data visualization (designing tables and figures), and data structure and management. Emphasis is on becoming independent in research processes. The instructors will mentor students as they develop their own analytic projects.
The Integrative Learning Experience (ILE) component can be met in this course.
Decision and Cost-Effectiveness Analysis (elective)
This course covers the fundamental principles and mechanics of decision analysis and cost-effectiveness analysis. Topics covered in the course include basics of probability (including Bayes’ Theorem), structuring decision problems as decision trees and Markov models, components of preference (value preference, time preference, and risk preference), valuing multidimensional outcomes, evaluating decision trees, sensitivity analysis, value of information, and basic principles of cost-effectiveness analysis. The course has a weekly lab that involves use of decision analysis software to reinforce concepts presented in class. Labs are also used for development, progress review and discussion of small group decision analysis projects, which culminate in formal presentations the last week of class. Weekly problem sets are also used to reinforce the concepts presented in class.
The Integrative Learning Experience (ILE) component can be met in this course.
Approaches to Studying Determinants of Health Inequities (elective)
Our health is determined by many interconnected forces driven by the social, political, economic, and environmental conditions under which we live and work. How we understand and experience illness and health is just as much a product of our context as it is of our biology. Theories can help organize our rationale for studying the determinants of health while research methods help us measure and interpret what we learn. Ethical issues abound as we attempt to understand and address the inequalities that are pervasive throughout our contexts. This course will use case studies, scientific literature, documentary footage, and journalism to appreciate the complexity of studying the determinants of health while exploring some of the methodological solutions that have advanced public health research. Students will have an opportunity to work on at least two different topics with their class and one of their own choosing.
The Integrative Learning Experience (ILE) component can be met in this course.
Health Policy (elective)
This course is intended to further students understanding of health policy and financing in the United States through study of the Patient Protection and Affordable Care Act (PPACA). Specific areas of study will include accountable care organizations, health information technology, employer and individual insurance mandates, comparative effectiveness research, and insurance expansions. Learning takes place through readings of selected manuscripts, lecture and discussion, and assignments.
The Integrative Learning Experience (ILE) component can be met in this course.
Contemporary Issues in Biotechnology: The Practitioner’s Perspective (elective)
In this course, students will gain an appreciation for the biotechnology industry, its premise and continued promise, as well as what is required for biotechnology entrepreneurs in the 21st century to attract investment capital. Areas ripe for investment and development will be explored, as will lessons that have been learned over the past four decades that have been witness to the creation of thousands of biotechnology companies, and the very way that innovation is supported by the pharmaceutical industry and regulated by worldwide governments.
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Meghan Longacre is a child developmental researcher with expertise in the socioecological influences on children’s, adolescents’, and young adult’s health risk behaviors. For the past 12 years, her research has focused on the prevention of childhood obesity. Her current work examines the influence of food marketing on preschoolers’ diet. Meghan has worked with several prominent community organizations, including the Montshire Museum of Science in Norwich, Vermont, and WGBH, the Boston PBS Affiliate, to design and evaluate research-informed curricula to promote energy-balance practices in preschool, middle-school, and high-school settings. She serves on the board of editors for the Journal of Nutrition Education and Behavior, and is a reviewer for NIH’s Time-Sensitive Obesity Policy and Program Evaluation mechanism. As a qualitative researcher, Meghan consults with research teams regarding appropriate use of qualitative methods within child-focused research projects.
More recently, Meghan served as the director of the Hybrid (online/on-campus) Master of Public Health program at The Dartmouth Institute for Health Policy and Clinical Practice. She currently teaches the Qualitative Research Methods short course in the Hybrid MPH program. In addition, she is the co-Course Director for the “Practicum” series of courses (PH261-PH264), which combines the Applied Practice Experience and Integrated Learning Experience requirements for the Hybrid MPH program. Since coming to Dartmouth in 2001, she has mentored numerous undergraduate and graduate students.
She earned a BA in psychology from Rutgers University, and an MS and PhD in family studies and human development from The University of Arizona.
Practicum and Practicum Intensive
The TDI Hybrid MPH includes a concurrent practicum course that runs throughout the entire program, combining an Applied Practice Experience, or APE (a field study) with an Integrated Learning Experience, or ILE (written culminating project). Students develop and execute their own individual practicum with faculty support, focusing on a specific problem area or question. Skills gained in the program serve to improve health and/or health care, develop or refine policy, or generate new knowledge in a real-world setting. Using systems thinking, qualitative and quantitative methods, along with effective inquiry, student practicums will provide actionable insights and feasible recommendations.
Qualitative & Survey Research Methods
This course introduces the basic principles of qualitative research design and analysis using grounded theory along with the fundamentals of developing and analyzing surveys. Students will gain experience with interviewing and focus group facilitation, survey design and sampling, data collection, analysis, interpretation and reporting of results. In addition to gaining knowledge about primary research methods, students will be introduced to the use and analysis of data from publicly available national survey data.
The public health field internship provides students with an opportunity to apply principles and skills learned in the classroom - the measurement, organization, and improvement of public health care - to real situations in the field. A minimum of 120 hours is to be spent at the placement site during the winter and spring terms. Typically, this internship occurs in the final term of the year, but other arrangements are possible, typically for part-time students, with permission of the course director. Students who have completed their internships prepare and present an overview of their experience at the conclusion of the spring term and complete an exit appraisal of their experience and achievements.
Required for MPH; Not available for MS, PhD, Post-doc or Special students.
Prerequisites: PH 100, 102, 111, 115, 117, 139, 140, 151, and 154 or consent of course directors.
MORE ABOUT PAUL'S WORK
Meghan Longacre serves on the board of editors for the Journal of Nutrition Education and Behavior, and is a study section reviewer for NIH’s Time-Sensitive Obesity Policy and Program Evaluation grants. She serves on The Dartmouth Institute's curriculum committee, and also serves as a board member for the Montshire Corporation at the Montshire Museum in Norwich, Vermont.