PH 118:

Community Health: Needs Assessment, Program Design, and Evaluation

(1.25 units)

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.

PH 140:

Applying Health Statistics

(1.5 units)

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.

PH 125:

Introduction to Qualitative Methods for Public Health & Healthcare Studies

(0.50 unit)

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.

PH 101:

Inferential Methods in Epidemiology and Public Health II

(0.50 unit)

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.

PH 111:

Medical Care Epidemiology: Principles, Applications and Insights

(0.25 unit)

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.

PH 117:

Intro to Quality Improvement in Health Systems

(0.75 unit)

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.

PH 112:

Medical Care and the Corporation (elective)

(1.0 unit)

This course examines the critical issues facing business leaders as they approach and finance health benefits for employees, manage cost, and choose the best strategy for recruiting and retaining a productive workforce. Students will build an understanding of the structure, economics and dynamics of the employer based health care system from the perspective of corporate leaders, learn how the ACA has fundamentally changed the strategic landscape and comprehend alternative approaches to help businesses cope with these strategic issues.

This course is cross-listed with Tuck School of Business in their MBA program.

PH 130:

Practical Approaches for Today's Health Care Ethics Challenges (elective)

(0.50 unit)

This highly interactive, inter-professional elective emphasizes critical thinking, real-world application, and decision-making to clinical, research, public health, and organizational ethics issues. Students will build practical ethical reasoning skills by applying ethics principles through case study discussions regarding challenges faced by today’s health care professionals. Students will learn to use a systematic ethical analysis process to recognize, respond to, and prevent ethical conflicts to foster an ethically aligned organization.

PH 105:

The Patient Revolution: Capturing the Patient Voice in Healthcare Policy and Research (seminar elective)

(0.25 unit)

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.

PH 106:

Policy for Clinicians: Influencing Formulation to Lead in Implementation (seminar elective)

(0.25 unit)

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.

PH 108:

Recording clinical encounters: what are the implications and the potential benefits? (seminar elective)

(0.25 unit)

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.

PH 109:

Systems Thinking (seminar elective)

(0.25 unit)

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.

PH 104:

Strategies to Pursue Personal Health and Create a Culture of Wellbeing (seminar elective)

(0.50 unit)

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.

PH 107:

Ethics & Health Policy During the Covid-19 Pandemic (seminar elective)

(0.25 unit)

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.

PH 126:

Statistical Measurement and Analysis for Healthcare Quality Improvement (elective)

(1 unit)

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.

PH 131:

Patient Centered Health Communication (elective)

(0.50 unit)

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.

PH 120:

Health Coproduction (elective)

(0.50 unit)

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.

PH 141:

From Observational Data to Valid Inference: Regression and Other Approaches (elective)

(1.5 units)

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.

PH 151:

Environmental Health Sciences and Policy (elective)

(0.50 unit)

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.

PH 134:

U.S. Maternal and Child Health Care (elective)

(0.75 unit)

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.

PH 115:

Leading Change in Value-Based Public Health and Healthcare

(1 unit)

A core aim of The Dartmouth Institute is to measurably improve health. In this course, students will develop skills to define and lead important improvement initiatives: design thinking, finance for non-finance professionals, persuasion and leadership. Students will learn strategy, budgeting, resource allocation and financial decision making as needed to build a “business case.” The course weaves in negotiation, persuasion, and team interaction to develop valuable leadership skills. Students will hear from important leaders from finance, issue advocacy, and public health. Each student will define a real-world project inspired through design thinking with the intent of implementing it in a community; over eight weeks each student will construct a persuasion case that includes the “business case” and conclude the process by pitching to a community leader.

PH 124 & PH 129:

Advanced Topics in Quality Improvement (elective)

(1.5 units (PH 124); 1.0 unit (PH 129))

This course addresses advanced topics in improvement science and coproduction and explores implementation science, value creation in health care, coaching, and leadership/change management. Students will have the opportunity to apply skills from prior courses (PH 117, 126, & 120 (coproduction)) to case studies and other learning opportunities related to improving health and health care services. Content for the course will include both U.S.-based and international material.

The Integrative Learning Experience (ILE) component can be met in this course.

PH 147:

Advanced Health Services Research (elective)

(1.5 units)

This course will develop student analytic competencies to the level necessary to conceptualize, plan, carry out, and effectively communicate small research projects in health services or epidemiology. Lectures, demonstrations, and labs will be used to integrate and extend methods introduced in other QBS and TDI courses. The students will leverage synthetic electronic health record data provided by the Analytics Institute at Dartmouth-Hitchcock and publicly available data in classroom lab exercises and course assignments. Many of the labs build on one another, and the aim is that the skills developed in the labs will assist the students with their own student-led projects. The instructors will mentor students as they develop their own analytic projects. Practical skill areas include programming in R, developing an analytic workflow, data visualization, and data structure and management. The main goal of the course is to firmly ground students in the scientific process of observational research.

The Integrative Learning Experience (ILE) component can be met in this course.

PH 119 & PH 121:

Decision and Cost-Effectiveness Analysis (elective) 

(1.5 units (PH 119); 1.0 unit (PH 121) )

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. Weekly problem sets are also used to reinforce the concepts presented in class. 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.

The Integrative Learning Experience (ILE) component can be met in this course.

PH 116:

Approaches to Studying Determinants of Health Inequities (elective)

(1.5 units)

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.

PH 113 & PH 123:

Health Policy (elective)

(1.5 units (PH 113); 1.0 unit (PH 123) )

The course begins with an investigation into how health policy is shaped by legislation, regulations and the courts. After understanding the process, each student chooses a policy topic they care about and begins to build a persuasive advocacy strategy for making the change they want to see happen. The course then delves deeply into theories of change and effective communication and negotiation with stakeholders. Each course assignment is a piece of the final project, which is a written policy advocacy strategy that includes: an analysis of a policy issue, a summary of relevant research, a stakeholder analysis, an advocacy campaign plan, a metrics-based evaluation plan, and prepared written and oral communication points that target different audiences.

The Integrative Learning Experience (ILE) component can be met in this course.

PH 114:

Contemporary Issues in Biotechnology: The Practitioner’s Perspective (elective)

(0.50 unit)

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.