The Role of Schools of Public Health: Training, research, advocacy and policy

1. The Role of Schools of Public Health: Training, research, advocacy and policy OSI Seminar - Varna, Bulgaria Presenter: Don McVinney Lecturer, Columbia University School of Social Work, U.S. National Director of Education and Training, Harm Reduction Coalition, U.S. mcvinney@harmreduction.org

2. Education and Training • Teaching– Adult learning (androgogy) versus childhood learning (pedagogy); • Adults have life experience to draw upon: their own resources and experiences

3. Education • Involves critical thinking • “Opening out” of the mind • Understand the meanings behind social problems • The process of thinking is an end in itself • Connections may not be made about what one is learning until years later • More unpredictable outcome than training • Sometimes students initially feel less skilled because the educator calls into question what they presume to know (unlearning then learning) • More future-oriented • Setting: Classrooms in schools of higher education, such as universities

4. Training • Providing practical skills that one can employ readily and immediately in one’s work • More factual • More rigid approach to learning • “Narrowing in” of information that is most relevant and useful • More present-focused • Settings: In the community: in-service workshops; community-based organizations

5. Types of Training • Professional, para-professional or “staff” (volunteer or paid) training and development • Goals: • Give participants new knowledge and information • Provide or enhance skills for professionals to be or to become more effective in their work • Clarification of values (example: attitudes about drug users) • “Popular education” (Paolo Freire, Pedagogy of the Oppressed) • Providing knowledge and skills to clients and consumers; empowerment approach

6. Types of Knowledge • Specialized knowledge – For example: licit and illicit drugs • Goal: Increase competence related to vulnerable populations or to individuals • “Tacit knowledge” – intuitive and intangible approach • “Professional use of self” (social work) • Postmodern perspective: Many ways of knowing • Philosophically, is intervention an art or a science? (logical positivist versus postmodern debate)

7. The Need to Impart Knowledge: The gap between research and practice • On the one hand, practice approaches may be several years behind research • Costs of implementation may be prohibitive • There may be political rather than scientific motives for not promoting an effective intervention (example: syringe exchange to reduce HIV infection) • On the other hand, effective clinical interventions may be widely used in the community years before a research grant is written, funded, intervention studied, data analyzed, and disseminated (often to a limited audience)

8. The Gap Between Research and Practice • Scientific advances are not being incorporated into practice interventions (Conclusion of report, 1998, Institute of Medicine, U.S., Bridging the Gap Between Practice and Research) • Hypotheses: • Lack of ability to communicate to community stakeholders effectively • Few partnerships between academic researchers and policy makers to help communities see the benefits • Political barriers: Politicians may not be scientists • Science is increasing debunked because it is a threat to people of faith who may have political capital

9. Research-Practice Disconnection • Researchers/academics and practitioners in the community both have vast amounts of knowledge • Knowledge “explosion” and access to information through the internet • Often impossible for practitioners to keep up, even in their own field • Little research is being done to study how information can be disseminated: so-called “technology transfer”

10. Research and Practice: A Two Way Street • Greater understanding is needed about the different cultures that exist: • Often a separate knowledge base from which we work (scientific versus personal or experiential) can be bridged • Terminology (scientific or vernacular) can be adapted • Academics need to get out into the field more • Community stakeholders need to be invited into the academy to share perspectives