Rocking HPSR Teaching, Eight Days A Week: Reflections from #HSR2018
As I write this blog, I am back in Manila, Philippines and it has been a couple of weeks since #HSR2018. It was such an inspiring and productive week; and being a new member of Health Systems Global (HSG), it was also the first time I attended a global health policy and systems research (HPSR) conference. I am still very much in a Liverpool state of mind and thus I am presenting my reflections on the skills-building session Strengthening Capacity for Teaching and Learning HPSR for Educators and Learners with lyrics by The Beatles.
Lucy in the Sky with Diamonds
Until two months ago, I was merely a member of HSG because I had registered on the website. On a regular workday, I received an email from Lucy Gilson (you know, this year’s Lifetime Achievement Awardee) who encouraged me to join the Teaching and Learning HPSR Thematic Working Group (TWG). I followed her advice and shortly after I was exchanging emails with the TWG’s organizing team for the skills-building session Strengthening Capacity for Teaching and Learning HPSR for Educators and Learners. The TWG, a growing community of HPSR educators and learners, is a warm and amazing group for sharing ideas and materials for HPSR education – quite precious, like diamonds!
Our session was scheduled to begin at 8:00 am on Monday, 8 October. During planning, we were concerned about the early start (Would people attend?) and the small, narrow conference room without tables (How would we conduct World Café sessions in this set-up?). It was early and many of us were still quite jetlagged or tired from long-haul flights.
We were pleasantly surprised to see our session brimming with wide-awake delegates from countries such as Ghana, South Africa, Canada, Malaysia, Panama and Chile. As for the World Café setup, just like an adaptive health system, we were able to move around the room comfortably! We conducted small group discussions covering the following aspects of teaching and learning HPSR: (1) educating educators, (2) leadership development and reflective practice, (3) using audio-visual aids, (4) supporting each other in teaching and learning HPSR, (5) educational research, and (6) syllabi and pedagogy.
In real life, we know that these issues are not mutually exclusive, so my reflections from the session cut across these six themes.
I Get By With a Little Help From My Friends
How are educators equipped to teach and learn HPSR? The participants were very open in sharing their experiences and this kind of “education,” it seemed, was acquired formally and informally.
Firstly, what to teach in an HPSR course? How do we even learn what to teach? Based on participants’ stories, it seemed common for educators to be daunted by the task of teaching HPSR for various reasons (I felt this way when I was planning for an HPSR course and I thought my feelings stemmed from me being from the private sector, and not an academic). Another typical concern was that health systems was not directly part of the existing curriculum for undergraduate or graduate courses, and so designing or implementing the curriculum proved to be a monumental challenge. There is always the risk of curriculum sclerosis (being too rigid) or trying to capture too much in too little time.
A recurrent and predominant theme was that educators effectively learned from their own supervisors and colleagues – those who truly connected with them, encouraging and guiding them through curriculum, resources and networks. This was especially important for new educators who had only recently shifted from being a graduate student to becoming a teacher.
Many of us shared drawing from our own public health experiences. As HPSR is context-heavy, these experiences provide rich learning materials and provide "comfortable" starting points. It is also very useful to always keenly listen to the perspectives provided by disciplines or practices different from ours. For example, observing or working closely with politicians can provide practical insights to solutions from which we can learn. It was interesting to note that no one said, “Oh I was prepared from my PhD studies…”.
Mentoring comes in many shapes and sometimes we need to think out of the box. While preparing for the Philippine Department of Health HPSR Fellowship capacity building workshops, I decided to follow #HPSR on Twitter and there I discovered @H_S_Global, @hpsa_africa, @KarensComments, many other HPSR ‘diamonds,’ and was thrilled to find @Lucy_Gilson whose HPSR Methodology Reader I had devoured daily for three months. The Reader and Twitter were turning points in my own journey of HPSR teaching and learning.
We Can Work It Out
Second, how to teach HPSR? It was truly enlightening for me to grasp how values were integral in teaching and learning HPSR: that it is intertwined with trust, that it is participatory and rooted in experience, that it is adaptive and not “pre-cooked,” that it requires understanding of cultural issues and respect for context.
Certainly, content and structure are important, and we have examples of CHEPSAA and the HPSR competencies derived from a global mapping and consensus-building process, but course content and delivery should be very flexible. Learners of HPSR cut across age groups! Several of the participants admitted that they were younger than some of their students. Just as importantly, educators should exhibit an openness to sharing materials (I personally thank CHEPSAA!).
Audio-visual materials can be helpful, but it can also be unhelpful. The choice of audio-visual materials should have a rationale. We simply aren’t trained to make our own audio-visual materials, and why reinvent the wheel? That said, there were suggestions for the TWG to create a page where recommendations for films and other media can be crowdsourced, with a brief description of how it can be valuable for teaching HPSR. An example cited was the film And The Band Played On to learn about the origins of HIV.
The teaching and learning of HPSR is not exclusive to universities. Some of us, myself included, work with government, non-governmental organizations and even the private sector. Therefore, “how to teach” can also mean “how to convince” or “how to persuade” decision makers and funders to prioritize health systems the way they often do for typical programmatic work. Socialization, networking and this kind of interplay with power are also soft skills which HPSR practitioners and educators should be capacitated with.
I Want To Hold Your Hand
I facilitated the discussion on “How Do We Support Each Other in Teaching and Learning HPSR?” The responses varied from support for individual researchers, intra-organizational support and support via collaborations between organizations.
Personal issues were raised because, after all, researchers are also humans with lives outside of HPSR. Consistent with the values of openness and mutual respect in HPSR, in our own little ways we can provide support for our fellow HPSR educators and learners by espousing a nurturing environment that promotes the wellbeing of our colleagues and students.
Female participants shared that their families would complain about them “sacrificing getting married or having children” to pursue post-graduate studies, although I imagine these issues are not unique to HPSR. It was thus reassuring to hear that some universities have formal support systems in place. One such model was assigning teams which included non-HPSR lay volunteers or third party monitors (i.e. outside of the student’s department) who serve as friends for basic psychosocial support for graduate researchers.
In terms of collaborations, particularly partnerships where one organization or group serves to "capacitate" another, issues raised included the sustainability of these relationships, support for longer term goals, and evaluating whether knowledge was truly "transferred" to the recipients. Once again, feedback, monitoring and evaluation are crucial in these endeavours. Another model of partnership, where two or more institutions are considered “equal”, is ideal but we know this is probably really hard to implement (just think of all the politics!). A good example of a thriving partnership cited is CHESAI in Cape Town.
Imagine we had about 30 educators, four hours, in one room…so much synergy and vision for the teaching and learning of HPSR in that short yet productive session! Between today and #HSR2020, there is so much to do and we do not even need to look elsewhere: we can continuously crowdsource with each other!
Let me close the blog on a high note with the hopeful voice of John Lennon…
You may say I’m a dreamer, but I’m not the only one.
I hope someday you’ll join us… in HSG and in the Teaching and Learning Thematic Working Group!
Venus Oliva Cloma-Rosales, MD MPH,Managing Director, 101 Health Research