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Shape the Future of the Public Health Workforce with Your Comments on the Core Competencies

Date: 3/14/2013 4:09 PM

Related Categories: Council on Linkages, Workforce Development

Topic: Council on Linkages, Workforce Development

Tag: Core Competencies for Public Health Professionals, Council on Linkages, Workforce Development

C. William Keck, MD, MPH, Chair, Council on Linkages Between Academia and Public Health Practice
The most recent version of the Core Competencies for Public Health Professionals (Core Competencies) was adopted by the  Council on Linkages Between Academia and Public Health Practice (Council on Linkages) in 2010. These competencies are widely used by health departments and academic institutions to guide workforce development activities, education, and training; are addressed in three Healthy People 2020 objectives; and are referenced by the Public Health Accreditation Board in Domain 8 of its Standards and Measures. With implementation of the Affordable Care Act, decreases in health department budgets and workforce, and the increasing need for greater coordination of public health and healthcare services, the roles and functions of public health professionals are changing. To ensure that the Core Competencies continue to meet the needs of the public health workforce, the Council on Linkages is exploring the possibility of revising the Core Competencies in consideration of the many changes occurring within public health practice.
As part of this exploration, the Council on Linkages is seeking guidance from the public health community. Should the Core Competencies be revised to address new and emerging needs of public health practice? If the Core Competencies are revised, what changes should be made to increase their use and usefulness for the public health workforce? What else should we be considering?
At its March 27, 2013 meeting, the Council on Linkages voted to initiate the process of revising the Core Competencies. Your input and ideas throughout this process will help the Council on Linkages determine whether or not revisions are needed.
Thank you for your comments. Hearing and learning from the broad public health community will guide us in ongoing efforts of the Council on Linkages to support our outstanding public health workforce!
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The PHF Pulse Blog welcomes conversations and commentary from contributors. Posts may not necessarily reflect the views of Public Health Foundation.


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Tom Quade


A refreshed look at core competencies in public health would be enriched by a perspective of standing at the intersections of practice competencies in closely related fields. For example, spending time in the overlap of public health, the built environment, urban planning, social justice, health equity, and public policy might shed light on a common set of competencies with a common vernacular and sets of skills that educators, practitioners and those who credential both, can use together for greater impact on the health of the population.

Ron Bialek


Allison, Great idea!! We cross-walked the Core Competencies with the 10 Essential Public Health Services to demonstrate that these competencies can help individuals provide essential services. Likewise, it makes sense to crosswalk the Core Competencies with the foundational capabilities. We probably will do the crosswalk with what the IOM developed as well as the expanded list in the recent Trust for America's Health report, "A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years." Thank you for the excellent suggestion.

Allison Thrash


I do not have a comment about revising the specific, individual core competencies. I would just like to suggest that in the upcoming review process the competencies be “crosswalked” with the foundational capabilities (as discussed in the 2012 IOM report, “For the Public's Health: Investing in a Healthier Future”). If we are to make the case to policymakers that health departments must possess certain cross cutting capabilities or skills in order to be successful, it would be helpful to be able to show the link to our workforce development needs.

Kristine Gebbie


One of the challenging issues with competencies is to keep clear in one's thinking (and on paper) the level of abstraction and the exemplar individual to whom any one competency set will be related. Competencies stated primarily for the workplace are generally at a fairly high level of abstraction, and measurable over time. Those intended for use in education generally move to a more specific level that facilitates development of sub-competencies and learning objectives, and thus organization into courses or curricula. A VERY useful exercise would be to map across work done by the COL, which is much more workplace oriented, and ASPH, which is more academic in its focus. That mapping, associated with one or more exemplar public health practitioners, would allow clearer identification of the competencies to be exhibited in the workplace, and the more specific statement of how those competencies will be achieved in an educational setting.

Terry Dwelle


The COL core competencies more closely align with public health practice than the ASPH set though there is significant overlap and more alignment with the seven cross-cutting domains of the latter. The competencies provide a standard base for the design of academic courses, practice evaluations and continuing educational strategies for the practice community.

Mark Edgar


In Wisconsin we have used the Competencies to assess the workforce and attempted to design the process to have benefits at multiple levels. The individual completing the on-line assessment was able to download their individual results, as a guide to thinking about where to focus their future training. Each participating Local Health Department will receive an aggregated agency-specific report for organizational level planning. Finally, we are producing regional and state-level reports to help with prioritizing and developing educational offerings and to serve as benchmark information for the LHDs. We have reports that PHAB site visitors have been very positive about this approach as part of a strategy for meeting the Domain 8 standards. The timing for reviewing the competencies does seem appropriate. Whether revisions are needed can be identified through that process.

Louise Kent


Here are some thoughts from our staff: (1) We think the Core Competencies still hold relevance, even with implementation of the ACA, and do address our changing roles. (2) It would helpful to link the specific competencies to accreditation standards and measures to the extent possible, as we could see the natural linkage on quite a number of the competencies. (3) We also believe there's a need to tease out support staff (i.e. those who provide supportive clerical services) from non-managerial public health professionals (i.e. sanitarians, health educators, public health nurses, etc.) in Tier One. We participated in Kentucky's Core Competencies self-assessment through KY TRAIN, last May, and found that the Tier One results were not able to give us a good picture of the self-assessment of our non-managerial staff. We do want our support staff to have competencies in some of these areas, but not all and not to the extent of those providing that higher level of professional services.

Gary D. Gilmore


The Core Competencies are regarded by public health professionals and academic institutions that prepare them as validated skill sets comprising a highly valued guidance system. The three major reasons that are cited by Bill related to the changing roles and functions of public health professionals are compelling in terms of needing to first review the current Core Competencies at all three levels, and then revise and add to them accordingly. I would want to be certain that we continue to focus on the value of the Core Competencies in guiding professional preparation, credentialing, and professional development.

Ron Bialek


In a discussion with Public Health Training Centers (PHTCs), we received useful feedback about potential revisions to the Core Competencies. Some PHTCs have already explored whether or not the Core Competencies adequately address changing roles that are resulting from health reform and other changes to public health practice. Their conclusion is that the current set of competencies is sufficient, and that providing examples of how the new roles relate to the competencies may be preferable to revising the competencies. We also heard that many public health practitioners do not understand the competencies the way they are currently written. The suggestion was made that the Council on Linkages focus more on simplifying the language of the Core Competencies, rather than making significant changes to the competencies. How do others feel?

Kristine Gebbie


It has been my observation that any competency set needs to be reviewed for possible revising or updating at about 5 year intervals. Over that time, the context in which the competencies are applied may have changed, or the practice field evolved due to new science, or the understanding of how a set of core competencies intersects with professional or organizational competencies evolved. Given that the review process will take several years, starting the process about 3-4 years after adoption of a set makes a good deal of sense.

Janet Place


The HRSA Public Health Training Centers are power users of the Core Competencies and many of them are working with health departments pursuing accreditation. Competency-based training needs assessments are being used to develop staff development plans. With regard to updating the competencies, one of the areas that stands out is the integration of public health and primary care. Too often, public health practitioners do not have the skills to truly be at the table with regards to primary prevention. Too often these integration projects focus on the clinical role of health departments which is still very prevalent, especially here in the south. I also think that we need to work harder to convey the meaning of the competencies, they still read very academically. I am excited about the revision process!

Jack DeBoy


I believe the COL's core competencies were originally intended to be inclusive of the many disciplines within public health and the Council, recognizing this, urged individual disciplines (e.g., epidemiology, laboratory practice, nursing) to develop their own sets of competencies more specific to each discipline. For these reasons the COL's current set of core competencies are set at a higher, broader, or more academic levels than may be especially useful in developing job descriptions for individual public health employees. However, in light of the continuing need and development of more discipline-specific competencies, I do not see the higher-level intent of the COL's set of core competencies to be in any way a shortcoming. I would urge the COL to retain the more general emphasis of its competencies to continue to provide academia, local and state health departments, and private public health entities with the bigger or wider picture of health personnel competencies.

David Knapp


Sitting in a conference in 2003 I was introduced to the Council on Linkages Competencies for Public Health. Being new to the TRAIN experience and still trying to spell Learning Management System (LMS), I realized then that the real value was the ability with in the TRAIN to align these competencies with the courses found therein. Back then we were hanging our hats on certification, the accreditation buzz had not quite made it to us yet, and Healthy People 2020 was a bit out of reach. Public health understands that workforce development, courses and curriculum, assessment and analysis, job description, performance evaluation, Public Health Accreditation Standards, Healthy People 2020 objectives this is the common thread that ties all of this together within the TRAIN LMS and the Council on Linkages Public Health Competencies. Today, we have our Public Health leader’s attention. They see the linkage; they see the documentation trail through the TRAIN LMS. Council, I challenge YOU, YOU have attention of the Public Health audience and they want to use YOUR words, they want to apply YOUR standards, they are beginning to see how this moves them forward into the NEW Public Health, but the competencies, and they still have a difficult time finding the meaning in the words you write. Maybe this is a time for change, for looking at the language of the competencies, to provide explanation and to harness the moment that I first felt back in 2003 sitting in a conference taking it all in.

Diane Downing


It does seem like a good opportunity to begin the process of revising the Core Competencies. As public health responds to changes resulting from the Affordable Care Act it will be interesting to see if the current Core Competencies continue to apply. Could be viewed as a test of the ability of the Core Competencies to stay relevant in times of perhaps dramatic change for public health. During the development of the initial competencies and the last revision process I found the discussion the process generated about the work of public health in general very valuable. I also noticed that 11 health departments have been accredited by PHAB-congratulations to those 11. I would be interested to hear if any of the 11 used the core competencies as they prepared their departments for accreditation. I am looking forward to the revision.

Ron Bialek


We know that at least one of the newly accredited health departments, Livingston County, NY, used the Core Competencies. The health department used a quality improvement tool, a radar chart, to assess competency gaps and needs. As the Council on Linkages considers revising the Core Competencies, it may be useful to read the recent report from Trust for America's Health, "A Healthier America 2013," In this report, "Foundational Capabilities" for health departments are listed and discussed. The Council may wish to consider these capabilities as it reviews and potentially revised the Core Competencies.

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