Developing the New Columbia Core Curriculum: A Case Study in Managing Radical Curriculum Change

Abstract

Curricular change is essential for maintaining vibrant, timely, and relevant educational programming. However, major renewal of a long-standing curriculum at an established university presents many challenges for leaders, faculty, staff, and students.

We present a case study of a dramatic curriculum renewal of one of the nation’s largest Master of Public Health degree programs: Columbia University’s Mailman School of Public Health.

We discuss context, motivation for change, the administrative structure established to support the process, data sources to inform our steps, the project timeline, methods for engaging the school community, and the extensive planning that was devoted to evaluation and communication efforts. We highlight key features that we believe are essential for successful curricular change.

Many commentators have noted the need for public health education to be dramatically updated to address 21st-century health challenges^1–15 (Begg MD, Fried LP, et al., unpublished manuscript, 2015). As described in two earlier articles,^3,4 the Columbia University Mailman School of Public Health took on this challenge and spent several years designing and then implementing a new Master of Public Health (MPH) curriculum. The rationale for this effort and the ultimate design of the new MPH (the why and the what) are thoroughly reviewed in the earlier articles. In this article, we articulate how we approached the process of radical curriculum change, with a view to providing guidance on change management and evaluation and communication strategies for such a significant undertaking.

CONTEXT

Columbia University founded its school of public health as the DeLamar Institute of Public Health in 1922. It is one of the oldest schools of public health in the nation and is situated in one of the nation’s oldest academic institutions. Columbia itself was established in 1754 as King’s College by royal charter of the English monarch, King George II. Its growth was interrupted by the American Revolution, which caused a cessation of teaching for eight years. The college was reopened with a new name (Columbia) in 1784. A new charter was issued to Columbia by the State of New York in 1810, which remains in effect to this day.

We share this rich history merely to demonstrate that Columbia University is old and steeped in tradition. Some fear that very old, venerable institutions are less amenable to change. Thus we made a case study of change in a well-established institution with ample history, culture, and tradition, making the case that deliberate and planned change can succeed even at such institutions.

MOTIVATION FOR CHANGE

As described in two previous articles,^3,4 Columbia recognized, as did many others with public health institutes, that public health needs are rapidly changing worldwide. Some of the most critical influences on health include globalization, urbanization, climate change, and the aging population. These changes mutually affect health. Scientific knowledge that has emerged in recent years—such as the importance of and capabilities for a life course approach to prevention to ensure that health is optimized into the oldest ages—and an understanding of social and environmental effects on health dictate new content education.

Because of the complexity of the challenges, many have argued for the application of more interdisciplinary and systems-based approaches to problem solving.^1,16,17 Accompanying this position is the strong belief that current educational approaches, many of which have been in place for decades (if not a century), are insufficient for current and future public health challenges.^3,4 This recognition demands curricular change.

When Linda Fried came to Columbia as dean of public health in 2008, she engaged faculty in a strategic planning process, one component of which focused on public health education. At a faculty assembly in early 2009, she presented data on changing health needs and scientific capabilities and data from student course evaluations and graduate exit surveys that supported the argument for change. She clarified that longer careers and longer lives mean that public health students now need to be educated to lead through 2050 and to be able to place specific disciplinary foci in the broader context of the complexity of public health challenges.

It was clear that the field of public health practice needed to change and that public health leaders had to be able to lead the redesign of a health system so that it improved population health. Fried appealed to the faculty’s dedication to students and their desire to ensure strong preparation for the next generation of public health leaders. Faculty responded with enthusiasm and expressed their desire to engage in a comprehensive reexamination and renewal of the MPH curriculum.

STRUCTURE FOR CURRICULUM RENEWAL

The faculty gave their assent for major curricular change in April 2009. The dean’s office took the next several months (until the end of the fall 2009 semester) to consider various structures to facilitate change. In February 2010, Dean Fried asked Sandro Galea, chair of the Department of Epidemiology, to take the lead in designing the new curriculum. Further, she rallied the financial resources to support faculty leadership for change.

The school’s approach from the start was to encourage a bottom-up strategy, leveraging the strength and experience of the Columbia teaching faculty. Clearly a bottom-up approach would require more time and patience than would a top-down approach, but Galea and Fried felt strongly that this was critically important for the success of this venture.

Galea, in consultation with the dean and other school leaders, created the Curriculum Renewal Task Force, which included representatives from every department and academic unit in the school, ensuring that key constituents contributed to the entire process. There were a dozen members in all, including a representative of each of the school’s six departments, a student representative, the task force chair, and four individuals from the dean’s office representing educational programs and student affairs. Members of the Curriculum Renewal Task Force from outside the dean’s office received partial salary coverage (on average, 10%–20% of their annual salary) for their extensive work within and outside the task force.

Out of this central committee came 10 subcommittees, each led by a member of the task force. The 10 subcommittees focused on the following areas:

1. The integrated core curriculum

2. Disciplinary education and dual degrees

3. Certificate programs

4. Integration of science and practice

5. Integrative practicum experience

6. Leadership and innovation

7. Transforming the educational experience (with technology)

8. Ongoing curricular review

9. Department operations and implementation

10. Student advisory group

The design phase took place from March 2010 through about August 2011. In September 2011, the implementation phase began under the oversight of Melissa Begg, professor of biostatistics and the school’s vice dean for education.

INPUTS FOR CHANGE

The curriculum renewal process was data intensive. Data collection and review efforts in the design phase included systematic reviews of the published literature on public health education; analysis of curricula at leading schools of public health; student course evaluations; graduate exit surveys; alumni surveys; employer surveys; interviews with leaders in the field; focus groups with current students; town hall meetings with current faculty, staff, and students; and written feedback from members of the Columbia Mailman community. These were collected via a specially designated curriculum renewal Web site.

The last two approaches warrant further comment. At each of the many town halls conducted, all members of the Mailman community were invited to participate, and the moderator vowed to remain in the room until the last question was answered to reassure the community that all voices were heard and valued. In addition, all written materials for the new curriculum were posted on a dedicated, password-protected Web site, and feedback on those materials was collected electronically. Every comment posted received a response.

The task force duly considered all comments and suggestions and then provided written responses to all of them. The task force adopted many, but certainly not all, excellent suggestions for change (many comments contradicted each other, reflecting the diversity of opinion on crucial curricular elements). However, if a suggestion was not accepted, an explanation for the decision was always provided, so no comment went unheeded.

The ultimate design of the Columbia MPH curriculum is thoroughly described in an earlier article⁴; very briefly, it includes (1) an integrated and intensive core semester experience that emphasizes a life course approach to prevention; (2) a new, case-based course called Integration of Science and Practice designed to foster decision making and critical thinking skills; and (3) a new course, titled Leadership and Innovation, intended to develop skills in communication, teamwork, leadership, and professionalism and an enhanced capacity for novel thinking.

PROJECT TIMELINE

Change at such a dramatic level requires careful planning and execution, which in turn requires considerable time. Initially some key participants argued for a launch of the new curriculum in the fall 2011 term, but others argued forcefully for a fall 2012 launch; the latter group prevailed.

The timeline was set to devote approximately 18 months to the design phase of the project, followed by 12 months for the implementation phase, before the start in September 2012. Figure 1 shows how the overall timeline took shape.

FIGURE 1—

Timeline for Master of Public Health curriculum renewal initiative: Columbia University, Mailman School of Public Health New York, NY.

Note. CR = curriculum renewal.

ENGAGING THE SCHOOL COMMUNITY

Faculty, staff, and students were deeply involved in every step of the curriculum renewal process. They joined subcommittees and attended focus groups and town hall meetings. More than 400 individuals sought and were granted access to the curriculum renewal Web site; no one who requested access was ever denied. Faculty participated in numerous teacher-training programs and workshops designed for curriculum renewal—with particular focus on the use of case approaches to teaching and methods for generating more active student engagement in the classroom. The original set of cases to be used in the new curriculum were not generated by faculty but by a case–method expert based in Columbia’s Journalism School.¹⁸ The public health cases have been placed on a Web site for potential purchase by other programs and educators.¹⁸

Interdisciplinary teams of faculty from multiple departments designed, and would teach, most new core modules. This was a significant departure from the tradition and prior practice of the school. Therefore, frequent meetings were held for faculty developing each new course in the shared curriculum to give ample opportunity to develop a common language, identify complementary strengths, and gain experience in working together across disciplines. All faculty identified in fall 2011 as instructors in fall 2012 received support for 10% of their annual salary one full year in advance of the launch of the new curriculum to cover their efforts during the preparatory year.

Once teaching began in fall 2012, faculty received compensation for teaching in proportion to the length of the modules they taught; specifically, a faculty member teaching the equivalent of a full-semester, three-point course would receive support for 20% of her or his annual salary for a full year. Shorter teaching engagements were prorated according to this standard. Faculty members at Mailman are expected to cover their salaries through a combination of teaching and grant-funded research. Most involved in the new curriculum were able to continue their department teaching in addition to teaching in the core curriculum, and a few may have reduced their effort devoted to grant-funded projects (although we believe this was rare).

EVALUATION AND COMMUNICATION PLANNING

Starting in 2012, Columbia offered an MPH curriculum like none that preceded it in terms of broad content and interdisciplinary emphasis. Embarking on such an ambitious initiative involved risk. To best manage that risk, the curriculum renewal leadership devoted considerable time and attention to the development of continuous evaluation and feedback mechanisms to ensure that problems (which were inevitable when enacting such dramatic changes) could be identified as soon as they emerged and to minimize their negative impacts and rapidly generate solutions. Evaluation experts from throughout the school met to develop and hone plans. Figure 2 shows the elements incorporated by the plan they adopted.

FIGURE 2—

Key elements of the evaluation and communication plan: Columbia University, Mailman School of Public Health, New York, NY.

Note. CR = curriculum renewal; ISP = integration of science and practice.

We remained in close communication with other university officials throughout the process of curriculum renewal to ensure that all steps were appropriately reviewed by key members of the provost’s office and the Education Subcommittee of the University Senate. All parties demonstrated strong support through all steps in planning and implementation.

CONCLUSIONS

There are several key elements that were essential to a successful curriculum renewal process. First was the commitment of the dean, who provided the charge and financial, political, and moral support throughout the design and implementation phases of the project. Second was broad ownership of the new curriculum. The involvement of 170 faculty, staff, and students as well as alumni and employers ensured buy-in at multiple levels.

Third, open communication, respectful dialogue, and numerous modes and opportunities for feedback provided comfort and reassurance to our many constituents throughout a lengthy, complex, and somewhat frightening process. Fourth, the project required sufficient time for the design and implementation phases, and a premature launch could have been extremely damaging. Finally, thoughtfully designed evaluation processes ensured that problems could be identified and addressed early, before they could blossom into much larger concerns.

We learned a great deal in the curriculum renewal experience at Columbia. Our faculty learned to work together in a more highly interdisciplinary fashion and came to recognize that they had more in common than previously thought. Because faculty members were heavily involved in the process from the start, they felt deeply invested in the curriculum renewal initiative and eagerly volunteered to participate in its teaching.

This enabled us to recruit some of the most senior, respected, and effective educators throughout the school. As a result, our new MPH curriculum has had a strong start, as demonstrated by an analysis of the first two years of evaluation data in a companion article. (Begg MD, Fried LP, et al., unpublished manuscript, 2015). Ongoing monitoring, evaluation, and updating (following steps similar to those we have outlined) are essential to ensure its healthy continuation and effectiveness.