Evaluating the internalisation of the intrinsic role of health advocacy of student pharmacists in a new integrated Bachelor of Pharmacy curriculum: a mixed-methods study.

To keep up with the contemporary health landscape, there is an imperative need for healthcare professionals to practise health advocacy through health promotion on the individual, population, and systems levels. In the Academic Year of 2020/2021, the National University of Singapore (NUS) Department of Pharmacy implemented a new spiral curriculum integrating basic, clinical, and systems sciences with one of its aims to deepen students' health advocacy internalisation and prepare them as future health advocates. A mixed-methods approach was adopted. Questionnaires were disseminated across three time-points to elicit students' levels of internalisation of health advocacy, which were then categorised into levels, and a Mann-Whitney U test was conducted. In comparison with prematriculation, no significant difference was found after students underwent the first year of the curriculum, while a significant difference was found after students underwent two years of the curriculum. Semi-structured interviews were also conducted after each Academic Year to gain deeper insights into the questionnaire results. Thematic analysis of the interviews revealed that curricular integration in the first year was perceived to be lacking. However, with learnt knowledge constantly reinforced and more experiential learning opportunities incorporated throughout the second year, students found the integrated curriculum beneficial in instilling confidence to practise health advocacy. This study offers insights into the prospects of a spiral integrated curriculum in imparting health advocacy, and may even suggest its potential to be applied to other educational settings. Future follow-up studies can also be conducted on the same study population to evaluate long-term impacts and areas for improvement of the curriculum.

Correlates, motivating factors, and barriers of engaging in regular self-reflection among public health students in higher education-A mixed methods approach.

Despite the wide implementation of self-reflection in higher education, the body of literature has predominantly focused on students from the clinical health sciences rather than public health. The objective of this study was to evaluate the correlates as well as to explore the motivating factors and barriers of engaging in regular self-reflection among public health students in higher education. We used a mixed methods approach (explanatory sequential design), comprising a cross-sectional survey (quantitative phase) followed by in-depth interviews (qualitative phase). We evaluated the association between reflection frequency as well as the perceptions and facilitators in reflection using the modified Breslow-Cox proportional hazards regression model. Prevalence ratio (PR) was generated. Thematic data analysis was carried out to analyse the qualitative data. Quantitative findings revealed being a regular reflector was positively associated with being more motivated to learn when one applied self-reflection (adjusted PR 1.60, 95% CI 1.17-2.20), the perception of being more prepared for a public health career in the future (adjusted PR 1.28, 95% CI 1.02-1.60), as well as being given enough opportunities to carry out self-reflection in the public health modules (adjusted PR 1.24, 95% CI 1.05-1.45). Qualitative findings revealed most students started their self-reflection mainly due to extrinsic factors such as institutional support, social support, teacher influence and environmental influence. Of these, the most prominent was teacher influence, indicating that they are key agents in promoting self-reflection. Students expressed that it would be important to cultivate intrinsic motivation to sustain their practice of self-reflection along the learning journey such as for the development of career-related professional skills. Other than intrinsic motivation, environmental influences were also important to promote continual reflection among students such as the availability of ample opportunities. Prominent barriers to address included external student factors such as the imbalanced power relationship between teacher and student, and internal student factors such as the perception that self-reflection was too cumbersome and time consuming.

An Integrative Approach to Needs Assessment and Curriculum Development of the First Public Health Major in Singapore.

Although public health undergraduate education is increasingly popular in the West, studies describing the needs assessment and curriculum development of public health undergraduate education programs are lacking in the Asia Pacific. The objective of this study was to describe the needs assessment and curriculum development of a second major in public health for undergraduates in the National University of Singapore, the first in Singapore. We used the integrated framework for curriculum development in higher education, which consisted of five stages. In Stage 1, the environment was assessed on the need for a new curriculum. Externally, there was a demand for public health workforce in Singapore based on a review of reports from the Ministry of Health and the job portals. Internally, there was a demand from existing students of the university, along with support from the faculty to offer a new curriculum. There was no university in Singapore offering an undergraduate major program in public health. In Stage 2, competencies to be developed were identified from public health job descriptions using job portals, the needs of public health stakeholders, and competencies listed in the public health curriculum accreditation frameworks such as the Council on Education for Public Health. In Stage 3, based on data triangulation, the curriculum was designed as a second major that is offered to all students of the university from year 2 onward. Students have to complete a total of 12 modules, of which 6 are core and 6 are elective. The capstone module is a 320-h internship module where students will be attached to public health-related agencies, organizations, or non-governmental organizations. Our curriculum is generally aligned with undergraduate public health programs in other established universities in the United States of America, United Kingdom, Australia, and Hong Kong. In Stage 4, various pedagogical strategies were identified for the core modules. We are currently at Stage 5 where implementation, monitoring, and evaluation are still being carried out. We hope that the lessons learnt will serve to inform other universities in the Asia Pacific that are considering implementing such programs and broadening their offerings in public health education.