Round 2 March 19 to April 2, 2010

This effort is supported by a Cooperative Agreement with the CDC Office of Public Health Preparedness and Response. 2

Speakers C. William Keck, MD, MPH Akron Health Department, Retired, and Professor Emeritus, Northeastern Ohio Universities Colleges of Medicine and Pharmacy Kristine Gebbie, DrPH, RN Joan Grabe Dean, Hunter-Bellevue School of Nursing City University of New York Elizabeth Ablah, PhD, MPH Assistant Professor, University of Kansas School of Medicine 3

Objective of Todays Webinar To review the project tenets, target audience, and the Round 2 format and content so that respondents both understand the key issues are prepared for the responding process. 4

Agenda, Project Tenets, Target Audience, and Performance Level 5 C. William Keck, MD, MPH

Agenda 6 TimeTopicSpeaker(s) 1:00 – 1:05 p.m.Welcome and IntroductionsLiz Weist 1:05 – 1:20 p.m.Webinar agenda Project tenets, target audience, and performance level Bill Keck 1:20 – 1:45 p.m.Competencies 101 Draft domains and competencies Round 2 instructions Kristine Gebbie and Elizabeth Ablah 1:45 – 2:00 p.m.Questions from the AudienceKristine Gebbie

Project Charge To develop a model of core competencies for all-hazards public health preparedness and response 7

Pandemic and All Hazards Preparedness Act 2006 (PAHPA) PAHPA, Section 304(d): The Secretary, in collaboration with the Centers for Public Health Preparedness and other public or private entities shall… Establish core curricula based on established competencies leading to a 4-year bachelors degree, a graduate degree, a combined bachelor and masters degree, or a certificate program Facilitate the development of a competency- based training program to train public health practitioners 8

Project Tenets The resulting competency model will: Provide a proposed national standard of public health preparedness and response skills for mid- level public health workers across all sectors and settings Apply to all-hazards scenarios Be behaviorally-based; focusing on observable actions Reflect and build upon existing competency models Supplement existing core public health competency models

Project Tenets (continued) The resulting competency model will: Align with the Department of Homeland Security Target Capabilities List, spanning across the prevent, protect, respond, and recover missions Inform curricular planning for the public health workforce Be utilized by the CDC Centers for Public Health Preparedness 2010 grantees Be available to other public and private entities

Target Audience The model will represent individual competencies that public health mid-level workers, regardless of their employment setting, are expected to demonstrate to assure readiness. It includes neither entry-level workers with limited experience in public health nor staff in designated high-level leadership positions.

Target Audience (continued) The model defines a mid-level public health worker as an individual with: –10 years experience and a high school diploma, bachelors, or higher degree, or –5 years experience with an MPH equivalent or higher degree

Target Audience (continued) Aside from years of experience and education, these workers may have responsibilities for: -- Program support, coordination, development, implementation, management and/or evaluation; -- Supervision; -- Establishing and maintaining community relations, presenting arguments and recommendations on policy issues, etc.

Target Audience (continued) Some examples: Administrative supervisors, such as purchasing managers and human resources staff Chief clerks of vital records Public health nurses who run well-child clinics and/or who may assist with epidemiological tasks Public health sanitarians who undertake routine food, water, pool, and/or restaurant inspections; and/or who may help with epidemiological tasks; and, Senior lab technicians who support lab scientists and others in organizing, conducting, and reporting lab tests.

Target Audience (continued) Why are office and administrative workers included in this group? PAHPA legislation specifically includes all workers, a term that extends beyond the health professions usually included. The experience of the non- professional workers identified in this model (at least 10 years in a public health organization) makes them key participants in any major response.

Performance Level The model will target proficiency as the level of competence that public health workers are expected to demonstrate to assure readiness. Other workers may be required by a specific position or activity to achieve expert competence.

Round 1 to Round 2 Round 1 (September 2009) included 11 domains and definitions and was commented upon by 223 respondents Round 2 (to be released on Friday March 19) will include nine domains and 29 competencies

Kristine M. Gebbie, DrPH, RN Competencies 101

What will be reviewed Defining competency Uses of competencies Application to this target audience Competencies and capacity Outcomes from previous workgroups

Definition "a cluster of related knowledge, skills, and attitudes that affect a major part of one's job (a role or responsibility), that correlates with performance on the job, that can be measured against some accepted standards, and that can be improved via training and development. Parry, S.R. "The Quest for Competencies." Training, July 1996, p. 50.

How do competencies fit in? Workforce competencies Instructional Competencies & Curriculum Organizational performance Individual worker performance Intervening variables

Competency an individual measure of applied skills and knowledge that enable people to perform work. consists of –action verb (observable or measurable performance of a worker) –content (subject matter, type of performance, specific task) –context (limitations or conditions of work environment).

Uses of competencies Components of job descriptions. Training needs assessments. Curriculum development. New employee orientation and employee training. Self-assessment by workers.

Education or the workplace? Workplace statements –complex performance within the workplace, akin to KSAs of job classifications. –a series of embedded tasks that are either sequential or parallel. –demonstrated over long periods of time. –require contextual measurement. –allow for a range of indicators to measure competence.

Example of a workplace competency A public health worker responds to an emergency event within the emergency management system of his/her program, organization and community.

Education or the workplace? Instructional Competencies –the building blocks of learning experiences. –structured learning activities. –require higher levels of performance to be built upon lower level ones. –determine the measurement indicators. –require measurement in the short term.

Example of an instructional competency At the completion of this course, the MPH student will be able to design a community assessment process that is guided by information about exposure or potential exposure to CBRNE

Instructional Framework Domain Area: (9 domains) Topic Area: Competency A Learning Objective 1 Indicator(s) Learning Objective 2 Indicator(s) Competency B Learning Objective 1 Indicator(s) Learning Objective 2 Indicator(s) Essential Important Suggested NA Job relevance

Blooms Taxonomy KNOWLEDGE COMPREHENSION APPLICATION ANALYSIS SYNTHESIS EVALUATION Increasing independence

Sample Skills by Blooms Taxonomy Application: practice, calculate, compute, sketch, illustrate, interview, operate, simulate, demonstrate, apply, schedule, utilize, relate, diversify Analysis: interpret, test, differentiate, scrutinize, investigate, compare, contrast, discriminate, distinguish, question, manipulate, dissect, estimate, measure

Competencies combine Knowledge: facts and figures Skills: psychomotor or mental operations Attitudes or values: perspectives or ethical frameworks

Level of worker expertise Novice: new to a skill or attribute –New to that level –May be a seasoned professional with limited exposure to the area. Proficient: detailed knowledge in area –Can perform the competency well without reference materials or guidance Expert: mastery of a skill –Can perform the competency even under adverse conditions or without usual supports.

Warning! If you change the verb, you change the competency Mastery Complexity of competency NoviceProficientExpert Knowledge Application Synthesis & critique

Our target audience: workers Employees of public health organizations (or organizations carrying out public health functions) Not limited to professionals Adding these competencies does not change the basic job description or worker competence in other areas

Core, not specialized Core means all of them for everyone! These competencies will NOT turn every mid- level worker into –An emergency planner, or an interagency incident commander –An epidemiologist, laboratorian, public health nurse or other specialist There will be workers on both sides of this group

Competencies, not capacity Competencies are what the worker is able to do Capacity is what the organization is able to do Organizational capacity is dependent upon, but more than, the competencies of its workforce: –Equipment –Budget –Policies and systems –Access to information

Nine Competency Domains and 29 Competencies A link to the two-page summary of the competencies was included in the ed webinar invitation you received. 37

Competency Domains 1.Communication 2.Hazard, Vulnerability, and Risk Assessment 3.Interventions 4.Leadership 5.Legal 6.National Response Framework 7.Planning and Improvement 8.Surveillance and Investigation 9.Worker Health, Safety, and Resilience 38

Draft Competencies 1) Communication 1.1 Manage information related to a response. 1.2 Deliver key messages using principles of crisis and risk communication. 2) Hazard, Vulnerability, and Risk Assessment 2.1 Contribute subject matter expertise to a general community hazard vulnerability analysis (HVA). 2.2 Analyze specific threats to ones own responsibilities or program in health emergency(ies). 2.3 Plan mitigation approaches for vulnerabilities specific to ones own responsibilities or program. 39

Competency Domains 3) Interventions 3.1 Perform preparedness activities consistent with duties, responsibilities, and role(s). 3.2 Perform response activities consistent with duties, responsibilities and role(s). 3.3 Perform recovery activities consistent with duties, responsibilities, and role(s). 40

Competency Domains 4) Leadership 4.1 Solve problems within event context. 4.2 Manage emotional responses to an event in self and others. 4.3 Facilitate collaboration with team members and across sectors. 4.4 Maintain situational awareness. 4.5 Maintain respect for all persons and cultures. 41

Competency Domains 5) Legal 5.1 Act within the scope of ones legal authority for the most effective public health response. 5.2 Refer issues/matters that are outside the usual scope of legal authority through the chain of command. 5.3 Propose improvements in use of law for ongoing and future emergency response. 6) National Response Framework 6.1 Perform assigned role within the organizations incident command structure. 42

Competency Domains 7) Planning and Improvement 7.1 Contribute subject matter and programmatic expertise to the development of preparedness and response plans. 7.2 Identify opportunities for improved response based on experience in exercises and/or real events. 8) Surveillance and Investigation 8.1 Report information potentially relevant to both the identification and control of public health emergencies through the chain of command. 8.2 Collect information according to protocol. 8.3 Manage the recording or transcription of epidemiological data according to protocol. 43

Competency Domains 9) Worker Health, Safety, and Resilience 9.1 Maintain family emergency preparedness plans to reduce unnecessary stress. 9.2 Perform basic Psychological First Aid. 9.3 Apply First Aid, CPR, and an AED in accordance with established standards. 9.4 Monitor physical and mental health risk and protective factors in self and others. 9.5 Modify behaviors and attitudes according to changing conditions and personal limitations. 9.6 Communicate unresolved threats to physical and mental health to self and others through chain of command (Pre, during, and post-event). 9.7 Comply with competent instruction for use of personal protective equipment. 44

Round 2 45 Elizabeth Ablah, PhD, MPH

Responding to Round 2 You will be asked to comment on 29 draft competencies for nine domains. Round 2 is organized by the nine domains. Each page contains the domain title, domain definition, and draft competencies. Existing domain titles and definitions are not open for comment in Round 2. You will be given an opportunity to suggest new domains. Focus on substantive changes to competencies. Do not worry about grammar. 46

Responding to Round 2 Options for each competency Accept as is -- proceed to next question Suggest change -- write changes in text box If you need to leave Round 2, you will be able to return to complete it using the same link, which is unique to your address. The deadline is 5pm EST on Friday April 2. 47

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