Applied Practicum Registration Form – EGC || Field Education and Practice

ID Number

Full Name

First Last

Starting Date

MM slash DD slash YYYY

Foundational Competences

Foundational Competences (select 3)*

Apply epidemiological methods to settings and situations in public health practice

Select quantitative and qualitative data collection methods appropriate for a given public health context

Analyze quantitative and qualitative data using biostatistics, informatics, computer-based programming and software, as appropriate

Interpret results of data analysis for public health research, policy or practice

Compare the organization, structure and function of health care, public health and regulatory systems across national and international setttings

Discuss the means by which structural bias, social inequities and racism undermine health and create challenges to achieving health equity at organization, community, and systemic levels

Assess population needs, assets and capacities that affect communities' health

Apply awareness of cultural values and practices to the design, implementation, or unique critique of public health policies or programs

Design a population-based policy, program, project or intervention

Explain basic principles and tools of budget and resource management

Select methods to evaluate public health programs

Discuss the policy-making process, including the roles of ethics and evidence

Propose strategies to identify stakeholders and build coalitions and partnerships for influencing public health outcomes

Advocate for political, social or economic policies and programs that will improve health in diverse populations

Apply leadership and/or management principles to address a relevant issue

Apply negotiation and mediation skills to address organizational or community challenges

Select communication strategies for different audiences and sectors

Communicate audience-appropriate (i.e., non-academic, non peer audience) public health content, both in writing and through oral presentation

Describe the importance of cultural competence in communicating public health content

Integrate perspectives from other sectors and/or professions to promote and advance population health

Apply systems thinking tool to visually represent a public health issue in a format other than a standard narrative

MPH Generalist Competencies and Product Identification

Please select 2 options from the first part of this section. At the latter, please provide information on products you think will be produced from this internship and how it can be linked to the competencies you selected.

MPH Generalist Competences

Apply health promotion skills specific to low resource settings to improve the well-being of communities.

Apply tools and concepts beyond the traditional public scope to innovatively solve health challenges at the district level.

Apply standards of professionalism, principle-based practice and ethics in addressing public health issues through public health practice and research.

Apply entrepreneurial thinking skills and dimensions through a public health approach to solving community health problems.

Demonstrate effective community engagement skills for public health practice, including activities that inform, educate and empower targeted audiences.

What two products will be produced from this internship. Indicate how the products are linked with the selected competencies.

Literature review

Qualitative data analysis

Quantitative data analysis

Research proposal

Data visualization

Needs assessment

Survey designs

Program design

Program evaluation

Advocacy

Forecasting/modelling

Institution/Organization Information

Preceptor Organization

Broad Organization Type

Consulting firm

Healthcare organization

Higher education

Other Government Agency

NGO Social Service Organization

NGO Health Organization

Other

Specific Agency Type

Clinic

Hospital/ Medical Center

School/ University

Other (please specify)

Name of precepto

Title of precepto

Professor

Mrs

Miss

Other (please specify)

Email address of preceptor

Phone number of preceptor*

Highest academic qualification of preceptor

PhD

Masters

Bachelors

Diploma

Other (please specify)

Public health discipline represented within the organization.

Community health education

Epidemiology

Health policy/ management

Biostatistics

Environmental Health

Other (please specify)

Specific program (s) with which an intern might assist with.

Data collection

Data analysis and visualization

Community health education

Community diagnosis

Research

Other (please specify)

This field is for validation purposes and should be left unchanged.

Foundational Competences

MPH Generalist Competencies and Product Identification

Institution/Organization Information

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