by Cathryn Meuer aula Casillas came to the Rollins School of Public Health (RSPH) looking for answers. For several years now, she's tracked down Atlantans exposed to syphilis and HIV, counseled them, tried to find their contacts, and lamented that infection rates remained dauntingly high. She felt she needed more training to deal with the challenges she faces each day as a health adviser with the Centers for Disease Control and Prevention (CDC). Casillas was one of the first 24 working public health professionals enrolled in the Graduate Certificate Program at Emory (GCPE), a program that allows students to complete on-line half of the coursework required for a master's degree in public health while they continue to hold down full-time jobs. In programs like the GCPE, the university's location is no longer a major limitation for taking courses because students can learn from anywhere. In academic lingo, this approach is called "distance learning." To the school, the Web-based certificate program is a vital way not only to reach workers in the field but also to equip them with contemporary public health skills. Interest already had been brewing at the school to create a distance learning program when the CDC invited applicants for grants to support such programs in the summer of 1996. The RSPH was one of four institutions awarded the grant. The Woodruff Health Sciences Center at Emory, looking for new ways to educate health care professionals, also contributed funding to develop the program.

After waiting years to find a way to keep her job and get a graduate education, this fall pediatrician Lynne Feldman became one of 34 students in the second GCPE. The district health director from South Georgia joined students logging on from as far away as California and as close by as the Emory campus.

he school developed a cost-effective technology known as eLearn, which is easily accessible for both faculty and students. "We wanted to put the power of the classroom in the hands of faculty members," says William Morse, RSPH director of information services, "so that all they had to know was how to cut and paste, as they would in commonly used software applications." In July 1997 came the real test of whether the program would work. "The system suddenly came into contact with 20-odd critics," principal investigator Frederic Kennedy says of the first GCPE class. Casillas was one of its members, and in many ways, exactly the kind of person the program wanted to reach. She had been in her field long enough to know that current public health practices could use some help from the classroom. As a CDC public health adviser at the Fulton County Health Department's sexually transmitted diseases clinic, Casillas counsels many current or past crack cocaine addicts. Daily, she sees the connection between America's crack epidemic and the spread of diseases such as syphilis and HIV. "Many of our patients are repeat customers who often refuse to name their partners. This means there's always someone left out there who isn't treated and continues to spread the infection." Into this frustrating work came the graduate certificate program with its vision of giving public health workers enough theoretical knowledge and hands-on applications to make an immediate difference. "Complex social problems don't fall into nice, neat little penicillin packages," says Kathleen Miner, associate dean of applied public health. She was active in the development of the GCPE and teaches its Capstone course, in which interdisciplinary teams of students research real cases and devise strategic plans and budgets for providing public health services.

Andy Heetderks dialed in for on-line lectures from across the Pacific while he traveled as a program consultant for the CDC's Division of Tuberculosis Elimination. Because phone service and even electricity aren't available in some places he works, he especially appreciated the convenience afforded by the GCPE.

hile much of the work is done through the World Wide Web, students spend seven sessions on campus receiving instruction in a traditional classroom setting. From the on-campus weeks, students carry home to their computers mental pictures of their professors. Establishing those human relationships can be an important ingredient to making Web-based study work. "In the classroom you can look out at the audience and gauge reactions," Miner says. "If you see blank stares, you ask a question to see if students are keeping up. Using eLearn, students get instructions at their own pace. So gauging comprehension of learners takes on different forms than in face-to-face instruction. For example, we create usage statistics that tell us when students log on and for how long, and we post all student responses on a discussion board." The developers continue to work diligently to make the GCPE Web site interactive, engaging, and easy to navigate for both students and faculty. Each week, students log in at their convenience to hear a prerecorded lecture, to take a self-quiz, or to participate in discussion boards that post other students' comments. The certificate program does not try to duplicate the traditional classroom but rather offers interactive instruction in a way that gives students a sense of community while allowing them flexibility. Students receive applied assignments, opportunities to participate in group projects, and access to lecturers. In the electronic chat room, they have real-time conversations with other students and professors. Participants can even draw on-line, using "whiteboards." Even though the certificate classes are delivered by modem, they maintain the same academic rigor as the traditional classroom setting, says GCPE coordinator Beth Braun. They cover the same graduate-level material and at the end of the semester, GCPE students must demonstrate the same competency as "traditional" students.

rofessors find GCPE students to be more demanding than younger students in the full-time master's program. Older than typical RSPH students, GCPE students have five to 20 years of work experience and want relevant information they can use tomorrow morning, Miner says. They offer much in return. "They are trailblazers, exceptional professionals whose dedication to their education is as strong as any students I've seen. They are our colleagues." Last July, 19 pioneering GCPE students earned the school's first graduate certificates after completing requirements in concentrations such as epidemiology, health policy and management, and health education. But their study isn't necessarily over. Next fall, they can enroll in another new program, the Career Master of Public Health. Many plan to go on for the full master's degree, including Marnell Kretschmer. She's a living endorsement of the program and even timed her second child to arrive at the end of the certificate program and before the start of the Career MPH. Miner is leading the new career masters program effort and anticipates at least half of the interdisciplinary coursework, homework, and tests for that program will take place over the Web, too. Students will come to campus twice a semester for long-weekend sessions. The Career MPH will target people with five to 10 years of experience and will be ideal for those who find it difficult to take time off from work, including Emory faculty and staff.

As a certificate student, an assistant for a state tuberculosis program, and a mother, Marnell Kretschmer says the GCPE coursework was tough and that balancing her workload was even tougher. Still what she learned has already been useful on the job, she says, making it easier to put out statistics on TB control in Kentucky, where she lives.

n the meantime, the GCPE will continue to evolve as the school gains more experience using the Web. At the suggestion of students in the first cohort, the program was extended from 12 to 16 months to provide spring and winter holiday breaks. The school also learned from the first go-around how to better maximize the power of the computer to enhance instruction. "For instance, the Web is growing so fast that the ability to search for appropriate reference material requires new skills," Miner says. "In many courses, we're trying to help students learn appropriate search methodology so they can access credible information that's supported by good science."

As the school grapples with the quickly changing versatility of the Web, it is also discovering hundreds of opportunities for ways to teach and learn. So many options, though, often become considerable fodder for debate: Should simulations and games be used to teach courses? Should class size be limited? Should all courses in the school eventually include some Web content? Whatever the choices, the school is clear on its approach: technology does not drive content; students' ability to learn does. "All our curriculum choices are tailored to learning, and the vehicle for doing that is technology," Miner says. While Emory may never join the ranks of many new "virtual universities," Miner believes that more and more higher education will be on-line as technology evolves. "It will be the way people will communicate and learn," she says, "both in the sense of professional education and education provided in the workforce. It's already part of the way we do business in the workplace." Adds Dean James Curran, "Our distance learning program combines Internet technology with one-on-one student-faculty interaction. This investment in technology of the future allows us to meet the needs of today's public health workforce." To learn more about the GCPE and the Career MPH, visit the GCPE website. Cathryn Meuer is an Atlanta freelance writer. This article is printed in part from Public Health, a publication of the RSPH.

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