by Cathryn Meuer aula Casillas came to the Rollins School of Public Health looking for answers. For several years now, she's tracked down Atlanta residents exposed to syphilis and HIV, counseled them, tried to find their cont acts, and lamented as year after year infection rates have 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 is one of 24 working public health professionals enrolled in the Graduate Certificate Program at Emory (GCPE). The program allows students to complete half of the coursework required for a master's degree in public health while they continue t o hold down full-time jobs. In this new age of technology, more than half of the coursework takes place on-line. In academic lingo, this approach is called "distance learning." To the school, the Internet-based certificate program is a vital way not only to reach workers in the field but also to equip them with contemporary public health methods.

Paula Casillas is one of the first graduates of the Graduate Certificate Program, directed by Tina Paul.

nterest 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 Rollins School of Public He alth was one of four institutions to receive the support. The Woodruff Health Sciences Center at Emory, looking for new ways to educate physicians, also contributed funding to develop the program. The school had nine months to not only adapt coursework for the Internet but also develop the program's technological infrastructure. Frederic Kennedy took on the role of principal investigator, while the technology development fell to William Morse Jr . and Stuart Myerburg. Morse, director of Information Services, designed the infrastructure with two goals in mind: the technology--known as eLearn--had to be cost-effective, and it had to be easily accessible for both faculty and students. "We wanted to put the power of the classroom in the hands of the faculty members themselves," Morse says, "so that all they had to know was how to cut and paste, just as they would in many commonly used software applications." Myerburg, who manages special web projects at the school, actu ally built the site. With the infrastructure development under way, faculty throughout the school went to work on adapting basic courses for presentation via the computer. Tina Lynn Paul, the GCPE director, took on the management and evolution of the program, training facu lty to adapt their teaching for the new format and working with the technical experts to design the system.

Tina Lynn Paul directs a program that allows graduate students to take classes over the Internet.

n July of 1997 came the real test of whether the program would work. "The system suddenly came into contact with 30-odd critics," Kennedy says of the first class to enroll in the GCPE. Casillas was one of th ose class members. In many ways, Casillas is exactly the kind of person the program wants to reach. As a CDC public health adviser, Casillas has been stationed at the Fulton County Health Department STD clinic, across the street from Grady Memorial Hospital in downtown A tlanta, since September 1994. Before that, she staffed an STD clinic in Long Beach, California. In other words, Casillas has been in her field long enough to know that current public health practices could use some help from the classroom. "Many of our patients are repeat customers who are familiar with the system and often refuse to name their partners," Casillas says. "This means there's always someone left out there who does not get treated and continues to spread the infection." Many of the people Casillas sees in the clinic are current or past crack cocaine addicts. On a daily basis, she sees the connection between America's crack epidemic and the spread of diseases such as syphilis and HIV. Into this frustrating work comes t he graduate certificate program with a vision of giving public health workers enough theoretical knowledge and hands-on applications to make a difference right now. "Complex social problems don't fall into nice, neat little penicillin packages," says Kath leen R. Miner, associate dean of applied public health, who has been active in the development of the GCPE and teaches its Capstone course.

hile much of the work is done through the Internet, students do spend six separate weeks on campus receiving instruction in a traditional classroom setting. From the on-campus weeks, students carry mental pi ctures of their professors home to their computers. Paul believes that establishing those human relationships are important if Internet-based study is going to work. "In the classroom you can look out at the audience and gauge reactions," Paul says. "If you see blank stares, you ask a question to see if students are keeping up. But over the Internet, you run the risk of the student just floating away or feeling iso lated." For that reason, the developers have worked diligently to make the GCPE web site interactive, engaging, and easy to navigate for both students and faculty. In Paul's office, she clicks past the day's two dozen e-mail messages to give a tour of the GCPE website. Each week, students log in at their convenience to hear a pre-recorded lecture, to take a self-quiz, or to participate in discussion boards that post other students' comments. "The program allows a lot of flexibility," Paul says. "Students can join in a discussion and have conversations with each other, but they don't have to be on-line at the same time." When students do wish to participate in a real-time discussion, they h ave access to an electronic chat room, where their comments can be read by others in the program as they type on keyboards. Professors hold office hours in these chat rooms. Participants can even draw on-line, thanks to the technology of a whiteboard. The certificate program does not try to duplicate the traditional classroom but rather to offer instruction to students in a way that gives them a sense of community while allowing them flexibility. Through the GCPE, they receive applied activities and assignments, an opportunity to participate in group projects, access to lecturers, and, in the chat room, real-time conversations with professors and other students. Paul emphasizes that although the certificate classes are delivered by modem, they are rigorous. "These are not correspondence courses or simple night school classes," she says. "They cover the same material as the traditional MPH program, and at the e nd of the semester, the students have to pass the same tests."

Marnell Kretschmer wants to continue her studies at the Rollins School of Public Health and has timed her next child to arrive at the end of the certificate program and before the start of the Career Master of Public Health.

s a certificate student, an assistant for a state tuberculosis program, and a mother, Marnell Kretschmer can verify that the coursework has been tough, and balancing her workload even tougher. Still the know ledge gained has already been useful on the job, she says, making it easier to put out statistics on TB control in Kentucky, where she lives. Her coursework also has helped her decide how to allocate limited funds. Andy Heetderks has dialed in for an on-line lecture from across the Pacific in his frequent travels as a program consultant for the CDC's Division of Tuberculosis Elimination. Because phone service and even electricity aren't available in some location s where he works, he especially appreciates the convenience afforded by the GCPE. "The beauty of the program is in the middle of the night you can do your homework," he says. Professors have found this group of students, who are older, with five to 20 years of work experience, is more demanding than younger students in the full-time master's program. They want relevant information they can use tomorrow morning, Miner says, but they offer much in return. "They are trail-blazers, pioneers, an exceptional group of professionals whose dedication to their education is as strong as any students I've seen. They are our colleagues." Chris Parker, another GCPE student, brings with him a success story in exactly the kind of community involvement now considered crucial for public health programs. Over several years spent working on sexually transmitted diseases in Miami, Parker nurtu red a grass roots group that tackled the spread of HIV. That local group has grown to such an extent that this spring it is hosting a two-day national meeting on drugs, crime, and HIV. "Community coalitions are becoming much stronger now," Parker says. "W hen you empower a community to do one thing, you basically empower them to do other things, too." So far, Parker's career has presented him with what he calls a "bottom-up" perspective on public health issues. In Miami, he found the fragmented delivery of health services frustrating. "If you were to go to Liberty City and take any one of those home s, the person living there was probably being served by as many as ten different people. One worker from the criminal justice system might go see little Johnny when he was caught with drugs. An STD worker would visit to tell him he's been exposed to syphi lis. A TB worker would get involved. It feels like we are recycling that person through the public health system." With the certificate program, Parker hopes to gain more "top-down" understanding to help change the system.

A frequent business traveler, Andy Heetderks enjoys the convenience of the GCPE, often calling from remote locations around the world.

n July, the 24 pioneering students of the GCPE will earn the school's first graduate certificates. But their study will not necessarily be over. In January 1999, they can enroll in another new program, the C areer Master of Public Health. Many are already planning to go on for the full masters degree, including Marnell Kretschmer, who studies at night after her 2-year-old is asleep. Kretschmer is a living endorsement of the program. She wants to continue her coursework and has even timed her next child to arrive at the end of the certificate program and before the start of the Career MPH. While the new masters program is still in development, Kathy Miner, who is leading the effort, anticipates at least half of the coursework, homework, and tests for that program will take place on the Internet, too. She insists that more and more higher education will be on-line as the technology evolves. Kennedy agrees that distance learning is the mechanism of the future. "Distance learning has a definite role to play, for example, with international public health students, who can come to campus for only a short period of time, or, for that matter, t he student in south Georgia who can't leave a job to attend classes in person," he says. To learn more about the GCPE and the Career MPH, visit their online site: http://web.sph.emory.edu/gcphome.html.