Hello, everyone, and welcome to Idea Exchange, a podcast by the Association of Schools and Programs of Public Health. I'm your host, Miranda Bosse, and today we are joined by Dr. Miruna Buta, who is the Associate Teaching Professor in the Department of Health Systems and Population Health, as well as director of the online MPH program at the University of Washington. Dr. Buta's work focuses on creating inclusive and effective learning environments for future public health researchers and practitioners. Her research has explored healthy aging, organizational and social networks, and the dissemination and implementation of evidence-based programs. She is also the co-author of the playbook Teaching Public Health Writing from Fundamentals to Adaptations in the Age of Artificial Intelligence. And we'll be talking about that playbook today on today's episode. Today, we will also be talking about writing, learning, artificial intelligence, and what the future of public health education might look like in an AI-driven world. Dr. Buddha, thank you so much for joining me today. It is so great to have you.
SpeakerThank you for inviting me. I'm looking forward to our conversation.
Speaker 1Yeah, me too. So, first, I'd like to start out by highlighting a little bit about your journey into public health and your career thus far. So you've really built a career at the intersection of public health, education, and communication. So I'm curious, what originally drew you into public health and what has your journey at the University of Washington looked like thus far?
SpeakerYeah, um, so what drew me to public health was the ability to have an impact at a large scale and to use my research and social services training to do so. But my road has been somewhat unusual. So I was born in Romania and um I have a social work degree from Romania, and then I worked there as a juvenile probation counselor. I was one of the first uh juvenile probation counselors in Romania. We were trained by Dutch and British specialists to use this approach for juvenile probation that focused on keeping kids out of jail and into the community.
Speaker 1Okay.
SpeakerUm and I worked in one of the poorest neighborhoods in Bucharest. And while working with these kids who found themselves in a world of crime, I started to think about, you know, what I've come to think about as the social determinants of crime. What are the reasons why we kept seeing the same kids from the same kinds of families get into these difficult situations? And that prompted me to seek more knowledge and try to understand, seek more education, to try to understand what are some of the bigger picture systemic issues that our country was facing, but in general, that leads to kids ending up in these situations. Right. And so I ended up getting a master's degree in European social policy in Bucharest, um, and then a PhD in sociology from University of California, Irvine. And while I was doing my PhD in sociology, I became uh very much involved in um learning and applying social network analysis, which is this approach to research that focuses specifically on understanding patterns of relationships among different entities. And then at some point, I um I became very engaged in all of the you know statistical models and all of the nitty-gritty of analyzing data, this aha moment of wait a minute, I'm a social worker. Where I am right now is not satisfying for me. And so that uh prompted me to look at an impact, and that's how I uh transitioned to public health. And I had the opportunity to become part of the Department of Health Systems and Population Health at University of Washington.
Speaker 1Oh, great. No, that's really interesting to hear. So thank you so much for sharing your story and your unique path into public health and kind of how you started out working in social work and you know, working with um, you know, youth in the community and everything, because again, there's no one path that we all take in public health. So I love hearing how, you know, your unique path took you down this road and kind of where you ended up today at University of Washington. I'd like to transition into your playbook. You know, this is something we had connected early on about. You're teaching uh public health writing from fundamentals to adaptations in the age of artificial intelligence, uh, this playbook that you co-authored with Kelly Pasco. So, one of the most memorable lines in your playbook is writing is public health. It's what makes public health public. So, in your perspective, what does that phrase really mean to you?
SpeakerThank you for this question, Miranda. First of all, I want to acknowledge that the playbook that Kelly and I created owes a lot to the work of Jennifer Beard from Boston University, whose book, Teaching Public Health Writing, that came out a few years ago, really ignited the conversation in our field about how we teach our students this crucial tool. Um, it was in Jennifer's book that I encountered this quote, which turns out to be from an article led by uh Laura Magana, the ASPPH president and CEO, describing the launch of the ASPPH Regelman writing and public health program.
Speaker 1Okay.
SpeakerSo, in my view, saying that writing is what makes public health public highlights the importance of communication in our field. If the mission of public health is to create the conditions in which people can be healthy, then we need to be able to convey clearly and succinctly what we know contributes to people's health. I think that communication is also important because our main job is to create an environment in which diseases and accidents do not happen and people are able to thrive. So our work is often invisible. It's about prevention. And I think this contributes to the current lack of understanding of what public health does and why it's essential for our society. And so, because of this, articulating and spreading the word about the work that we do is something we're able to do well.
Speaker 1Yeah, no, I I couldn't agree more. So thank you for sharing that because it's it's really crucial, you know, the way we communicate about public health. And you're so right, speaking to a lot of the, you know, things that are happening right now, you know, the way we communicate to our constituents and to communities as public health practitioners is so important. And so where does that start? You know, right with our classrooms and with our academics. So I love that you alluded to that. So your framework highlights that public health writing isn't just academic writing, it includes, you know, policy briefs, infographics, social media, and community outreach, and so much more. So, kind of alluding to what you were just talking about, why is communication versatility so critical in public health today?
SpeakerYeah, I think communication versatility really ties into this idea that people need to be exposed to our messages and to understand them. Yeah. So we have to think about who is our audience, how they access information, and what level of detail or scientific jargon they need to be able to act on the information. For instance, policy briefs, right, which is one of the things that that we use in our in our field that we teach our students how to write, these are often aimed at decision makers who don't have the time to review the scientific literature and are not experts in the field, but would like to make evidence-based decisions about the health of their communities. Because they have limited funding, they have limited resources, and they want to make sure that those resources go towards solutions that have been proven to work. And in this case, having a policy brief that summarizes the evidence, compares solutions, and provides recommendations is a way to ensure that decision makers have access to the research that best addresses the health issue they're trying to tackle. Another example that I love and I find extremely useful comes from my hometown of Seattle and specifically from the work of Public Health Seattle in King County, our local health department. They created this four-tiered system for rating the food safety of local eating establishments from excellent to needs to improve. And the innovative and fun part of this campaign is that each restaurant in King County now displays in its window a sign that shows the rating it has received with the excellent status depicted by a big smiley emoji on a green background. So green as in go, go, go. Yeah. And then needs to improve status is depicted by a concerned emoji on a gray background. So I think that this campaign is an excellent example of public health communication because it accomplishes several things, right? It gives people a quick, easy way to access the safe to assess the safety of an eating establishment before entering it.
Speaker 1For sure.
SpeakerIt does that in a way that people with different levels of health literacy or English language proficiency can easily understand. And it lets people know that the local health department is looking out for them, right? So it brings together all of the things of these things that I think are important for our uh work and our mission.
Speaker 1Yeah, of course, right? Because especially, you know, you alluded to this earlier that so much of what is done in public health is invisible. And so being able to uh recognize and show that this is public health, you know, that this is whether it's through an emoji or through some other way uh means of communicating with multiple different audiences, um, that's a really great way of doing that. So, you know, thank you for sharing that, especially something right in your hometown that you're able to see, right? So, you know, another major theme in your work is that teaching writing as a process rather than just evaluating the final product. You know, so how is your own approach to teaching evolved over time as you've looked at, you know, teaching writing as a process rather than just looking at the final product?
SpeakerYeah, so um, you know, early in my teaching career, I received feedback that um in the classroom that I relied too heavily on lectures with heavy uh text heavy slides without providing sufficient opportunities for students to engage meaningfully with the material. Um, and I think that's you know somewhat natural for a junior faculty member who's moving from a research world of the PhD program into the classroom, especially if you haven't had a lot of opportunities to actually teach, not just great papers, right? Yeah. So my response to this was to start using my research hat, my research skills, and um look for what works when it comes to teaching and starting to engage into um evidence-based practices for creative creating learning environment effective learning environments.
Speaker 1Okay.
SpeakerAnd so um, you know, in the classroom now I consistently incorporate active learning techniques such as think-pare-share activities, small group discussions. Um and then I also use uh something called protocols, which are these clearly defined guidelines for structuring classroom discussion to promote critical thinking and broader student engagement. Okay. And one of my favorite protocols actually is this uh methodological belief protocol developed by Peter Elbow, um, which asks students to find all the arguments in support of a particular issue, even if they initially disagree with it. And I use it in the classroom to help students understand why some people in the US may not agree with the idea of universal healthcare coverage, which I believe prepares them to have more meaningful conversations and think critically about their own assumptions.
Speaker 1Yeah.
SpeakerWhen it comes to writing specifically, what I try to do is to design assignments that help them look at different perspectives, again, kind of using these structured uh tools like protocols, think about pros and cons of a particular issue. And one thing that I have started to do is grade assignments uh pass fail and give students an opportunity to revise because I think this is one of the um aspects that is missing in a lot of public health courses, um, the opportunity for students to act on the feedback that they receive on their writing and produce another draft that shows how they've incorporated that feedback.
Speaker 1Yeah, no, I love hearing that, giving students an opportunity to take the feedback, sit with it, and then act on it in real time, right? Not just getting that grade and saying, okay, well, that's it, and then I'm gonna shove it into a folder or put it into a, you know, an online file and never really look at it again. And then figuring out, okay, how do I adapt the file? How do I make it better, improve it in real time? So uh I appreciate you sharing that learning process of this is how we teach our students to write better and engage in real time. So, you know, building upon some of this work that you've done in the classroom and, you know, learning yourself as a professor, let's break down some of the components of your playbook now that we alluded to earlier. So, you know, your playbook introduces approaches like writing to learn, uh, writing to engage, and writing in the disciplines. So, can you explain to our listeners how those approaches help students become stronger critical thinkers as well as communicators?
SpeakerYeah, so these approaches are part of this pedagogical movement called writing across the curriculum. And there are they are ways to move students toward higher level uh critical thinking skills. So I can talk about each of those approaches. Uh, writing to learn leverages writing as a tool to process, understand, and synthesize information. Um, and in this approach, students may be asked to reflect on a specific subset of material or a given lesson, writing a summary or a reflection. Um, and in doing so, the focus shifts from are they using the right language or you know, is their grammar correct, to their ability to retrieve and synthesize information, but it's relatively narrow and more simple. And it's they they tend to be uh low-stakes assignments. But writing to engage expands on writing to learn by asking students to further engage with critical thinking and apply what they have understood and reflected upon in the writing to learn assignments to build stronger connections between concepts, frameworks, different parts of the material that they have been exposed to in the classroom. So kind of focusing on not just one um set of concepts or materials, but really making these connections across um different areas of the class that they've been exposed to. Okay. And these assignments help them solidify foundational knowledge, apply it to new contexts, and and start to draw these new connections, make you know, promote under a different level of understanding based on these connections that they're drawing. And these can be lower or high-stakes assignments. And then the last one is writing in the disciplines, and this focuses on introducing or reinforcing writing genres and formats that professionals in the field use, right? So kind of coming back to our earlier conversation about the different types of products of communication products that we use in our field, starting from academic journal papers all the way to infographics. This is uh the type of assignment that introduces students to the specific products that they will encounter as a member of this of this field and discipline and how to tailor professional communication to specific audiences. So really getting acculturated into what it means to be a public health uh professional and researcher.
Speaker 1Yeah, that's really interesting and how they start with one, you know, framework, one one stop on the map, if you will, and then build upon that foundation, right? So I appreciate you you explaining how that playbook really breaks it down, right? That they're starting out in writing to learn and then breaking it down into the next step, into the next step, and the next step to prepare them to be better health communicators and know, okay, how do I write for this audience or for this specific product that I'm working up towards, right? So, you know, your framework encourages designing assignments around authentic public health problems, specifically for community engagement. So, why does real world relevance matter so much for student learning in your perspective?
SpeakerYeah, thank you for this great question. I think real world relevance matters for student learning in three important ways. First, because we are training the next generation of public health practitioners and researchers. We want students to understand the complex health issues that our communities are facing, because that will allow them to either design practical, feasible, and appropriate solutions or to do research that helps advance our understanding of what solutions are needed. So, regardless of which path they take in the public health field, they need that real-world connection and understanding.
Speaker 1For sure.
SpeakerSecond, I think that if students can more clearly see the potential impact of their work, they will be more engaged and have higher levels of satisfaction with their education.
Speaker 1Yeah.
SpeakerAnd third, with the advent of artificial intelligence, which you know we'll talk about as well, um, I think that we need to shift the focus of our classes to teaching students the skills and knowledge that cannot be gained from uh generative AI output. Uh, building trust with communities, really listening to how they define the priorities for their health, identifying their assets, co-creating solutions takes time and thoughtful engagement that is better learned by doing.
Speaker 1Yeah, no, absolutely. I couldn't agree more. And better learned by doing, you know, that is such a great takeaway, even just from that statement that you made right there, right? Because those are things that can't be taught by or can't be done by generative AI. And so, you know, building upon all of those things, you know, you're working with your students on how do we become better communicators, how do we really build trust and engage with our communities? Um, I want to now move into that generative AI space, you know, that we were kind of talking about earlier. So looking at generative AI and artificial intelligence broadly now, as we discuss the impact on public health and higher education. So when Gen AI tools like ChatGPT became widely available, uh what was your initial reaction, you know, as an educator? Did you see them as a challenge, an opportunity? You know, kind of where did you fall within this spectrum of Gen AI?
SpeakerYou know, as an educator, my initial reaction was to see these tools as a challenge because they interfered with our ability to assess student learning. Yeah. Um, you know, was the paper that I just read the result of a student's thoughtful analysis of the issues or you know, their writing process, or just AI output, right? So that was that was kind of the big initial reaction. And this contrasted, honestly, with my personal experience as a user of these tools who found value uh for day-to-day tasks that would have otherwise taken me um, you know, a long time, such as composing emails to argue with a contractor or creating a chore list for our teenagers. Right. So I felt like I was wearing these two hats as an educator. I was concerned about the tools, but I could also see their their values as a user. So wearing these two hats of educator and user, combined with the realization that these tools are here to stay and are getting better and better, led me to rethink my perspective from focusing on how to prevent students from using generative AI tools or figuring out if a particular paper was written using AI, to how to help students use these tools ethically and critically. Okay.
Speaker 1Yeah. No, that's a great perspective. And I think it's very real. Um, and it's what a lot of us have been facing, right? Because it is this, okay. Well, you know, we can see the opportunity, but we also see the very real challenges that they present, but it can help me do this. But what's the hindrance, you know? So it's kind of that back and forth. So I I really appreciate your perspective on that. And so I'm curious, instead of framing AI as simply something to ban or embrace, uh, your playbook introduces the concepts of AI resilient and AI-assisted assignments. So, what's the difference and why is that distinction important in your playbook?
SpeakerYeah, um, well, in my view, AI resilient assignments are types of assignments that cannot be done by simply putting the prompt into a chat bot. And this kind of ties into our um earlier conversation about real world relevance and what our students can learn by doing. Maybe students would use AI to help with some pieces, but the core of the assignment focuses on developing or practicing a skill that cannot be outsourced to the AI tool. And here are a couple of examples. My colleague Steven Bazrushka and I used to teach a class on social determinants of health, in which one of the assignments designed by Steven was asking students to organize a community event where they would talk to people about the content that they were learning in the class. And we gave them a few options. They could show a documentary, play a specially designed board game, or do a formal PowerPoint presentation. The only requirement was to engage a non-academic audience. And students got very creative with their events, had a lot of fun doing them, and got to practice public health communication. The other example is from a class I taught this past fall on the foundations of public health, in which students learn about the 10 essential public health services framework. And I asked students to pick a public health issue that they care about because that makes it more real and more interesting and engaging for them.
Speaker 1Sure.
SpeakerAnd then explore the websites of their state and county health departments to see what services these agencies are offering to address the issues, the issue that the students care about. And then I asked them to map these services, the services that they found on the websites, to the essential services framework and discuss how the state level and county level approaches might differ. The goal was to make the real-world public health work tangible for them and to teach them about comparative analysis. And I was really happy to see that it resulted in some very thoughtful submissions where students really reflected on, you know, how the state level work was more focused on policy and the county level work was more focused on service delivery, what were some of the gaps, and what were some of their recommendations for how to how to bridge the two. Yeah. On the other hand, um AI-assisted assignments are based on the understanding that AI tools have some usefulness for our field, and that part of our mission as educators is to prepare students, as I said earlier, to use them ethically and critically. And an example here would be asking students to use AI to distill an academic paper into a set of messages that is at a sixth grade reading level, which they can then test with an audience to see if it's accessible and actionable. Right. So really leaning into these tools and seeing what they do well, what maybe they don't do as well, and then making an informed choice if they need to in the real world about whether they need to use these tools and what would be the benefits for that type of work. Yeah.
Speaker 1Yeah, absolutely. And it it ties back into that communication aspect, right? And that community engagement aspect that we were talking about earlier, right? And especially with your second example, you know, okay, use AI to condense this paper for a sixth grade level and see how does it work in real time, and then how would you properly communicate those concepts? So that's a really interesting kind of full circle moment of seeing how the AI would work in real time. So, you know, in your playbook, you write that AI may streamline writing in some senses, but that it can also remove the struggle that's essential for learning. So, what do you think students still need to experience for themselves in order to truly learn how to think and how to write?
SpeakerThere are two things that come to mind. One is that we need the creativity and originality of our students. Uh, this is the best asset. This is what makes me go into the classroom and be energized every day that I teach. At the end of the day, AI tool outputs are only as good as the prompts and information we give them. They're just tools. They don't have the creativity and originality of real human beings. So I think that we need our students to take the time to think about issues by themselves or with their peers, think outside the box, think in partnership with our communities, and then be able to translate that thinking into written communication. And that takes time and practice. And I think we need to be very open with them about writing being a process and not expecting them to know it well going in, and then creating those environments that support their development and their going through this process. The other thing that I think is important here is that we need students to develop their own voices. We don't want all public health communication to sound exactly the same because it uses the same corpus of words and phrases that the AI tools have been trained on. And so I think communicating to students that there is tremendous value in having a diversity of voices and approaches to public health communication is going to be very important. And we really want our students to embrace that.
Speaker 1Yeah, no, absolutely. And I love that you mentioned the creativity of students because it really is so energizing going into the classroom, you know, and working with different students from all different backgrounds and seeing what individual perspectives that they bring to the topic that you're teaching. And you can't replace that with AI. And so the fact that you're incorporating that into your day-to-day practice as an educator, I think is really important. And so I think a lot of educators are anxious about AI in the classroom. So, what advice would you give faculty who are still trying to figure out how to navigate this moment, you know, in this anxiety about AI?
SpeakerTalk to your students, discuss with them what their views are on AI, how they're using it, and how they want the class as a whole to approach it. I think we focus a lot on the students who might use AI to complete assignments, maybe in an unethical way. But I have been surprised at the number of students who refuse to use AI for ethical or professional reasons. They say we want to learn, we want to develop skills, and they are pushing back against sometimes instructors using AI in the classroom. And then at the same time, we have students whose first language is not English or who have not had the mentorship and training to help them succeed in a field that depends on a particular type of writing and communication, right? Yeah. So for them, these tools present an opportunity to be heard and understood. And so as an instructor, I think it would be very important to understand where students are and how to strike this balance between different needs and goals in a diverse classroom.
Speaker 1Yeah. No, that's that's really great advice, right? Just start by talking, start by engaging with people, meeting where they're at. I mean, that's essentially what we're doing here, right? Opening the conversation, seeing how do we bring these things into the classroom? When is it right? When is it wrong? Um, and where where do we go from there, right? Because we don't know until we start having those conversations. So thank you for that perspective.
SpeakerI I think this is a case of one size doesn't fit all, right? It has to be, it has to be an approach that is adaptable to different types of content that we're teaching, different types of students, you know, undergraduate education, graduate education. There's going to be different approaches depending on who the students are and the content that we're teaching. And also who we are as instructors, right? What do we value and how do we want our classes to go at the end of the day?
Speaker 1For sure, right? It's it's a learning process and we're all here to, you know, learn together, absolutely. So thank you for that. So if you could leave students and educators with, you know, one message about a lot of the things we've talked about today, writing, learning, and adapting in the age of AI, I know it's a loaded question. Uh, what would that message be?
SpeakerYeah, I think I would encourage students and educators to see this time as an opportunity for us to think together about what we want public health education to look like in the near future, both in terms of what we teach and how we teach it, and also how we measure success.
Speaker 1Yeah, I think that's a great way to look at it, right? There's a lot of things that you can think, what is the next step going to be? It could be, you know, anxiety-provoking to look at it this way, but to frame it as an opportunity, I think is a really great perspective. So I want to thank you so so much, Dr. Buddha, for joining me today for such an imperative conversation around AI and public health, as well as teaching and writing and learning in the classrooms, especially as they continue to evolve. And to our listeners, thank you so much for being a part of this important conversation. If you are interested in sharing your work or participating in a future episode with us, we invite you to stay connected with the Idea Institute and with ASPPH. Thank you for helping us turn ideas into action within academic public health.