PubMed · 10245894
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B Checkoway, T O'Rourke, D Macrina. 1980. Whom do providers represent?. https://pubmed.ncbi.nlm.nih.gov/10245894/
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While researchers and decision-makers increasingly recognize the importance of public participation in environmental decision-making, there is less agreement about how to involve the public. One of the most controversial issues is how to involve citizens in producing scientific information. Although this question is relevant to many areas of environmental policy, it has come to the fore in watershed management. Increasingly, the public is becoming involved in the sophisticated computer modeling efforts that have been developed to inform watershed management decisions. These models typically have been treated as technical inputs to the policy process. However, model-building itself involves numerous assumptions, judgments, and decisions that are relevant to the public. This paper examines the politics of public involvement in watershed modeling efforts and proposes five guidelines for good practice for such efforts. Using these guidelines, I analyze four cases in which different approaches to public involvement in the modeling process have been attempted and make recommendations for future efforts to involve communities in watershed modeling.
The Community Partnerships Program, sponsored by the W. K. Kellogg Foundation, served as a catalyst for significant changes within East Tennessee State University (specifically its schools of medicine, nursing, and public and allied health) and the rural communities involved. The authors describe the development and implementation of the program and its effects on the students, faculty, communities, and the three participating schools over the period 1992-1999. They also review the changes the program fostered in health professions education and the resulting institutional changes at their university. The primary motivation for change at East Tennessee State University was the desire to develop primary care providers who could more effectively function in an interdisciplinary and interprofessional health care system and who would be sensitive to community needs in rural and underserved areas. The planning process, curricular transformation, implementation of inquiry-based learning, community collaboration, and interdisciplinary education involving students from the three health professions schools are described, including challenges and difficulties (e.g., student attrition; retention of volunteer community-based clinical preceptors; initial faculty resistance; a climate of competition rather than cooperation). Outcomes are described, including students' enrollment and attrition in the program over time, performances on the U.S. Medical Licensing Examination, program graduates' career choices, and the types and locations of their practices. The program's students performed as well on professional licensing examinations as did their peers enrolled in traditional programs. Program graduates have been much more likely to select primary care careers and to practice in rural locations than have their non-program peers. The development strategies and experience gained could give useful insights to other universities contemplating a community-based component for health professionals within their existing curricula.
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