I spent Friday in Wolverhampton at the Chartered Institute of Environmental Health’s Education and Research Special Interest Group’s conference. This is the second year we’ve seen a conference aimed specifically at promoting research, writing and publication for the environmental health profession. And this year the CIEH’s Education team came along and joined in. For the record, the event was sponsored by the CIEH West Midlands Region and Highfield Publications.
The title for the conference was “Preaching what you Practice”, which speaks to the generally dismal performance of environmental health practitioners (EHPs) in building the evidence base for the profession by failing to design studies in environmental health practice, or even to write up and publish their experiences in tackling the conditions that affect the health outcomes of everyone in our communities.
The challenge for putting environmental health practice on a firm foundation of evidence is now increasingly urgent, particularly in England, where environmental health and public health are coming together in their natural home in local government. Public health is a field founded in clinical thinking and practice where research and publication are the essential prerequisites of practice. Environmental health, although rich in data, has a very poor track record of writing and publishing what it does and how it achieves its successes. This must change.
Today, the challenge was thrown down to us all, students and thirty-year-qualified old lags like me, to start writing up what we do, how and why we do it and how effective that is in making improvements in peoples’ health and wellbeing.
Tony Lewis (@CIEHEducation) spoke to the link between research and demonstrating the competence of practitioners. As EHPs, we are unused to other professions demanding that we demonstrate our continuing competence, and tend to rely upon the quality of our professional qualification process and getting the requisite hours of CPD under our belts. But, as Professor Harold Harvey says, “changing environments … render knowledge obsolete”.
It is said that the half-life of knowledge is two years, so after four years, 75% of whatever is learned at university is no longer relevant to practice. I’ve been qualified for 31 years, and there is only a fraction of the technical content of my degree which remains of use to me. So, the question has to be, on what do I base my competence now, if it is not the content of my four-year degree and associated work experience? And as the pace of change hastens in environmental health practice and its role in local government regulation, where most of our members work, how can we demonstrate our competence and the foundation of our practice in evidence?
I was competent once; am I still competent in the same task now? I am competent in this field of practice; am I competent in that other field? My professional registration would suggest that I should be, but can I prove it to skeptical challenge? I can surely depend on the post-qualification training and experience I’ve had, but how good was it and how relevant was it? Did it conform to the best available evidence? Has the evidence behind practice in a particular field moved on since I last attended a course? So competence must mean something more than attending training and doing the job.
Arguably, competence also demands that I am a reflective practitioner; that I consider what I do, how and why and with whom, before I do it; that I carefully observe and record the delivery of what I do and its outcomes; that I reflect on the evidence and review it to inform future practice. That is, of course, the Kolb learning cycle, but it’s missing one vital thing: publication of what I learned. That’s research in the real world, and that’s how we go about building the environmental health evidence base.
Of course, the evidence base requires more than simply my contribution, either as an individual practitioner or as a member of a team, it requires somewhere it can be stored, indexed, made available to colleagues, accessed, critiqued, challenged and improved upon.
This is why groups like the UK Environmental Health Research Network (@EHRnet_2012) exist and why CIEH are building a knowledge base for environmental health practice. This is why I am determined to write up what I do, talk about it, share what I’ve learned, accept challenge and criticism and, through this process, make my own small contribution to the competence and evidence base of the profession.
Watch this space.