Pedagogy for Transformative Teaching and Learning

As Editor of Pedagogy in Health Promotion, I have the great pleasure to read numerous submissions offering stimulating and creative approaches to teaching and learning. The curricular work in these papers is solidly grounded in pedagogical principles and evidence-based methods, along with a strong dose of inspired and passionate teaching. My bird’s eye view of this pedagogical landscape leads me to a very positive appraisal of the current and future status of education in public health and health promotion. As a community of educators, we are on our way toward achieving a standard of transformative education in our field.

Transformative learning is a paradigm-shifting approach that enables learners to critically reflect on their existing frames of reference and beliefs, and transform them into new ways of understanding and problem solving through a reframing of issues (Mezirow, 2000). This approach posits that a central goal of adult education should be to enable “the process of helping learners become more aware of the context of their problematic understandings and beliefs, more critically reflective on their assumptions and those of others, more fully and freely engaged in discourse, and more effective in taking action on their reflective judgments” (Mezirow, 2000, p. 31). The importance of a transformative paradigm is accentuated in the Framing the Future 2030 initiative of the Association of Schools and Programs of Public Health (ASPPH, 2023), which includes a major domain focused on transformative education. UNESCO also endorses transformative education as critical for motivating and empowering learners to make informed decisions and take action on the individual, community, and global levels (UNESCO, 2023).

The papers included in this issue of Pedagogy in Health Promotion offer examples and guideposts for transformative teaching and learning. Common themes indicate the importance of a focus on student-centered learning, employing active learning techniques, and promoting critical reflection as key elements of a pedagogy that has the power to transform. The ideas presented in these papers prod us as educators to challenge some of our longstanding views of teaching as well as demonstrate curricular methods that can expand students’ worldviews of public health.

Traditional grading often serves to measure only quantifiable knowledge, and incentivizes teaching and learning limited to those factors. The first three papers in this issue discuss innovations for grading student work that reinforce learner-focused elements and support the contemporary movement in education toward “authentic assessment.” The premise of authentic assessment is that the primary purpose of evaluating student work should be to educate and motivate students to perform in the real world; accordingly, assignments should reflect future work expectations (Wiggins, 2011). Grading schema can facilitate or impede this goal. Kruger (2023) argues that penalizing students for late work disengages them and diminishes their motivation for deeper learning. Using flexible deadlines helps promote a supportive and more equitable learning environment and can lead to improved learning outcomes. She notes her positive experience using flexible deadlines in her undergraduate courses, with no decline in the quality of work. Instead of enforcing rigid deadlines under the guise of preparing students for the real world, Kruger encourages educators to initiate the transformation into a world that promotes positive mental health and supports people of different abilities and backgrounds.

Specifications grading is an alternative to traditional student assessment as reported by Gay and Poproski (2023). The authors provide a useful description of the approach, which gives students autonomy and choice regarding their level of achievement based on well-defined learning outcomes. Their evaluation of the specifications grading scheme used in their public health graduate level course found no effect on final grades. Students were overwhelmingly positive about the approach and reported less stress, clearer understanding of course objectives and expectations, and more engagement with course content.

Another alternative approach to grading is discussed by Kalbarczyk et al. (2023), who use “ungrading” as a means of minimizing structural biases and exclusionary practices in assessment. Graduate students in two public health courses were given full credit for completing all assignments, meeting assignment expectations, and timely submissions. The emphasis was on facilitating student engagement through thoughtful instructor feedback and ongoing conversations with students. The authors report very positive feedback, noting that students reported feeling that they could concentrate on learning course material without worrying about their GPA and that the un-graded approach encouraged them to put in more effort into assignments and class activities.

The next two papers offer approaches that incorporate authentic assessment to help learners work collaboratively on projects in order to better grasp and apply complex health promotion concepts and practice. Buckner-Capone (2023) describes how she uses metaphor as a tool for helping students to progress through course assignments and build community. She employed the metaphor of climbing mountains to facilitate the work process for student teams developing an evidence-based community health promotion program plan. Portraying the assignment as a team mountain climbing journey with defined steps helped to demystify the work, motivate students, and support the development of teamwork skills. The approach described by Buckner-Capone is an imaginative example of how a curriculum can be crafted to transform the learning experience.

Teaching students the social ecological model and how to apply it is a challenge for many of us. McGee et al. (2023) used a flipped classroom whereby public health students reviewed readings and other background materials ahead of time, with class time devoted to working in teams to critique and apply social ecological theory and to develop a multilevel conceptual model. The authors employed a collaborative learning framework to promote student autonomy in the learning process and enhance their understanding of the issues and develop solutions to problems and challenges. Findings from their evaluation of the course indicated that students improved their ability and confidence in applying multilevel theory. The active learning teamwork approach was deemed by students to be very beneficial in helping them better understand the social ecological model and how to employ it in health promotion practice.

Building on students’ lived experiences is another means of facilitating transformative teaching and learning. Adamson et al. (2023) asked students to write self-reflections on their personal and observed experiences with health behaviors. This autoethnographic approach was used to support critical thinking about the process and challenge of behavior change, including the role of race, gender, socioeconomic status, and health status. Students were required to identify at least three sources that supported their critique of their selected themes in order to ground the reflection in the literature. They also were asked to identify at least one theme demonstrating ways that messages were gendered, racialized, or differentially targeted socioeconomic status groups. The authors conclude that autoethnography is a useful assignment for helping students challenge their preconceived notions of health and behavior change in the context of addressing health inequities.

Developing a pedagogy that is truly transformative should be informed by the perspectives and experiences of the students themselves. Tsui et al. (2023) conducted a participatory oral history project with public health students at an urban public university in order to understand how students experienced the early COVID-19 pandemic and the antiracism activism of the summer of 2020, and how these experiences shaped their views of public health education. Students described their experience of trauma and isolation during this period, and expressed a desire for public health education to support a sense of connection to others in the school and help sustain them through challenging times. Based on principles of trauma-informed education and their oral history findings, the authors provide numerous recommendations for promising educational practices in public health and detailed suggestions for how to integrate trauma-informed teaching and learning into public health pedagogy.

Incorporating principles of social justice into a public health curriculum in a way that is truly transformative is the focus of the final paper in this issue. Munala et al. (2022) provide a roadmap for curricular reform that integrates social justice throughout the MPH curriculum. Their approach involved three basic elements, including developing a definition of social justice specific to public health; building a social justice training program into the core curriculum; and evaluating the process using mixed methods to assess student and instructor experiences. The authors outline the domains and competencies developed for the social justice training program and provide a map linking the domains to specific class topics. The overarching goal of the process was to explicitly integrate social justice throughout the public health curriculum and prepare students to critically assess health inequities and develop the skills to address them. The paper serves as a model for pedagogical praxis that has the potential to transform public health’s approach to social justice into a more comprehensive and impactful endeavor.

Brookfield (2000) asserts that transformative learning cannot occur without a process of critical reflection that examines power conditions and contexts. He emphasizes that transformative learning necessarily involves a fundamental questioning of an individual’s assumptions and perspectives, leading to a reframing of how one thinks and acts and to the challenging of culturally dominant values and ideologies. As educators in professions committed to health equity, our pedagogy is strengthened if we employ concepts and methods that support fundamental shifts in how to teach, think about, and promote health. This issue of Pedagogy in Health Promotion offers a variety of approaches and tools for rethinking education with the goals of supporting and empowering our students and helping them formulate worldviews that reflect a deeper understanding of the many forces that drive health and how to effectively work toward change.