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Luke Davis: Fostering a growth mindset through implementation science

June 19, 2024
by Mike Honsberger

Associate Professor Luke Davis, MD, uses a feedback-driven approach in teaching implementation science.

Yale School of Public Health Associate Professor Luke Davis, MD, hopes that students will carry a growth mindset with them years after taking his Implementation Science course (EMD 533), even if the details of the course are forgotten.

A growth mindset is one in which a learner believes that they can improve their abilities through effort. This requires embracing feedback to drive self-reflection and improvement. Davis, an associate professor of epidemiology (microbial diseases) and of medicine, believes that this mindset is critical not only for graduate students, but for public health practitioners as well. Because of this belief, he structures his course around the principles of feedback, continuous growth, and transparency.

Implementation science is the systematic study of methods for introducing or improving the delivery of evidence-based or proven interventions into real-world practice. Research has shown that it takes 17 years for 14% of original research to make its way into practice.

This gap between evidence and practice is a driving force behind the development of implementation science practices. One important reason for students to learn about implementation science is that its principles are not limited to public health. Every field of research faces the same difficulty in applying proven findings. This systematic approach is crucial for ensuring that interventions are not just theoretically effective but are also practically applied in clinical and public health settings. Awareness of this gap, and methods to mitigate it, will prepare YSPH students to be future leaders anywhere, in public health or beyond.

We find that if we show (students) that ‘know-do’ gaps are ubiquitous in public health and lead them to the starting line, most take off running with implementation science methods and never look back.

Luke Davis, MD

In EMD 533, students collaborate on a modified grant proposal. They select a topic for their project and form small teams built around their interests. Students are asked to commit to a project and a team before they learn anything about implementation science. Davis said this helps emphasizes for students that the process of developing the final project is equally as important as the subject matter. To help students find a project that relates to their interests, he has developed a number of prompts to assist them.

“As public health changes,” Davis said, “my teaching fellows and I are continually introducing new project prompts to engage students’ interests, which are also changing. We find that if we show them that ‘know-do’ gaps are ubiquitous in public health and lead them to the starting line, most take off running with implementation science methods and never look back.”

Once students have selected their project, they embark on a series of homework assignments designed to progressively build toward the final grant proposal. The assignments are intended to be cumulative, so that by the time they select their final project, they are well-prepared to take it on.

To help students keep up with their work and to further develop a growth mindset, Davis gives prompt, thorough advice on all assignments. This includes detailed individualized feedback, a rubric, and an answer key provided within days of the due dates. These materials facilitate student reflection on their own performance in relation to Davis’s expectations. This type of reflection is critical in developing a growth mindset and metacognition in learners.

Metacognition refers to an awareness of the scope or breadth of one’s knowledge and thinking processes. Stronger metacognition leads to self-regulated learning, a requirement for the kind of lifelong learning YSPH encourages for its students. Regardless of students’ interest in implementation science, these self-reflective skills will be an asset in their future endeavors.

Davis values transparency in his teaching. In his syllabus, he discusses some of the reasons he focuses so much of his course on group work. This includes the importance of teamwork in public health practice in addition to logistical reasons like allowing more time for each final presentation in his course. By better understanding the reasons behind the course choices instructors make, students can better position themselves to learn more and achieve greater success.

One of the choices that all instructors struggle with is what content can and cannot be covered in a single course. Over the years that Davis has been teaching EMD 533, he has struggled with this constraint. It is one of the factors that led to the development of a new MPH track in implementation science at YSPH. The track launches this fall.

This track requires students to take EMD 533 and Adjunct Assistant Professor Archana Shrestha’s half-credit course Implementation Science to Address Chronic Diseases: Global Health Case Studies (CDE 553). The latter course, to be offered for the first time in Spring 2025, will provide students an opportunity to dive deeply into the application of implementation science for chronic diseases. Davis sees these two courses converging on implementation science by taking an inductive and deductive approach, respectively.

In addition to these two courses, MPH students seeking to complete the implementation science track will need to take electives clustered into three themes: quantitative methods, qualitative methods, and evidence synthesis; program evaluation; and economic evaluation. In EMD 533, Davis covers overviews of formative implementation science research, designing strategies, adapting, and evaluating interventions, as well as the ethical considerations of implementation science. However, taking courses for the implementation science track in these three specified areas will allow students to explore the methods often used in implementation science practice more deeply.

The inspiration for the development of the new academic track came from Davis’s work with students across YSPH on implementation science-related research. He found that while many were familiar with the concepts involved in implementation science, they were not always making connections with the methods they were learning elsewhere in their coursework. The new implementation science track also reflects the growing expertise that YSPH is developing in implementation science. This is apparent in the Yale Center for Methods in Implementation and Prevention Science (CMIPS), founded and directed by Donna Spiegelman, the Susan Dwight Bliss Professor of Biostatistics and co-director of the implementation science track. Students pursuing the implementation science track will be well suited to be involved in the work of CMIPS-affiliated faculty, which includes Davis and Shrestha.

Closing the gap between research and practice requires multiple approaches – effective communication on the part of researchers, the involvement of various stakeholders, and continuous feedback from the community.

One way that Davis operationalizes student engagement and encourages greater communication is through the use of a Canvas discussion board. Students are required to complete a small number of thoughtful reflections on the course readings. These can include ideas or questions for further discussion or specific areas of interest or curiosity. This assignment reflects the importance of effective communication in implementation science.

Davis regularly uses issues and questions from the Canvas discussion posts to decide what to emphasize in his lectures. In this way, he maintains an ongoing dialogue with his students to optimize the relevance of his teaching.

Even with the success of EMD 533, Davis is not yet ready to consider the development of the course complete. He is continually looking at ways in which he can improve his teaching.

One area he is working to improve is student verbal participation throughout the course. Effective communication is critical in public health practice. To support these skills, Davis is working to create a classroom environment where all students, not just the extroverted ones, feel comfortable speaking up in class. Future iterations of his class will see him implement these interventions and monitor their impact. In this way, Davis not only teaches, but models the growth mindset that he hopes his students will take from his course.

Submitted by Fran Fried on June 18, 2024