The Title V MCH Internship – 2023 Evaluation Report Highlights

Title V MCH Internship Program Overview

The Title V Maternal and Child Health (MCH) Internship Program is a summer internship experience for graduate and undergraduate MCH students from funded HRSA MCHB training programs with state and jurisdictional Title V MCH agencies. The Title V MCH Internship Program provides students with the opportunity to assist the current MCH workforce with addressing program goals, use newly learned skills, learn from practice-based preceptors, and to attend web-based professional development sessions. Professional development webinars included a program overview and skill-building sessions led by subject matter experts in change management and adaptive leadership, systems integration, equity and engagement, and evidence-based decision making, and other professional development and networking opportunities such as a discussion-based session with a panel of former interns. The internship program team selects student applicants from three MCH training programs: (a) Centers of Excellence in Maternal and Child Health (CoE; graduate) (b) MCH Public Health Catalyst (Catalyst; graduate); and (c) Maternal and Child Health Leadership, Education, and Advancement in Undergraduate Pathways (LEAP; undergraduate) and matches a paired student team with a state or jurisdictional Title V program.

Placement of Students among State and Jurisdictoinal Title V MCH Agencies

During Summer 2023, the Title V MCH Internship Program funded and matched 24 students with 12 state Title V agency preceptors. The 2023 internships were completed remotely over a 10-week period.

Evaluation Approach

Student interns completed evaluation surveys before and after the internship experience and after each web-based professional development session. Preceptors at each site were also invited to provide feedback using a structured evaluation survey at the end of the summer. This report presents a summary of findings related to the overall experience for both students and preceptors and highlights the reported strengths and weaknesses to be used for continuous quality improvement. The topics covered in this document were requested by the internship program team.

Part 1: Match Process, Program Supports, and Remote Experiences

Student interns shared positive aspects of working with another student as part of the internship, including the value of making a professional connection with a peer and having an extra source of support while working as a team on their project.

• “Loved this part. It was great to develop a relationship with another graduate student that also professionally and personally we were similar, really created a great environment. Also was great to share skills with each other if one had more skills in one area than another.”
• “It was positive to have someone to navigate the internship with. I appreciate having someone to communicate with and make important decisions about our project together. Additionally, we had a different professional background and knowledge that complemented our work.”
• “I appreciated being able to learn about my partner’s experience pursuing an MPH. As an undergraduate, she also helped guide me during our project, since she often had more experience that I did in some skills, like qualitative analysis.”

At the end of the summer, 90.9% of the preceptors reported that they were satisfied or very satisfied with both the match between the interns and the state site project and with the way that the interns were matched as a team (Figure 1). Those who hosted a graduate and undergraduate pair indicated that the graduate student was able to mentor an undergraduate student to some extent; as such, there appears to be room for improvement in this area.

Supports Received from the Internship Staff and Preceptors

Nearly all students were very satisfied with the support they received from the internship staff and preceptors (Figure 2).

When asked to describe their experience, students indicated that preceptors were interested in them personally and professionally and provided encouragement, support, and constructive feedback.

• “My preceptor was amazing and really took time to gauge our personal interests and invest in us professionally.”
• “My preceptors were always encouraging and gave constructive feedback during check-ins, so I believe I received sufficient support.”
•  “I knew I had support if I ever needed it! And felt that if something went wrong, I had more than one option for who to reach out to.”

Feedback from Students and Preceptors on Remote Experience

By the end of the internship, all students were highly confident in their ability to learn from others in a team environment and to complete tasks and projects as remote interns. However, students mentioned that it was sometimes difficult to network and build relationships in a virtual environment, and they encountered some difficulties with technology and scheduling.

• “I think it is more of an effort to network because it’s remote. It’s not possible to spontaneously have a few minutes of small talk. But it’s not impossible, just takes more effort and preparation.“
• “Sometimes casual conversations and connections were difficult to have, but small acts of communication via Teams chat to say good morning or weekly check-ins were helpful.”
• “It was difficult to stay engaged and build strong interpersonal relationships, since I only talked with my preceptors once a week during our check-ins. Otherwise, I would also see them when I sat in general team meetings. Another challenge was accounting for time zone differences.”
• “Getting used to how to use Microsoft Teams was very challenging at first, especially with scheduling, however, once I got used to it everything became easier.”
• “Sometimes it was hard to connect with people because it was virtual, similarly, sometimes my internship partner and I had conflicting schedules.”
• “Time difference across time zones was huge, but we found a working place.”

Preceptors who reported that remote placement worked well attributed this to allowing sufficient time for building personal connections at the beginning of the summer and regular videoconference meetings throughout the internship period. However, preceptors at sites who experienced challenges with the remote experience cited the same issues that students noted, including difficulty with internet connection or coordinating work across time zones.

• “While my preference is always to meet someone in person, at least once, we feel like it went very well. Our students were excellent communicators, and I think at least by the 3rd week felt comfortable asking questions and reaching out when they needed to.”
• “Microsoft Teams worked well for daily check-ins, along with weekly 1:1 and section meetings.”
• “[There were] 3 different time zones [between the 2 interns in our office,] with one being 2-3 hours different than most of the team. All were flexible and made meeting times work. Access to students zoom account existed as we needed to have zoom accounts to access certain zoom meetings, which we were not able to do.”
• “I feel like working remotely made it more difficult for the interns to complete tasks. They both had technology difficulties that made it difficult to communicate.”
• “Remote is different than in person–some advantages yet need to spend time up front connecting with the students virtually.”

Part 2: Reflections on the Experience working with Title V, the Project, the Internship Overall, and Intentions Post-Internship

Students were enthusiastic about their experience working in a state Title V agency.

• “It was a good learning experience as I’ve never worked with a state health agency before. The challenges included learning about the culture of a state I’ve never lived in or been to before, as well as adapting wording/language based on state/government politics.”
• “Highlights [of this experience were that] everyone was passionate and educated. Challenges [of this experience were that] government can take a lot of time to process through things, and I learned it can be difficult to work through so many units/hoops/politics.”
• “It was a great experience to learn more about what people’s jobs are like at the state level, and the staff were super welcoming and available to answer any questions. I would say the only challenge that limited networking potential was the remote work, but that’s just the reality now!”
• “[Even though I was remote,] I was so glad to spend time at my site — I would highly recommend those who can go to their host site. It was so much more immersive, and I got exposed to many more opportunities and projects and people than I could remotely. I loved my preceptor and so glad to be continuing to work under her for the coming months. I also really enjoyed my partnership and feel proud of the work we did and will continue to do, I think it’s very meaningful. It was challenging to navigate a leadership role I wasn’t expecting with my partner, but I’m glad I communicated this to my preceptor.”

Preceptors appreciated the students’ energy and were grateful to have extra help to bring additional project work to completion.

• “It’s great to have new perspectives and energy from the interns. They bring a valuable point of view and are able to move work forward that we may not have capacity for.”
• “The interns get to learn a great deal about state programs and processes and the state benefits tremendously! Interns really helped with our new [gestational diabetes mellitus] initiative and helped to inform activities.”
• “[It’s great] that it is Title V/MCH specific, and [that] student[s] gained essential knowledge provided through the Title V MCH internship program staff. Also, [I appreciated] the cross collaboration [that having a pair of interns] provided.”

Reflections on the Project and Overall Experience

At the end of the summer internship, student teams prepared a summary of their project and presented it to other interns and fellows during live-streamed webinars. Students were proud to share their accomplishments and discover what the internship experience was like for teams at other sites. They also felt they had gained valuable practice with presentation skills and interacting with MCH professionals.

• “I loved presenting my work. I felt accomplished showing the fruits of my summer internship, while gaining presentation skills in the MPH area.”
• “Presenting our findings to a larger group was super interesting and challenged us. What I learned from the opportunity is how to clearly focus on project objectives and bring forth discussions at a level that all can understand.”
• “Creating our final presentation helped us synthesize what we did over the summer; it
  was a good opportunity to practice presentation skills.”
• “I think having the opportunity to present the findings of our project is great because it allowed us to share the work we did and reflect on the internship.”

At the end of the internship, nearly all the interns said they were highly likely or somewhat likely to:  seek a job in a Title V agency or state-level MCH program (91.7%); a job working for a community-based organization that focuses on MCH (83.3%); or, another type of organization (e.g., professional advocacy, research, etc.; 100%) that focuses on MCH, after graduation. Similarly, the majority (87.5%) indicated that they were highly likely or somewhat likely to seek additional education in MCH after finishing their current program.

Part 3: Student and Preceptor Feedback Regarding the Orientation Webinar and Preceptor Tips for Success

The majority of the students found the orientation webinar helpful. Some commented that the information about workplace etiquette was not applicable for those with previous work experience, especially after relying on web-based platforms during the COVID-19 pandemic. That said, students appreciated that the orientation was designed to meet the needs of students with differing levels of professional experience. For example, when asked what the most helpful aspects of the webinar were, students wrote:

• “Covering program logistics and expectations, so I have a clearer idea of what to expect, what to prepare, and how to work with my partner.”
• “Expectations for remote work and tips working as a team.”
• “Getting a better idea of who we will be working with and what roles they play within Title V.”

Preceptors were invited to their own orientation webinar with internship staff prior to the start of the internship. When asked to provide feedback about the support provided by the Title V MCH Internship staff, preceptors reported that the onboarding meeting was helpful, any questions they had were answered, and that the overall the internship was well organized by the Title V Internship Program staff team. For example, when invited to provide feedback about the on-boarding process, comments from preceptors included:

• “The onboarding process was clear and easy to understand. This was my first time precepting and I thought the process was very smooth and appreciated all the clear communication.”
• “We appreciated the opportunities to discuss projects [with internship program staff] before the application was formalized and to discuss the internships in the early days helpful. I felt like the group calls [with the internship program staff and other preceptors] were very helpful.”
• “I think it went smoothly but maybe detailed communication around start dates, expectations etc. would have been good earlier on given our onboarding process at the state does take a few weeks.”

Most preceptors (81.8%) felt that students had enough information about their agency and their project when they began the internship and gained enough information about Title V and the field of MCH in general during the course of the 2023 Title V MCH Internship Program. When asked what other information might have been helpful to provide to student interns before they began the 2023 Title V MCH Internship Program, suggestions from preceptors included:

• “Additional discussion about brief overview of simple project management skills” (e.g., steps for successful intense, short-term projects).
• “Some background regarding how things typically work in state government” (e.g., academic vs real life applications).
• “[Ask host sites to provide] some state-specific information to the interns before they start.”
• “Provide an overview of Title V and how the block grant process works.”
• “Highlight the wide variability across state block grants.”
• “Provide an overview of key issues in Maternal and Infant Health.”
• “[Emphasize] the importance of [providing] background information on a program when interacting with the community.”
• “Explain the importance of perception of program staff to the community in Title V work.”

Preceptors were also asked to offer tips for future preceptors that might help Title V staff to prepare for a virtual internship. Recurring themes brought forward by preceptors were setting specific expectations in the very beginning and conducting ongoing evaluation of the project work; scheduling consistent virtual meetings as a group and separate time to connect one-on-one with individuals; and, the importance of using convenient/easy to access virtual software (e.g., Google Drive, Microsoft Teams) as a shared space for resources, materials, etc.

Other valuable tips from preceptors included:

• “Because first days can be ambiguous, especially in a remote environment, I prepared several documents and asked students to review prior to the internship start date… [This included] a “welcome” sheet with pictures/bios of the staff [with whom] they’d be working most closely [and] a list of resources/documents that the students could review to get started…We set up a [virtual] meeting [the first] morning to do introductions and share more about the projects. [Throughout the summer,] I was always available via email/phone… and [we posted] a shared document where interns could add questions while they were working and all team members could respond.”
• “[We prepared a] 2-week schedule with onboarding requirements, meetings with internal and external staff, literature to review and website review allowed the interns’ time to go smoothly and they clearly knew what to expect…Another tip is [to schedule] frequent meetings, [we met] 4 times the first week, 3 times the 2nd week, [then] twice per week until the end of the project which kept us all connected with each other and the progress.”
• “We had our interns meet the whole Title V staff one-on-one for 15-30 minutes and our family partners, so they could really see the depth and breadth of the program. They both stated many times that they really appreciated that opportunity.”
• “Have a potential smaller sub-project for students to work on in case they finish their assigned summer project earlier than expected.”

Part 4: Student Feedback on the National MCH Workforce Development Center (WDC) Core Content Learning Webinars

In 2023, students were asked to provide feedback using a brief, 4-question survey after each webinar. Overall, students found the WDC core content webinars helpful, especially when the topic/approach was new to them and when the sessions involved interactive components. A recurring request was to give students the opportunity to apply concepts and discuss them in break-out rooms with their peers. Students also emphasized the need for presenters to allow sufficient time so they would not feel rushed, and to make a clear connection between the information presented and how it applies to their role working in the Title V agency or other MCH organizations.

Student Reflections on the Learning Webinar Series at the End of Internship

Students were asked a retrospective question about all of the learning webinars at the end of the internship, reflecting on the web-based modules as a whole. Their detailed responses underscore themes that were present in webinar evaluations throughout the summer: the importance of interacting with the presenters and other interns and the opportunity to understand how the information presented can be put into practice, especially in the context of the Title V agency.

• “The ones that stand out to me are: 1) the data-centered session with the Graduate Student Epidemiology Program (GSEP): I thought this was an innovative and unique look into how we gather data and I felt I could implement this directly into my project; 2) Change Management and Adaptive Leadership: I thought these speakers were really engaging and it was a topic I had not been exposed to before (whereas I’ve completed lots of equity/engagement, relationship building, and self-assessment modules); and 3) Alumni Panel: I really enjoyed culminating the experience with a panel of alumni who had recently done the internship and were now in the ‘real world.’”
• “I think hearing about other interns’ experiences [during the Leadership Coaching sessions with Janine Hill] was really helpful. I also enjoyed the professional development series hearing other MCH experts. Additionally, the MCH work plan workshops are beneficial.”
• “I enjoyed [the webinar] sessions because they provided a way to see other groups/ individuals’ problems in their project and put it in perspective of my own.”
• “The [Equity and Engagement Core] sessions that we had about community engagement were incredibly helpful, as that is always an area where I try to be mindful and intentional, but where I felt that I still needed more guidance/training.”
• “The most helpful aspects of the training sessions were those that allowed us to apply concepts to our projects. I liked the training sessions where there was time for group discussion and provided real world context and examples.”
• “Learning about different [aspects of] Public Health and having guest speakers in various MCH related careers to give us insight about what that may look like for us. I also found it very helpful to meet and learn from other undergraduate students [about] public health curriculum at [other] schools, as well as learning [about] graduate students’ field of study.”

2023 Title V MCH Internship Program Conclusions

The students involved in the 2023 Title V MCH Internship assisted the current MCH workforce in state Title V agencies by successfully partnering with a peer to complete a short-term state-requested and designed project. Through this experience, they gained valuable exposure to Title V in collaboration with practice-based preceptors and other Title V agency staff and other MCH students. In addition, they gained professional knowledge and skills by participating in web-based learning sessions and had the opportunity to apply newly learned skills to their work with Title V partners.