Model Practice: Student Interview Teams

Student teams established at health departments or at universities work in close collaboration with health department personnel to integrate students into routine activities.

A main point of contact, or a coordinator, should be designated at the health department and at partner universities. These roles are critical to facilitating the process of starting a team, ongoing identification of interested students, and the day-to-day management and maintenance of a team.

Students should be hired into paid positions whenever possible. This ensures that students are invested in the work and enhances reliability and retention of team members. Providing paid positions may also widen the pool of applicants and ensures that people of varied economic backgrounds can participate. Hiring mechanisms vary by jurisdiction. FoodCORE centers have hired students as:

• Temporary health department staff
• Part-time staff or through job-sharing of a full-time position
• Paid interns
• Contract employees with universities or other groups

There are many reasons why health departments may consider hiring students through job-sharing.

In temperate climates, many acute infectious diseases follow a seasonal pattern. For example, illnesses caused by Salmonella spp. or Campylobacter spp. rise in the summer and decline in the winter. In contrast, illnesses caused by influenza rise in the winter and decline in the summer.

By job-sharing across multiple sections of the health department, staff can leverage student workers for enhanced capacity during their busiest seasons. Students benefit from this arrangement by broadening their infectious disease experience in multiple areas. Job sharing also allows a health department to combine limited resources from multiple program areas that may have otherwise been insufficient to fund a student team.

If students can't be hired into paid positions at the health department due to resource constraints or logistic difficulties, health departments may also consider establishing academic-practice partnerships with schools of public health. This approach was implemented by the Connecticut FoodCORE center and has been used successfully outside of FoodCORE in Arizona and Washington.

At the University of Washington School of Public Health, Student Epidemic Action Leaders (SEAL) receive in-classroom training and gain applied epidemiology experience at state and local public health departments while earning course credit towards their degree program requirements.^[[2]] Not only is epidemiologic capacity for public health preparedness and response activities enhanced, but resource and training burden on health department staff is minimized.

For more information about setting up a student team at an academic institution, visit the SEAL Team Website or contact Janet Baseman (jbaseman@uw.edu) and Nicole Marshall (schwalbe@uw.edu).

If multiple hiring mechanisms are available at the health department, selecting the most flexible option is generally best for establishing and maintaining a student team. To streamline hiring efforts, human resources staff at the university and health department should be engaged early and throughout the process to determine available hiring mechanisms and ensure all necessary paperwork and requirements are completed before students start working.

FoodCORE funding provided specifically for student teams varies by center and depends on several factors, including the number of students. In 2024, the average funding for student positions in FoodCORE centers was $32,000 with a range in funding from $5,000–$81,000, where the higher funding levels provide support for a larger student team. In addition to the costs associated with paying students (e.g., wages and indirect administrative costs), there are other costs and considerations associated with training, supervising, and managing the team, as described below.

It is also important to determine requirements for student supervision and how that supervision will be accomplished. For example, in some centers, a health department staff member must be on-site for students to work. This can be challenging when students conduct interviews during weekend or evening hours as is recommended in the “Initial Case-Patient Interviewing” model practice.

Alternatively, students in some centers may be approved to work partially or fully remote. A health department staff member will need to identify methods of meeting with and supervising students in a virtual setting. Determining these scenarios before students begin work will make the process go more smoothly and allow teams to be functional more quickly after students are hired.

Various avenues can be used to identify potential students, but engaging academic partners is a key component of recruitment. By establishing strong and mutually beneficial partnerships between universities and state health departments, students gain applied public health training and mentorship, and health departments benefit from additional staff capacity and a potential recruitment pool for future permanent positions.^[[3]]

FoodCORE centers have recruited graduate and undergraduate public health students, nursing students, pre-med students, and students from other disciplines such as infectious disease or microbiology, as well as some doctoral students. If more than one university or college is located near the health department, recruitment can occur at multiple places. Students have been successfully recruited through:

• Courses or seminars at nearby universities or colleges (e.g., guest lectures, adjunct faculty, etc.)
• Contacts (e.g., faculty members and advisors) at nearby universities or colleges
• Student associations
• Listservs and career center websites to announce opportunities
• Master of Public Health (MPH) program orientation events and career days
• Students who proactively contact the health department inquiring about available opportunities
• Word of mouth (e.g., current student response team members sharing opportunities with their peers informally, or outside of official avenues)

Recruitment is a recurrent or ongoing process as students complete their studies. Ideally, students will be available to participate for at least one full year. Hiring students early in their academic career (i.e., in the first year of their MPH program with the potential to work for up to two years) can minimize turnover and training. To ensure continuity, FoodCORE centers have found it beneficial to have new students overlap with more experienced students, when possible, even if only for a few months.

When selecting and hiring candidates, previous work experience should be considered. Centers have found that students with customer service experience excel at patient interviews.

Students should be trained in the specific jurisdictional structure, processes, and protocols. This should include details about the system(s) used to identify cases for interviewing as well as where information from interviews should be submitted or stored. This aspect of the training should cover all systems, resources, and contacts that the students will need to understand and use when completing interviews.

Additionally, students should be trained to follow all standard operating procedures of the health department, especially those that address data and patient confidentiality; time, attendance and leave policies; and appropriate conduct in the workplace and during interviews.

In addition to interviewing techniques and protocols, training should cover information about enteric diseases (including pathogen-specific considerations and protocols), surveillance, and outbreak response to help students understand the broader context and impact of their interviews.

Providing technical skills training on topics like data management and analysis, epidemiologic methods, study design, and biostatistics should also be considered. Health department staff should also ensure that while performing public health work, students also further their knowledge of the diseases and epidemiologic methods to which their work applies.

Many training materials have already been developed. Appendix C includes a list of available training and other resources from FoodCORE centers. Some of the included resources are pre-recorded videos, which save staff time and resources and can be accessed by students asynchronously.

Training formats vary across centers, and with the number of students being trained, but include the following:

• Protocol for collecting demographic, clinical, and exposure information.
• Protocol for follow-up if a person is unavailable, including whether a voicemail or text message should be left, and if so, what the message should cover, including contact information for callbacks.
• Protocol for administering supplemental interviews, including the National Hypothesis Generating Questionnaire (NHGQ) or outbreak-specific questionnaires, if needed or requested.
• Protocol for data entry into appropriate databases, platforms, or systems.
• Protocol (if any) to interview people that speak a language other than English.
• Which educational materials are available to direct people to, or to send directly.
• Tips for responding to and managing common challenging situations. For example:
  • What a student interviewer should do if a person has not been notified of their diagnosis before being contacted for the interview.
  • What a student interviewer should do when a person is hesitant or reluctant to share information.
  • What a student interviewer should do when a person is angry or frustrated.
  • What a student interviewer should do when interviewing a person who should be excluded from high-risk transmission settings or occupations, like daycare employees or food handlers.
• When to escalate situations to their program manager or supervisor.

Training manuals

FoodCORE centers have found it beneficial to develop a written student training manual so that students have an easily accessible reference. These manuals are most effective when they are routinely updated to incorporate feedback from experienced students and any procedure or policy changes. Eliciting and incorporating student feedback helps tailor the training manual to answer specific questions that incoming students are likely to have about their roles, responsibilities, and the workflow.

Hands-on training

Some FoodCORE centers have also incorporated shadowing of existing interviewers (more experienced students or staff) and direct observation and feedback for new interviewers. In some centers, new interviewers also conduct practice interviews before conducting interviews with patients. This type of hands-on training can help solidify learning, provide additional opportunities to address any questions, and solicit student feedback. Ideally, new students will overlap with experienced students so that the more experienced students can help train and mentor the new students.

Reviewing interviews and other work conducted by the students to provide constructive feedback allows for ongoing quality assurance and improvement.

Reviewing and evaluating student performance allows health department staff to coach students and to identify if refresher training is needed.

FoodCORE centers have found various solutions to coordinating schedules for multiple students to ensure coverage during business and non-business hours. Many have used shared calendars (e.g., Google calendar, or a shared Outlook calendar for all students), which allow both students and program managers to see who is available or scheduled for interviewing. During an acute outbreak response, shared schedules can also facilitate staffing for surge capacity.

Some FoodCORE centers have incorporated a student team leader position that helps with team management and scheduling activities. This position can function on a rotation schedule so that the workload and experience can be shared among the students.

Program managers and supervisors should be aware of potential conflicts in scheduling, like holidays, academic breaks, and exam periods to plan for coverage or re-assign shifts as needed.

Centers have found that having regularly scheduled meetings with student team members and supervisors or coordinators are valuable for discussing any issues, concerns about specific cases or outbreaks, and other items that affect the students and their assigned activities. In jurisdictions where student team positions are partially or fully remote, student team members and supervisors or coordinators communicate with cameras on to improve engagement.

In most FoodCORE centers, student activities extend beyond interviewing. Depending on the needs and protocols in the jurisdictions, training requirements, and availability, FoodCORE students also assist with additional surveillance and outbreak-specific activities. For example, in some FoodCORE centers students conduct analytic studies, data entry and analysis, retail food sampling, and participate during on-site inspection or assessment activities.

During the COVID-19 pandemic and other large responses, students at FoodCORE centers provided significant support to health departments that had limited capacity to conduct enteric disease investigations. Students completed follow-up on cases, assisted with data entry, maintained enhanced surveillance activities, and carried out investigations while core enteric staff worked on the response.

FoodCORE centers have also engaged students in special projects, based on existing needs and interests, including surveillance evaluations and other analytic projects. In some centers, students can leverage their experience to meet field experience or practicum requirements of their degree program or to complete a thesis project. Advertising the capability of working on special projects to meet academic degree requirements in job postings may be a useful recruitment tool.

Evaluation should include providing individual feedback to the students and eliciting feedback from the students. The frequency of student evaluation and solicitation of feedback varies by center and by how long a student has participated but should be undertaken at least as frequently as there is turnover. Ideally, students can give and receive feedback on an ongoing, continuous basis as part of their routine activities.

Regardless of whether students work in the office, fully remote, or hybrid, supervisors and coordinators should schedule regular and frequent check-ins, identify various options for in real-time team interaction (e.g., Slack, Microsoft Teams, Zoom, etc.), and establish clear expectations for work deliverables. Supervisors and coordinators can use office hours, team and/or one-on-one meetings with students to identify competency gaps and training needs, discuss progress on projects, and offer encouragement and support.

FoodCORE centers use formal and informal evaluation processes ranging from day-to-day discussions to exit interviews. Their evaluation techniques include quantitative and qualitative components to monitor and improve efficiency and quality of the students' work. Feedback from students is used to guide changes for training and day-to-day activities that can improve workflow and the student experience.

In some FoodCORE centers, more formal evaluations have included the use of pre- and post-tests when training students. Some centers have also tracked information for individual students such as the number of interviews conducted over time, completeness of the interviews, and the number of different investigations in which they have participated. These data are tracked in databases, such as REDCap, which is a web-based tool for secure and flexible data collection and can be shared with the students during a formal review. Some centers share these data with their student teams on a regular basis to ensure everyone is aware of the workload and assess where there may be gaps in surveillance.

Many centers have also found it beneficial to track information about their student teams over time, including the number of students who have participated and what positions or opportunities students take when leaving the team. See Appendix E. for more specific information about how FoodCORE centers evaluate their student teams.