Developing the Next-Generation Health Policy Workforce Using a Competency-Informed Approach

Health policy leaders today face unprecedented challenges—from ensuring access to cutting-edge treatments and harnessing AI for better outcomes, to protecting population health in the face of climate change. Tackling these complex issues effectively demands broad perspectives and new kinds of expertise.

To meet this need, Duke-Margolis developed a health policy core competency framework to prepare the next generation of health policy professionals with the knowledge, skills, and cross-sector experience needed to drive practical, evidence-based solutions that improve health and health care for all.

A competency-informed approach to developing future health policy leaders provides:

Clarity and consistency around learning goals and outcomes and individual and program assessment;
Connectivity between education programs and needed health policy knowledge, skills, and experience to succeed in an ever-changing field;
Customization of learning opportunities to individual development goals, needs, experience, and career paths; and,
Collaboration between learners, educators, and practitioners to facilitate applied and real-world learning.

About the Duke-Margolis Health Policy Core Competency Framework

Informed by feedback from a broad range of health policy professionals, the Duke-Margolis Health Policy Core Competency Framework is organized into 6 domains – 1) Health Care System & Policy Process, 2) Policy Development & Evaluation, 3) Data & Methods, 4) Policy Translation & Communication, 5) Networks & Relationships, and 6) Leadership & Teamwork. There are 3-7 competencies associated with each domain, which describe key areas of health policy knowledge or skills, for a total of 26 competencies. Together, the competencies reflect a versatile, interdisciplinary skillset that will prepare tomorrow’s health policy leaders to solve today’s – and tomorrow’s – toughest health care challenges – with evidence, innovation, and impact.

Health Care System & Policy Process: Description:

Ability to describe and appraise the U.S. health care system, including the role of health policy, how it is made, and the factors and stakeholders that shape the policy-making process. Entails awareness of past, present, and future opportunities for system and policy reform.

Rationale:

A strong understanding of the U.S. health care system, health policy process, and opportunities for system and policy reform – in historical, contemporary, and comparative context - is essential foundational knowledge for health policy professionals.

Competencies:

1.1 Describe the structure, organization, financing, and regulation of the U.S. health care system and recognize how it compares to other health systems around the world.

1,2 Identify and critique key dimensions of health system performance

1.3 Delineate the structural, social, and political determinants of health and their influence on health outcomes, health and health care equity, and other dimensions of health system performance.

1.4 Define health policy and explain its role at local, state, federal, and global levels.

1.5 Explain the health policy-making process and associated legislative, regulatory, legal, ethical, and political constraints.

1.6 Characterize and relate key stakeholders in the health care system, their motivations, and their role and influence on the policy process.

1.7 Identify key historical and contemporary areas of health care system and policy reform, including major laws, acts, and regulation.

Policy Development & Evaluation: Description:

Ability to engage effectively in policy development and evaluation, including identifying, assessing, and framing health policy problems; identifying and analyzing potential policy options to address them; formulating policy recommendations or positions; and evaluating policies to assess their implementation and impact. Entails awareness and consideration of strategies to facilitate policy development and evaluation, including stakeholder engagement.

Rationale:

Throughout their careers, health policy professionals will be required to contribute to or lead aspects of policy development and evaluation, including policy analysis, policy formulation, policy implementation, and policy evaluation. While health policy professionals may not be engaged in all of these facets throughout their career, the ability to recognize and examine health policy problems, identify policy solutions, assess policy impact, and anticipate and address levers or barriers to the policy process are critical and transferable skills across a variety of health policy roles and career pathways.

Competencies:

2.1 Delineate and frame health policy problems, outlining key policy questions, evidence gaps, and stakeholders and/or affected populations.
2.2 Identify policy options to address health policy problems and analyze their anticipated outcomes and trade-offs.
2.3 Develop and advocate policy recommendations or positions (e.g., legislative, regulatory, legal, organizational) to address health policy problems.
2.4 Formulate strategies to advance the adoption, implementation, and/or evaluation of health policies.
2.5 Evaluate the implementation and impact of health policies and identify potential adaptations or reforms to address existing barriers, challenges, and/or unintended consequences.
2.6 Apply awareness of stakeholders and/or affected populations and their perspectives to policy development and evaluation, including practical strategies to involve them in the process.

Data & Methods: Description:

Ability to locate, assess, interpret, and use data and evidence to delineate and assess health policy problems; identify and analyze policy options; formulate policy recommendations; and evaluate policy implementation and impact. Underscores recognizing the importance of evidence-based health policy, including associated research and analysis methods and techniques.

Rationale:

Data and methods are critical to support evidence-based health policy. Health policy professionals need to recognize fit-for-purpose health policy research and analysis methods and techniques and the ability to understand, critically assess, translate, and apply different types of data and evidence effectively and responsibly to inform policy development and evaluation. Health policy professionals in research-focused roles will need additional competency in research design, methods, and data analysis.

Competencies:

3.1 Understand the role, types, and sources of data and evidence used in health policy, recognizing existing gaps, limitations, and considerations of responsible use.
3.2 Identify fit-for-purpose health policy research and analysis methods and techniques.
3.3 Critique and interpret data and evidence and draw implications for policy, practice, and/or research.
3.4 Synthesize and apply data and evidence to inform and support policy development and evaluation.

Policy Translation & Communication: Description:

Ability to translate and communicate complex health policy concepts and topics to a variety of audiences in written, oral, and visual formats, including skills to tailor what and how information is communicated and disseminated to fit the purpose, context, and audience. Includes demonstrated capability to craft professional communication and dissemination products used in health policy.

Rationale:

Communication is a central element of health policy. Health policy professionals need to possess the ability to translate and communicate complex information effectively, tailored to diverse purposes, contexts, and audiences, using verbal, written, and visual formats.

Competencies:

4.1 Translate and communicate health policy concepts and topics, including policy recommendations or positions, in a clear, cogent, and audience-appropriate manner.
4.2 Understand health policy communication and dissemination strategies and how to tailor their use for different purposes, contexts, and audiences.
4.3 Develop high-quality written, oral, and/or visual communication products used to inform and influence the field of health policy, such as policy briefs, policy memos, white papers, journal articles, blogs, comment letters, presentations, op-eds, testimony, social media, and infographics.

Networks & Relationships: Description:

Ability to develop and maintain professional networks and relationships in health policy and bring them together around health policy issues and approaches. Underscores the importance of establishing networks and relationships with a diverse range of partners and collaborators, and considering their values, interests, perspectives, and experiences to build and sustain trust, cooperation, and shared learning.

Rationale:

Health policy requires different individuals, groups, and organizations to come together to address complex health and health care issues. In order to be effective in their roles, health policy professionals need the ability to develop and maintain diverse networks and relationships and to connect and activate them around health policy problems, priorities, and approaches.

Competencies:

5.1 Establish and maintain networks and relationships with individuals, groups, and organizations from different disciplines, professional roles, sectors, and communities involved in and affected by health policy.
5.2 Connect and activate networks and relationships around health policy issues and approaches.
5.3 Apply awareness and consideration of the values, interests, perspectives, and experiences of different networks, partners, and/or other collaborators in health policy contexts to build and sustain trust, cooperation, and shared learning.

Leadership & Teamwork: Description:

Ability to work with and lead individuals, groups, and/or organizations towards common goals to achieve a specific outcome(s). Includes capabilities to apply leadership, management, and teamwork practices and principles to motivate and empower others, advance diversity and inclusion, drive progress, navigate challenges and change, and seek and embrace opportunities for improvement.

Rationale:

Throughout their careers, health policy professionals will need to exercise leadership and teamwork to advance health policies, including the ability to work effectively and inclusively with others; make decisions; solve problems; respond to conflict and change; and identify and act upon opportunities for continuous improvement.

Competencies:

6.1 Understand and demonstrate principles of ethical and inclusive leadership – honesty, integrity, diversity, fairness, respect, empathy, transparency, and accountability.
6.2 Employ leadership, management, and teamwork techniques (e.g., goal- and vision-setting, communication, delegation, collaboration, problem solving, decision making, consensus building, time and resource management, negotiation, conflict resolution, change management, active listening) to motivate and advance the work of individuals, groups, and/or organizations.
6.3 Engage in continuous learning and improvement through reflecting on one’s strengths and developmental needs, seeking feedback from others, and harnessing growth opportunities.

Putting the Health Policy Core Competency Framework into Action

The Duke-Margolis Health Policy Core Competency Framework is designed to be a flexible, adaptive, and practical resource to inform and guide health policy education, health policy training programs, and health policy workforce development more broadly. It also serves as a critical tool to help students, trainees, and health policy professionals to assess and track their competency development, identify personal development goals, and monitor and recognize new or improved health policy knowledge and skills over time. To that end, the framework aims to recognize that competency development is dynamic and longitudinal, affording assessment and goal setting across diverse learning needs, experience, career paths, and professional stage and roles.

At Duke-Margolis, the framework is supporting a range of efforts, including but not limited to:

Evaluating and improving our current core education and training offerings;
Developing and implementing competency self-assessment tools and professional development goal-setting resources;
Creating new courses, curriculum, and initiatives to enhance health policy workforce development; and,
Building partnerships with students, faculty, and other collaborators to foster the development of emerging leaders in health policy.

Download the Duke-Margolis Health Policy Core Competency Framework

For example, in 2024 we piloted application of the Health Policy Core Competency Framework in the Duke-Margolis Summer Experience Internship Program, which involved 17 interns from Duke and schools across the U.S. During the program, interns worked on mentored research projects focused on a range of health policy issues – from advancing accountable care reform in the safety net to identifying barriers to cancer clinical trial access and participation – and participated in professional development activities, including health policy seminars, a career panel, and lunch-and-lunch sessions covering different health policy topics.

At the beginning of the program, interns were introduced to the Duke-Margolis Health Policy Core Competency Framework, completed a Health Policy Core Competency Inventory, and worked with their mentors to identify competency development goals for the summer and internship activities to support achieving them. Interns outlined a range of competency development goals, with competencies in the Policy Development & Evaluation and Data & Methods domains of the framework being most frequently targeted for development during the summer.

At the end of the summer, interns produced written reflections on their competency development and responded to survey questions aimed at assessing the usefulness of the framework in supporting their development in health policy and their individual progress in building their target competencies. All 17 interns found the Duke-Margolis Health Policy Core Competency Framework helpful for framing their summer experience. The majority of interns (59%) reported building all of their target competencies, with 100% building at least one target competency. Over three-fourths (76%) reported building other, additional competencies beyond those targeted.

This summer has been instrumental in building the Health Policy Core Competencies. I believe that the hands-on experiences and feedback from [my team], as well as the workshops, support, and activities through the Summer Internship Program, allowed me to quickly overcome initial challenges, and significantly strengthen my core competencies, preparing me for future contributions in health policy.

Learn More About the Health Policy Core Competency Initiative

Interested in learning more about our Health Policy Core Competency Initiative and/or potential collaboration on health policy competency development and assessment? Please contact Dr. Corinna Sorenson, Director of Academic Programs at Duke-Margolis and Assistant Professor in Population Health Sciences and Public Policy: corinna.sorenson@duke.edu.

Partner with Duke-Margolis

Interested in partnering with Duke-Margolis on health policy education and workforce development initiatives? Please contact Dr. Gillian Sanders Schmidler, Deputy Director at Duke-Margolis and Professor in Population Health Sciences: gillian.schmidler@duke.edu.

Support the Health Policy Core Competency Initiative

Interested in supporting our Health Policy Core Competency Initiative or other health policy education programs? Please contact Lauren McCrary, Associate Director of Development at Duke-Margolis: lauren.mccrary@duke.edu.

Developing the Next-Generation Health Policy Workforce Using a Competency-Informed Approach