About Bruce Lambert, Ph.D.: Bruce Lambert is the Director of Northwestern University’s Center for Communication and Health. He is also the Director of the Master of Science in Health Communication program that is offered through Northwestern University’s School of Communication. As Director, he oversees curriculum design and development and student admissions, advises students in the program, and supports and recruits faculty. He also teaches and does research on health communication, patient safety, health information technology, and medical liability reform as a Professor in the Department of Communication Studies.
Dr. Lambert’s research interests include preventing medication errors and enhancing patient safety through clear and consistent communications in medical and other settings. He has published articles in the Journal of the American Medical Association, Health Affairs, Health Communication, Social Science & Medicine, and elsewhere.
Prior to his work at Northwestern University, Dr. Lambert served as a Professor at the University of Illinois at Chicago for over two decades, and was a co-founder of the UIC Institute for Patient Safety Excellence. He is also the President of two consulting firms, BLL Consulting and Pharm I.R., Inc., both of which work to improve the integration of communication technologies into health systems. He blogs about communication at HowCommunicationWorks.com and has a YouTube channel of the same name.
Dr. Lambert earned his Bachelor of Arts, Master of Arts, and Ph.D. in Speech Communication from the University of Illinois at Urbana-Champaign.
[MastersinCommunications.com] As a scholar of health communication, patient education and safety, and information technology for over twenty years, how would you describe the field of health communication and its evolution over the past two decades? Why is health communication such a crucial industry and field of study, especially in this day and age?
[Dr. Lambert] Healthcare is a $3 trillion part of the United States economy. It represents between 15-16 percent of gross domestic product, and affects the life of every single American. Whether we are healthy or sick, healthcare consumes an enormous amount of resources and it profoundly shapes our destinies.
When we are sick it shapes our destiny in a direct way because it affects the quality of our care, and our experience of care, whether we feel and are indeed safe, etc. And it shapes our destiny when we are healthy because it consumes so many resources that if we had a more effective and efficient healthcare system, we would all have more money to take home in our paychecks, more money for schools and roads, and every other purpose we might put our resources towards. And our healthcare system is badly broken in ways that the communication arts and sciences are able to help repair.
At Northwestern University’s Center for Communication and Health, we have a mission. And that mission follows closely with what is called the Triple Aim for quality in healthcare, which was first introduced by the Institute for Healthcare Improvement, or IHI. And as the name suggests, this Triple Aim is comprised of three interrelated goals.
The first is to improve the health of the population, especially with respect to chronic disease. It is possible to dramatically reduce the prevalence and severity of a lot of chronic diseases, like heart disease, cancer, stroke, diabetes and so on, with better prevention and treatment. And this is instrumental in improving the health of the population overall.
The second is to improve the experience of care for individuals. Healthcare is too often frustrating, humiliating, embarrassing, maddening, and incomprehensible for individual patients. Not to mention, most importantly, unsafe. Millions of patients are harmed by healthcare every year. Tens of thousands, if not perhaps hundreds of thousands are killed by medical errors every year. And communication, or rather miscommunication or lack of communication, is implicated in most of those errors. So, the second aim is improve the experience of care for people.
The third aim is to reduce the per capita cost of care. Healthcare is slowly but surely bankrupting us all. We are like the frogs in boiling water. We don’t notice it on a day-to-day basis, but slowly and surely healthcare consumes more and more of everything we earn, both individually and as a country. And it is unsustainable. There are so many inefficiencies, and we think that by applying design thinking and using new communication tools and social media influence and interaction design, we can improve the efficiency of many processes in healthcare. That is why I believe health communication is such an important field to study. It is, I believe, the most or one of the most important applied domains for the communication arts and sciences for all the reasons I just described.
To your question about how health communication has evolved over the past 20 years, I think that really depends on one’s perspective. I think that health communication scholars have increasingly focused on real clinical settings and have engaged more directly in trying to use communication to improve the quality and safety of healthcare. I think there have been large trends and movements within healthcare towards setting and meeting certain standards of quality, especially since the Institute of Medicine’s report about human error in healthcare and how to address it. So, these are large-scale trends in healthcare generally and communication scholars who have studied healthcare have followed these trends as well. Healthcare professionals and institutions are doing more work directly in clinical studies trying to improve quality and safety of healthcare.
At the same time, there have been dramatic changes that are related to the growth of the Internet and social media. The modern Internet was really born in 1994 when the first web browser appeared. That was before Google, Facebook, and Twitter. That was before any social media. And within that span of time between 1994 and now, social media has grown to be an incredibly important communication channel. One of the most significant trends is the impact of modern digital media, social media, and mobile communications technology on health care and health communication. Scholars are now exploring the impact of global, social, and digital technologies on the way patients interact with their providers and the way health systems organize themselves, and how the use of medical records affects communication between teams.
We still have more traditional forms of mass communication such as television, radio, and billboards. But things like print newspapers and magazines have virtually disappeared. And the role of television has dramatically shrunk compared to digital media.
For people who study campaigns, their work has shifted significantly. There have not been many dramatic theoretical advances in the past 20 years. Most of what we know about audiences or about persuasion has remained stable, and we have seen just incremental changes—including perhaps the introduction of narrative messaging as a form of persuasion, which has led to incremental improvement in our understanding of how to evaluate messages.
Most of these technologies are far too diverse to draw any uniform conclusion about their impact in the short term and the long term. They have both helped us and harmed us. They’ve simplified certain parts of the care process, while complicating others. They have eliminated some errors and introduced others. Investigating these effects is one of the principal things that scholars of health communication do. Even one individual technology would be hard to make a simple straightforward conclusion about. There are so many contexts for health communication and so many different technologies. And many of their effects we don’t really understand yet.
[MastersinCommunications.com] Could you please provide an overview of the Master of Science in Health Communication program at Northwestern University, and how it is structured? What topics are covered in the core curriculum and what are the key learning outcomes students can expect from this program?
[Dr. Lambert] When we designed the Master of Science in Health Communication program, we did so with the Triple Aim mentioned above first and foremost in our mind. We wanted to create a program that gave students a strong grasp of the complexity of the health care system in America, communication’s role within this system, and how both patients and providers can be more effective in achieving their shared goal of individual and population health. Our program has a strong focus on patient care, patient-provider interactions, and understanding the health care system overall. I feel that this focus makes our program distinctive because students learn that all forms of health communication begin and end with the patient experience and health outcomes in mind.
Our core classes cover all the important aspects of health care in America, from the individual patient-provider relationship to larger-scale considerations for changing health behaviors and outcomes. Students learn about individual and community health education, and the health care system and its relationship to economic, social, and political systems. Students take eight core classes: How Interaction Works, The U.S. Healthcare System, Human-Computer Interaction, Changing Health Behavior, Engaging Patients in Healthcare, Difficult Conversations, a proseminar, and an internship or practicum course. These courses cover communication theory, individual psychology and behavior, the history and current status of American healthcare, how to involve patients in their own care and empower them to make positive changes, and the latest technologies that are being used in healthcare such as EHRs, mobile applications, and other technologies that seek to address fragmentation in the patient care experience.
A central philosophy that runs through each of the core classes is how engaging patients in their own care through various means and at different points in their care experience is crucial in improving their care experience and medical outcomes. So much of prevention and treatment of chronic disease is about getting people to change their own behavior whether it is exercise, drinking, diet, or smoking. The course Changing Health Behavior, for instance, covers these concepts in depth. Part of engaging patients in their care is developing and exhibiting patient empathy in all forms of communication, from online educational content to one-on-one conversations. Our class the Experience of Illness, for example, teaches students about the experience of illness from the patient’s point of view. This empathy can then translate into more effective messaging that then has a stronger impact on patient outcomes.
Part of the Triple Aim is also about reducing the per capita cost of care, and the very first course in our curriculum, on the US Healthcare System, introduces students to the Affordable Care Act, to Medicare, Medicaid, commercial insurance, how health care professions are organized, how care is paid for, reimbursed, how employer-based health insurance works, and how government-based health insurance works. They also learn how you measure the quality of care, how you create incentives for quality, and incentives for cost savings.
After the core classes, students take their choice of two electives from classes such as The Experience of Illness, Health and Media, Designing Health User Experiences, Organizational Behavior in Healthcare, The Social Context of Illness, and Learning and Health. These elective options change from year to year. Electives allow students to delve more deeply into the areas of health communication that most interest them, such as communication in palliative care settings, patient and consumer education through mass media channels, and how user experience design applies to inpatient and outpatient care settings.
Students who complete our program are going to understand how healthcare in the United States is organized, and have a strong grasp of the fundamentals of communication theory and how different health-related interactions work. They’ll have a set of conceptual principles that allow them to analyze any communications situation in terms of its component parts and how those parts relate to the desired outcome. And then they learn key design principles that will allow them to reshape interaction systems to more effectively achieve their desired outcomes.
Students also learn about the idea of normative design, which is the idea that whenever we attempt to redesign a system, we bring to it some set of, principles or ideals about what we think the world ought to be. And considerations of this get embodied in our design. Awareness of this can help students develop more effective campaigns, communication systems, and user interfaces for digital services for patient care and record-keeping. Students also learn principles of quality measurement and quality improvement so that they can design interventions, do small tests of various changes, implement the changes that work, and use social networks and other devices to disseminate changes in an organization. They also learn how to use social influence to change attitudes, intentions, and behavior of both individuals and groups.
Our students also learn how to do user-centered design of information systems and technology systems. It is important that our students understand how human computer interaction works, because so many healthcare interactions are mediated by computers, whether they are electronic medical records or patient portals or smartphones. They will learn, both conceptually and practically, how human computer interaction works, and have internship experiences that give them real life exposure to the way these problems manifest themselves in actual healthcare organizations.
While our classes are rooted in the theories that inform design choices and practical quality improvement projects, we do not teach theory for theory’s sake. We view health communication as an applied discipline. We’re mostly trying to empower students with practical knowledge that will allow them to do interaction design, and apply theories of social influence to improve the quality, safety, and cost effectiveness of healthcare.
[MastersinCommunications.com] For their final graduation requirement, students of the Master of Science in Health Communication program must complete an internship or practicum. Could you elaborate on this requirement, and what it entails?
[Dr. Lambert] The internship option is for students who have fewer than five years’ experience working in a healthcare setting or professional communication setting. Those students have to find an internship, and while we support them in finding their internship, it is ultimately their responsibility to find an opportunity with an organization and secure a position, normally in the Chicago area. The internship typically occurs during the summer quarter. They have to have about 70 contact hours, which allows them to work in a real health communication/organizational setting and begin to solve real problems in the space, see how problems manifest themselves, and use the tools that that they learned in class in an applied setting.
In contrast, the practicum is a course that our more experienced students take that helps them build on their leadership skills, while also giving them the chance to build their skills in advanced areas of communication, human-computer interaction, and campaign development. This year’s practicum, for instance, focused on visual communication, i.e. using information visualization to communicate complex information visually for different kinds of audiences.
[MastersinCommunications.com] What role does faculty mentorship play in Northwestern University’s Master of Science in Health Communication program, and how can students make the most of these mentorship opportunities and support systems? Additionally, what career development resources and academic services are available to students of this program?
[Dr. Lambert] At Northwestern, we provide students with extensive career and academic support that is tailored to their needs. Some of our students have up to 15 or 20 years’ experience in their careers, and therefore they might not consult career services as intensively or frequently as a recent graduate from college would. However, those who need it have a great deal of support on things such as resume workshopping, LinkedIn strategy, thinking about career goals and career strategy, job search, approaches to job search, and interview skills.
Students do not get an individual program advisor, as the curriculum is fairly set and therefore students need less guidance in terms of deciding which of their courses to take. With that said, we build faculty and professional mentorship into the program through the classes, the internship/practicum, and the proseminar which is a career-oriented one hour every Saturday where students meet 38 different representatives from the health communication industry.
Proseminar presentations are 45-minute talks with 15 minutes for Q&A where someone from health insurance industry, or drug companies, or the medical device industry, or a hospital or health system or start-up will come and tell us about their business. We’ll talk about the kinds of job opportunities, the kinds of career trajectories that people in their business have or what they’re looking for in future employees. And the students will be able to do Q&A. And those sessions are also networking opportunities for students to begin to tell their story, give their elevator pitch and get a lay of the land. People in health communication do so many different kinds of things and can work in so many different kinds of industries that our less experienced students especially just need to kind of get a map of the territory, and that we do with the proseminar.
At Northwestern we also have a program called EPICS, which is an acronym that stands for experiential programs, internships and career services. EPICS is a dedicated unit in the School of Communication that serves undergraduates and graduate students, including our master’s students. There is a dedicated EPICS staff person who works only with health communication students, and who meets with each of them individually to talk about their career plans.
We also have a lot of applied sessions for students. For example, on Saturday during the noon hour we often have workshops and informational sessions about building your LinkedIn profile, networking, how to craft your resume, and other extracurricular topics. For example, we just recently had a mock interview where we had a group of human resource professionals come in that do mock interviews with our students.
Additionally, students are welcome and encouraged to attend all of the activities that occur in the School of Communication on an ongoing basis, including a monthly health communication research seminar, and a weekly seminar sponsored by the doctoral program in Media, Technology, and Society, which is offered by the Department of Communication Studies.
[MastersinCommunications.com] What advice do you have for prospective students in terms of submitting a competitive application for Northwestern University’s Master of Science in Health Communication program?
[Dr. Lambert] In terms of hard requirements, we require applicants to hold a baccalaureate degree. It does not have to be in communication specifically. While we do not have a strict GPA cutoff, we do like to see GPAs of 3.0 to 3.5 minimum. That said, occasionally we get people who have had tremendous success in their professional career for 15 years. But, if you look back at their college transcripts from 18 years ago or 20 years ago, they don’t have the strongest transcripts. However, they have this fantastic career progression, and strong letters from people who have worked with them for years. We welcome candidates like that.
We read applications very carefully, and are looking for people who can add to our classroom environment. We require a personal interview and three letters of recommendation. Interviews are typically conducted in person but can be done via Skype if applicants are remote. The vast majority of our students are in the Chicago metro area or Northeast Indiana or southern Wisconsin. So they normally come for a face-to-face interview.
What we’re really looking for are people who have a clear idea why they want to be in health communications, as illustrated through their personal statement. Why specifically do you want to be in health communication? Why Northwestern for health communication rather than any other programs? Do you have a clear vision for what they think this degree will do for you? We try to evaluate the fit between applicants’ goals and what we have to offer. And then there are the intangible qualities that help us understand what will they contribute to the classroom. How will their life experience, their work experience, their particular specialty contribute to the classroom?
We look for proof of academic performance so that we are convinced they can handle the rigor of our program. And we look for references that testify to their character, work ethic, and ability to handle the classwork.
During admissions, we also think very carefully about the class cohort that we want to build. Sometimes people have really unique work experiences. For example, they have international health experience, which we don’t have that much of. And we think about how they will contribute great insights to the class discussion. Many of our students come from the health insurance industry, as well as the medical device or medical technology industries. We also have students who come from the medical or health communication industry, such as the FDA, or state and local government health departments. For example, a student in our class this year runs the clinical performance lab here at Northwestern. And we have people whose job it is to design, maintain, and support electronic medical record (EMR) systems in very large health systems. We also get medical providers such as nurses and physicians and pharmacists. And for our students who are recently out of undergrad, their strength is their scholarship—they are accustomed to doing the reading and the writing, and they have the most current academic knowledge having just been in an undergraduate program. They might know how to master modern digital learning systems, for example. We love to have that diversity, so that the classroom discussion can be grounded in all these different perspectives. I think it is one of the best parts of our program.
For example, when you have physicians, nurses, EMR designers, and social service professionals all taking the same class, you see them engaging in productive conversations about the challenges they face and what kinds of collaborative efforts would help to address them. Health care is necessarily interdisciplinary and collaborative, and therefore when we have people with such varied careers in one classroom, all with the same mission of better patient outcomes it is an instructional experience on many different levels, with students learning from each other and discussing innovative ways to solve current problems in health care.
I think our degree program hugely benefits anyone who goes through it, and I would love to see more clinicians in particular in our program, because I believe this demographic gets a particular benefit from what we teach here. They have the advantage of direct experience with patient care and being in a real health system, so they understand the real health communications challenges that doctors and pharmacists and nurses and patients face. And when they learn the content from our program, they put themselves on a fantastic career trajectory, because they have the deep expertise in their clinical specialty, and are then empowered by the social science and strategies of health communication.
[MastersinCommunications.com] What makes Northwestern University’s Master of Science in Health Communication program unique, and a particularly strong graduate degree option for students?
[Dr. Lambert] Northwestern is one of the finest universities in the world. If you look at global rankings in higher education, Northwestern is in the top 25 of rankings of the finest universities in the world. And its School of Communication is often ranked in the top three of schools in the nation, and its faculty have been the recipients of many NSF career awards and grants. The most important part of any graduate program is the faculty. And here you get to be taught by world class faculty who are advancing the field of health communication. Our program also has practical advantages. It is a Saturday only, executive style program. It is 40 weeks, so students can earn their master’s in a year, while still working full-time.
Our adherence to the IHI Triple Aim is also something that makes us unique. It keeps us focused on developing classes that are more holistic in nature, by which I mean we make sure our classes cover the status of American healthcare, patient psychology and behavior, and all the major communication dynamics that are present in the health care field, from the patient-provider dynamic to mass media and health marketing. Students don’t just learn communication skills and apply them superficially to health-related contexts. Rather, they learn from the ground up what makes for a strong health care system, and how communication plays a role in each aspect of medical care and community health and well-being.
Our program’s focus on social influence and interaction design and the connection between those two things also makes it unique. In addition, students get the benefit of the Northwestern Alumni Network, and the influence and prestige of the Northwestern University brand.
Our location in Chicago makes us an excellent choice for those seeking advanced professions in the health care and health communication field. Students get to attend classes blocks away from the best hospital in Illinois, Northwestern Memorial Hospital, and because several of the faculty in the program are from the Feinberg School of Medicine, they have direct connections to valuable contacts. Our proseminar also directly connects our students to leading professionals in the area within the field of health communication.
The field that we prepare our students for is a good field to be in. While no industry has perfect employment statistics, our students generally do extremely well in the job market, either with new jobs or promotions or raises in pay. There is tremendous demand for the skills that our program teaches. The fact that healthcare consumes 15-16% of all the dollars in the economy is both good and bad. It’s bad because it’s unsustainable, but it’s good for anyone who’s in this industry because it means there’s a lot of opportunity for employment.
And I would say one more thing about health communication. There is so much opportunity for meaningful employment. This is a domain of work where every single day you can feel extremely good about what you’re doing. You’re not trying to sell people tobacco or alcohol or consumer goods that they don’t need. At its core, health communication is about trying to help people relieve their suffering, prevent illness, treat illness, and avoid injuries. You can come to work every day generally feeling that you’re engaged in a very pro-social endeavor, with objectives that are moral and constructive for the community. As health communicators, we are trying to help people and relieve their suffering or improve these broken systems that affect all of our lives. And you can’t say that about every job.
Thank you, Dr. Lambert, for your excellent insight into the field of health communication and Northwestern University’s Master of Science in Health Communication program!