The MACH model: From competencies to instruction and performance of the public health workforce

In A National Public Health Strategy for Terrorism Preparedness and Response 2003-2008, the Centers for Disease Control and Prevention (CDC) outlined the 11 imperatives for preventing death, disability, disease, and injury associated with urgent health threats.(1) Imperative five, Competent and Sustainable Workforce, identifies four critical objectives: (1) increase the number and type of professionals who comprise a preparedness and response workforce; (2) deliver certification and competency-based training and education; (3) recruit and retain the highest quality workforce; and (4) evaluate the impact of training to ensure learning has occurred. The plan states: "Challenges that exist... include defining the role of certification, practicing quality assurance and performance measurement, developing customized standard competencies...."(1) The MACH (Miner, Alperin, Cioffl, and Hunt) Model, developed at the Rollins School of Public Health, serves as a logic map that describes the associations among the objectives and challenges within this imperative. The MACH Model places into context the organizational and instructional theories that underpin workforce preparation and practice. It also accounts for the two general types of needs within public health: those of the employee with skill deficits for specific tasks, which can be met through training or other expert systems; and those of the institution with deficiencies in the work environment, which can be met through management practices and organizational priorities.