!"#!$%&#!$'#!(%)*! )' Harvard’s “Aid for Health” Simulation in its !ird Year 5/.?"((&%<+.:'4%7("(:"+.(%6/>L+(>4%J(+%91.%Z/?4%B(2+>%8/D("3/$? @'(%/1&'#",%/"(%&'(%2#E=#1.*(",%#=%9+*%!#"%8(/>&'4%&#:(&'("%F+&'%;1+L(%N1+$/"/(,%F'#%F"#&(%&'(%#"+:+./>%2/,(%$/&("+/>%/.*%2#E#":/.+L(*% `#&,F/./Q8/"D/"*%<2'##>%#=%71G>+2%8(/>&'Hs%% ast March, at Harvard’s Kennedy to experiment with practice simulations, Institute and one of the world’s most School, the Prime Minister of role-playing, and “dramatic immersion.” prominent experts on negotiations. Malawi and his key ministers As every aid practitioner knows, tech- Additionally, they were matched with Lmet representatives from the country’s nical knowledge is rarely su"cient to aid practitioners and expert coaches for main foreign donors for the negotiation navigate interactions at country level. further preparation. of an aid package to help the country !ese tend to be highly political and At the beginning of the meeting, the achieve internationally agreed targets for socially complex, requiring skills that “Prime Minister” welcomed all delegates health development. In this situation, cannot easily be taught in a traditional and immediately issued the challenge: however, the Prime Minister of Malawi classroom environment. Malawi needs more aid to improve the was Harvard professor Stephen Marks, At Harvard, A4H has been put health of its people. !ough the inter- playing the lead role in Aid for Health into practice since 2009 by members national community had declared global (A4H), a student-led simulation exer- of the Global Health Student Forum goals for development, donors had not cise meant to transform the way global with sta# and faculty support, with provided the money it would take for health and development are taught the objective to provide students with developing countries to actually achieve across academic disciplines and schools. a unique interdisciplinary experience. them. Moreover, the donor countries !e idea for A4H emerged from From year to year, the simulation case had signed declaration after declara- discussions at the Harvard School of scenario continues to evolve, but in its tion claiming that they would change Public Health (HSPH), following a basics remains the same: !e “Prime their ways – most notably by increas- presentation on practices and politics Minister” calls a meeting of all the major ing country ownership and working of health aid during which present- international donors and stakeholders through existing systems. ers and students realized that existing in the Malawian health sector. His goal In the three hours that followed, the coursework did not cover these issues. is to coax foreign donors into increas- Ministers of Finance and Health tried to While Harvard certainly does a great ing their aid allocation for Malawi while persuade bilateral donors, UN agencies, job of teaching the core skills of pub- preventing them from attaching too and development banks to commit more lic health, students were concerned that many conditionals. money and allow the country to decide they were not su"ciently prepared to Issues such as Malawi’s acute short- where and how that money would be enter the professional world of global age of health care workers and lagging spent. Everyone strived to think beyond health with its crowded landscape of progress on its MDG targets for health zero-sum-bene$ts for mutual gains. It institutional agendas, mandates, poli- topped the agenda this year. was a much messier, challenging pro- tics, and programs. !e fourteen A4H participants cess than expected or re%ected in text- !is gap between professional pros- this year came from Harvard, Boston books. Many students looked stressed pects and academic preparation is espe- University, MIT, Tufts, and Boston but also excited, and laughter $lled the cially peculiar given the large number College. Each participant was assigned room when someone brie%y slipped out of Harvard alumni working for the to a delegation and role to impersonate. of character. For many participants, this WHO, CDC, USAID and other inter- Even before the actual negotiation, all experience not only transformed their national organizations. Instead of devel- participants underwent a special training understanding of the issues but also oping a conventional academic course session by MIT’s Lawrence Susskind, a#ected their career planning. on these issues, the decision was made founder of the Consensus Building A4H might be a new and unique )) experience at Harvard, but simulations consequences, they are skills that ideally for re#ection and structured debrie%ng and role-plays are already widely recog- should not be learned on the job. while the experience and the immersion nized as e!ective learning tools. "ey are In group role-play simulations, are still fresh is vital. Early in the pro- frequently used in industries where it is participants bene%t particularly from cess participants typically pursue “posi- desirable to program re#ex responses in observing and interacting with their tional” tactics to persuade others. Later stressful situations (i.e. the airline indus- peers in a dynamic environment where on, they begin to appreciate the value of try, the military, or in critical care medi- they have ample opportunity to evalu- reaching consensus and achieving “win- cine) as well as in business and manage- ate successful and unsuccessful strate- win” outcomes. Without the interactive ment. In the area of development and gies for dealing with novel problems. emotional experience of the simulation, health, simulations have so far not been Importantly, they receive immediate the value of these principles would be pursued. feedback on the consequences of their di$cult to realize. Simulations are particularly suited positions in a forgiving, friendly atmo- Overall, apart from being an enjoy- for learning intangible skills that are not sphere. As Nadler et al. (2004) found, able way of learning about international easily taught through didactic methods. negotiators who learn through peer- a!airs, the A4H simulation also re#ects Critical thinking is di$cult to learn in observation are considerably more suc- a broader move away from classroom- the absence of direct application and cessful at achieving negotiation goals in based education towards a more #uid, social interaction. Few would argue comparison to those who learn through learner-oriented, and experiential form that “leadership skills” or “teamwork” didactic or analogical methods. of learning that may better equip stu- are best taught by committing to mem- Learning via simulation thus allows dents to become change agents and ory a list of key features of great leaders process rehearsal that is bene%cial and leaders. or well functioning teams. In addition, informative, but also allows for criti- in situations in which there are serious cal experimentation. 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