Leadership Knowledge, Attitude, and Skill Changes Among LMICs Public Health Fellows in Korea: Pre- and Intra-COVID-19 Periods

Abstract

This study examined changes in leadership-related public health knowledge, attitude, and skill among 97 public health professionals from low- and middle-income countries (LMICs) who participated in the Korea International Cooperation Agency (KOICA) Master's Degree Program at Yonsei University between 2017 and 2022. A quantitative, two-wave panel design was employed using secondary data from three surveys administered at the beginning and end of the 18-month program period. Paired t-tests revealed a significant increase in knowledge scores (ΔM=+0.59, p<.001), but no significant changes in attitude or skill were observed. Multiple regression analysis showed that participants over 40 years old had significantly lower post-program knowledge scores compared to those under 30 (β=-0.69, p=.021). Program type was a significant predictor of skill scores, with Global Health Security (GHS) participants outperforming those in the Global Health Policy and Financing (GHPF) program (β=-0.42, p=.013). Notably, attitude change strongly predicted skill improvement (β=0.77, p<.001), while knowledge change did not. These findings suggest that the KOICA program effectively enhanced theoretical knowledge but had limited impact on attitude and skill in the short term, potentially due to challenges posed by the COVID-19 pandemic and limited opportunities for practical application. The results underscore the importance of competency-based training, learner-centered instructional design, and longitudinal assessment of leadership development outcomes in LMICs. Recommendations include tailoring curricula to specific programs, integrating practicum components, and conducting follow-up assessments to capture long-term changes in attitude and skill.