Author Archives: Timothy L Lash

Managing Up

Category : PROspective

These PROspective columns are meant to help RSPH EPI students to be more influential public health practitioners, especially after they graduate and join the public health workforce. Our department works hard to assure that students’ learning experiences prepare them with the knowledge, skills, and philosophy to be influential, but career skills are often as important in determining influence and success once graduated. This week’s PROspective takes on the difficult topic of how to succeed when your workplace supervisor stands in the way.

Supervising in Epidemiology

Poor supervisory skills can emanate from many sources, as described in this article from Harvard Business Review. One possibility, especially in some pubic health workplaces, is that the supervisors have never had any help preparing to manage. They may have risen to their position because of the skills in epidemiology, which typically provide little foundation for managing others well.

So how do you cope in this circumstance? I have written in a previous PROspective column about how to disagree, and many of those same skills may apply here. But beyond disagreeing about work products or workplace priorities, poor supervision often emanates from failure on the supervisor’s part to set clear expectations.

Setting Expectations

Expectations are the sets of goals and standards that your supervisor expects you to achieve, with some understanding of which are most important and should receive most of our effort. Failure to set and enforce standards and expectations is one of the most common management failures. If you are working without a clear understanding of what is expected, then it will be difficult for you to feel satisfied with your work.

Fortunately, failure of your supervisor to set expectations is something that you can help to address. If your supervisor has not set the expectations, you can take the initiative and suggest them. You can write out short and long-term goals and deadlines and ask for your supervisor’s feedback. Be sure that these pertain to the organization’s goals and priorities, and not to your own career aspirations. It’s a good idea to write these down also, and maybe to share them with your supervisor, but that’s a separate task. Hopefully the two will align.

Soliciting Feedback

Failure to provide constructive feedback is a second common failure associated with poor management. Again, it is something that you can help to address. When you reach a milestone, or complete one of the short or long-term goals on the list described in the previous paragraph, you can ask for feedback. Be sure to ask more than “Was my report okay?” You will probably only get back “Yes, it was good.” That’s not feedback that will help you to improve. Ask a question that requires a longer answer, such as “How can I do this task differently next time so that it will be even better?” Importantly, do not tie these requests for feedback to requests for additional compensation or leave time.

Zooming Out

Last, if your workplace dissatisfaction continues, it might be worth a self-check about whether your values align with the values of your supervisor or organization. If your values differ from theirs, it will be hard to ever feel satisfied with your work; a change may be needed.


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Flexibility, Empathy, & Patience

Category : PROspective

Whether you are brand new to Rollins (Welcome Class of 2022!) or returning for your 2nd year after a summer applied practice experience, you’re probably asking yourself, “What does success look like for the Fall 2020 semester?”

Excellent question. No one has ever done this before, so the truth is—no one knows how to make a success of it. We will all be learning, adapting, and improving as we go. That process will accrue benefits most rapidly if we recognize and practice flexibility, empathy, and patience in all of our endeavors and interactions. Humans are remarkably adaptable and resilient, much more so than we sometimes realize, especially when we can recognize common goals, reorient quickly when necessary, and maintain composure in the face of hardship. 

With that in mind, I want to take this opportunity to share a few pandemic-adapted suggestions that, in the past, have helped students to make the most of their Fall semester at Rollins. 

Stronger Together

One of the great strengths of the science of epidemiology is that those who study it come from widely different personal and professional backgrounds. We embrace the diversity of perspectives as a strength. In our previous educational experiences, some of us studied public health, while others studied biology, mathematics, economics, psychology, languages, or arts, among others. What you already know will help you with your curriculum this semester, so let it shine through. Bring your unique perspectives to your classrooms and share it with others, and listen to the unique perspectives that others will share with you. Realize, also, that because of the differences in earlier education and experiences, some parts of the curriculum will come easier to you and some will be more difficult. This too will be an individualized experience. There is no point in comparing your academic progress with your peers; you will only steal your own joy by making such comparisons. 

Commit to growing your network

This semester’s hybrid learning experience will make it more difficult to develop a professional network. We humans are pack animals and having six feet or a computer screen between us is an unnatural way to socialize. It is critical, though, that we adhere to these public health requirements during this pandemic – to protect our own health and the health of our entire community. Finding solutions and strategies for how to develop a social and professional network despite the barriers starts with realizing that it is a problem, and you will have to invest more than the normal effort to solve it. Get to know your peers in the program through the shared experience, even if virtual. Imagine how nice it will be to one day greet them in person, with a smile not hidden behind a face covering. The department’s Canvas site provides guidance on how to network with faculty. The guidance suggests that your initial contact with faculty include a specific request. My friendly amendment is to keep the bar low for that ask. For example, many faculty members hold regular meetings with their research groups. Rather than asking to join their groups, ask to listen in on one of their (now Zoom enabled) research group meetings. That is not difficult to arrange and provides a point of entrée to the group’s network.

Don’t forget career skills

The department’s overriding educational goal is to prepare students to be influential public health practitioners. The knowledge, skills, and philosophies that you will learn in the classrooms will be instrumental in achieving this goal. Important, too, will be the career skills that, despite often being complex and nuanced, are seldom part of the classroom learning experience. This column has often addressed these skills, so I encourage you to read the archives and begin work on honing these professional competencies. Once again, the lack of usual social interactions will make it more difficult to practice these skills during the pandemic. Recognize the problem, and plan to solve it. Realizing the importance of career skills and learning how to practice them will be instrumental in your success while at Rollins and for many years thereafter.

We can do it!

Welcome to the department and thank you for your faith in us to provide an excellent learning experience this semester. The faculty and staff have worked hard to prepare, and are ready to change and improve as the semester progresses. We look forward to working with you to make it a success.


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Active Listening

Category : PROspective

I have previously written a few PROspective articles on the importance of developing career skills that will help you to be influential. Today I am flipping the script and writing about how to be influenced.


Changing your mind is an important career skill, and possibly one of the most difficult to accomplish. We all have beliefs and values that developed over a lifetime, and changing them requires us to contemplate the possibility we were wrong. This contemplation poses a threat to our identity, and that’s where the difficulty begins.


To be influenced, we must start by realizing that we will have to let go or modify what we had previously believed. For a scientist, this willingness to change beliefs is inherent to our work. It is our job to change our minds in reaction to accumulating evidence. We can borrow this skill, which we develop as part of our scientific training, and apply it outside of the scientific realm.


Now, of course, we are in the midst of a time of social and cultural change when we must all be prepared to modify our beliefs and values. Borrowing our willingness to learn from our scientific selves and applying it in these other realms should accelerate our progress.


It is most important, then, to listen. Active listening is also an important and learnable skill. This week’s PROspective article provides ten concrete suggestions for how to improve your active listening skills. The article explains the importance of active listening in building relationships: “Active listening builds rapport, understanding, and trust.” It also emphasizes the importance of committing your whole self to listening: “Active listening involves fully concentrating on what is being said rather than passively absorbing what someone is saying… This type of listening involves participating in the other person’s world and being connected to what the other person is experiencing.” In these months of remote communication, #6 has become difficult or impossible (#6: Pay attention to their body language and make appropriate eye contact). This shortcoming requires all the more attention to the other aspects of active listening, especially avoiding internal and external distractions (#1), listening to the tone of voice (#4), and sensing the emotions of the speaker (#5).


Building active listening skills will help you to be rightly influenced, and will improve your ability to fully engage in the needed social and cultural changes that are at the forefront of our national conscience. And, if developed in this context, you will be able to loan your active listening skills to enhance your career as well.

Work and Study Efficiency in Difficult Times

Category : PROspective


I hope this message finds you and yours well during these difficult times. We have worked hard to keep open channels of communication with students and faculty and, in addition to concerns regarding physical and emotional wellbeing, a recurring theme has been a concern about the efficiency of the time they can allocate to work or study.

There is no single strategy to address this concern; though here are some ideas for how to take it on if you feel your efficiency could be better. It starts with reflection about the source of the self-perceived inefficiency. More than one of the below may be at play, and they may be weighted differently on different days or even over the course of a single day.

If you believe you could be more efficient with the time allocated to work or study, take a moment to think about which of the following may be operating and how to diminish their impact.



To start, it’s possible that your expectations of your efficiency are too high. Our schedules have been disrupted, we are grieving the loss or distance of our social networks, and we are all concerned about friends, colleagues or family who are not well and/or experiencing anticipatory grief about the same. It is normal to work less efficiently under these circumstances. Are your expectations of your efficiency calibrated to the reality of the current moment? Is some recalibration necessary? It’s also possible that you need to help your colleagues, instructors, and peers to recalibrate their expectations of you. External pressures that we cannot meet are uniformly demotivating, so do your best to avoid them or resolve them.



Second, it’s possible that you are distracted by more than the realities described in the preceding paragraph. When our ability to concentrate is diminished by circumstances, other distractions invade more easily, occupy more time and a higher proportion of mental reserves, and therefore have an ever larger than normal effect on our efficiency. Turn off the email, close the browser, turn off the television and music, keep clear of the kitchen. Duncan’s earlier PROspective article provided some great ideas for creating a productive work-at-home space.


Productivity 101

Third, it’s possible that you could be more productive with the time that you have available. There is a large literature on work productivity, most of which remains relevant even under new circumstances. Make a to-do list for the day that is realistic given the time that you will have available. Delete anything that is not important (aligned with your goals and values). Organize what is left into what is urgent (impending deadlines or helping someone else to keep working) and not urgent (chipping away at larger projects with later deadlines). Take on the urgent and important tasks first, working first on the ones that are least appealing to you. Be sure to save some time each day to work on what is important but not urgent, so that you don’t face unmanageable deadlines later. Work in short bursts without distraction (25 minutes is often recommended), and then reward yourself with a distraction (check email or Twitter or Instagram) for five minutes (no more). You can set a timer to keep the rhythm for you. Be sure, also, to optimize your productivity by eating well, avoiding too much sedentary time, and sleeping well. As advised in Duncan’s earlier PROspective, schedule time to give yourself a break; it’s too easy to sit in front of the work screen all day, even if that time is not productive.



Fourth, it’s possible that your motivation has truly waned. Lack of motivation may emanate from a combination of all the above, and is also possibly influenced by feelings of despair and loss of perceived control. To restore some of your missing motivation, start by addressing the first three. Also, find ways to restore a sense of control where you can. We cannot come back to campus for class, but we can organize our closet or write to a high school friend we have been thinking about for a long time. Taking on nonwork items that have been lingering on your personal to-do list will reassert your locus of control, and that will spillover to improve your motivation. Structuring your time will also remind you that you are in control: keeping a daily schedule will help to be sure you have regular sleep, diet, work, and relaxation.


Looking Forward

Feelings of inefficiency during times like these are normal, and some days will be more productive than others. On those days when you aren’t able to tackle as much as you would have hoped, give yourself some grace, and know that you’ll have another chance at it tomorrow. 

It might also be helpful to envision what success will look like for you in the long term. We will all one day tell the stories of what happened to us and what we did during the COVID-19 pandemic. You will want to say that you did your part and put your shoulder into it as best you could. Imagine your future self and the story you will want to tell, and then make it so.


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Tell an Influential Story

Category : PROspective

I recently submitted a grant application that proposed to develop a molecular profile to predict which breast cancers have high risk of recurring ten or more years after diagnosis. Here is the first paragraph of the application:


Imagine a 45 year-old premenopausal woman diagnosed with stage I, estrogen-receptor positive breast cancer. She, along with her partner and children, will face a year of surgery, radiation therapy, chemotherapy, fear, and disruption of their day-to-day life. She completes her treatments and endocrine therapy, and recovers. She and her family are immensely grateful, and although those years remain a part of the family fabric, the fears diminish with time. Now imagine this same woman 20 years later. She is excited about life following retirement, especially the prospect of spending time with grandchildren, but her breast cancer recurs and these things will never come to pass. Her physicians tell her she did everything right, that there was no way to know that the tumor might recur so long after diagnosis, that it was just bad luck, and that even in 2020, no one can predict which breast cancers have this malevolent potential and which do not.


I am an epidemiologist proposing an epidemiology research project, so why did I start with a story about a single person?

Because it works.


I want the grant reviewers to feel empathy and sympathy for this woman and her family, and to read the grant in the frame of mind of wanting to help. To be influential, one must change minds. To change minds, those minds must be open to change. Data and evidence do not open minds; emotions open minds. Telling a poignant story about one person that illustrates the nature of the problem will open minds, and then these open minds might be receptive to the data and statistics.


We see this strategy of opening minds used frequently in public spaces. Politicians tell stories about people they meet on the campaign trail, and then they tell us the statistics that demonstrate the broader need and their policies for how to address them. News stories highlight the plight of a single person as a vehicle to convey the story. Presidents bring people to their State of the Union addresses and ask them to be recognized before launching into the statistics that describe the bigger problem and how the administration will address them. Religious texts are full of parables that faith leaders use to introduce a larger message. Why does everyone use this technique? Because it works. Once you recognize the method, you will see it used wherever you look.


And now that your mind may be open to the idea, here’s some science to back it up. In her book “The Influential Mind,” neuroscientist Tali Sharot says that evidence tends to be persuasive when it fits your world view. But if you are trying to change minds, then you are inevitably communicating with others who have a different world view. On average, when we encounter evidence that is inconsistent with our world view, we interpret that evidence as wrong. The further away the new evidence is from preexisting beliefs, the less likely it is to alter them. To be influential, you must first address and influence the emotional state of the audience (which can be one or many people). Helping them to get into the right frame of mind will improve your chances of changing their mind with evidence.


Our students are adept at collecting, analyzing, and interpreting data, with the goal of changing policies in ways that will improve public health. To be truly influential, though, we must all be prepared for resistance. Inherent in the idea of changing policies is the idea that we will have to change minds that are resistant. Using tools like the ones above to open those minds is as important a skill as the research skills.

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Keep Calm and …

Category : PROspective

The two most important things I learned as an undergraduate were: (a) I can do a lot in 24 hours, far more than I had realized and far more than many people ever realize, and (b) I can only do a lot in 24 hours if I keep calm while doing it. The ability to work well under pressure is critical to career success, and can be learned. Today’s PROspective article provides ten concrete suggestions for how to manage your emotions and remain calm under pressure, which has a direct link to your wellbeing and to the quality of your performance.

There are a few aspects of this reading that resonate most strongly with me. First is the idea that some stress is normative. As the article states: “Our brains are wired such that it’s difficult to take action until we feel at least some level of this emotional state.” Accepting the feelings that come with intermittent moderate stress as motivational is a first step in turning it to your advantage.

Second, it is important to develop a reliable and healthy coping strategy that you can turn to when stress rises. Knowing that you have a solution provides relief from the aspects of stress that might prevent you from performing, and allows you to channel the stress towards achievement.

For me, the advice to disconnect rings true. I do not work well in the evening, so very seldom even try. I look forward to that time at home with my family, or to play guitar, or to read and watch TV (music documentaries are my latest guilty pleasure). I always have work I could be doing; not doing it reminds me that I am in control, and feeling in control is an important defense against stress.

Learning to use stress to your advantage is healthy and will give you a competitive edge. Like many career skills, it requires introspection and a commitment to being intentional about the goal. This week’s reading will give you some foundational knowledge as a place to start.

Professional Organizations

Category : PROspective

I have attended almost every annual meeting of the Society for Epidemiologic Research (SER) each June since 1998. The meeting begins with pre-conference workshops, and the agenda from there includes two and a half days of plenary sessions, symposia, and poster sessions.

In 1998, I hardly knew anyone and spent the meeting in awe of the speakers whose papers and textbooks I had been reading. I mostly sat alone, and did not have much to do outside of the scheduled meeting hours. By attending every year, and making an effort to participate, SER eventually became my professional home. Now when I attend, I return home happy and exhausted – seemingly every minute filled with meeting content, coffees, lunches, and late night drinks. I have worked at four academic institutions; SER has been one constant throughout. The meeting provides an opportunity to keep up on new methods and research findings, and to catch up with friends and colleagues, many of whom I would otherwise never see.

I have worked at four academic institutions; SER has been one constant throughout.

Joining a professional society offers opportunities for continuing education, networking, and professional development. There are many societies for epidemiologists to choose from. I always attend SER because I like the size and length of the meeting—about 1,200 attendees over only a few days. I also like the focus on just epidemiology, on methods, and on all epidemiologic topic areas. There are smaller generalist meetings—such as the meeting hosted by the American College of Epidemiology (ACE), larger meetings—such as the meeting of the American Public Health Association (APHA), and more applied meetings—such as the meeting of the Council of State and Territorial Epidemiologists (CSTE).

I always attend SER because I like the size and length of the meeting—about 1,200 attendees over only a few days.

There are also meetings focused on topic areas: cancer, cardiovascular disease, infectious diseases, environmental epidemiology, reproductive epidemiology, pharmacoepidemiology, and so on. Some are held at international destinations and others are always domestic. Most meetings are held at about the same calendar time each year, and have standard annual due dates for abstract submissions.

Membership in a society and participation in its annual meeting is an investment that pays long-term dividends. Like most investments, the returns are evident only over the long run and accrue only with regular contributions. An important consideration is what the society offers beyond its meeting: journal subscriptions or discounts on publication fees are typical, and many societies also offer access to professional and continuing education resources at their website.

Membership in a society and participation in its annual meeting is an investment that pays long-term dividends.

In today’s connected world, it is easy to undervalue the benefit of membership in a professional organization and attendance at its annual meeting. No social media interaction will ever match the exchange of smiles and handshakes between RSPH classmates who only see each other once a year. It’s worth it.

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Get to ‘Yes’

Category : PROspective

A lot has been written about the importance of saying “no.” The idea is to protect one’s professional time to be sure that it is mostly spent on the work most important to one’s self. Although there is merit in this mindset, taking it to its limit would make for a pretty miserable existence. How would it feel to work in a setting where no one ever agreed to help anyone else?


This weeks’ PROspective article offers suggestions for how to improve the chances a coworker will say “yes” when you ask for help. The first two suggestions are probably most relevant, especially early in a career: ask in person, and offer something in return. These two principles rest on fundamentals of human interactions. People are more likely to agree to help when asked in person, not by text, email, or telephone. In addition, offering something in return shows respect for the other person’s time and effort.


If you click through to one of the article’s links, you will find that humans feel a universal tendency “to repay or reciprocate when given a gift whether it has come in the form of a material object, a kind deed, or an act of generosity.” Its especially true when this interaction takes place in person. Taking too much advantage of this tendency can lead to unwarranted manipulation, so also a pretty miserable existence. Getting right this “dance of reciprocal giving and receiving” is important for all highly successful relationships, including those in the workplace.

Voicing Dissent

Category : PROspective

Most public health workplaces involve teamwork, and no team always reaches unanimous consensus on every topic. In fact, one of the strengths of teamwork is the integration of a variety of points of view. On occasion, you might be the only member of the team who sees things differently than the others.

This week’s PROspective offers guidance on whether and how you should speak up. I especially like that the article encourages you to think about whether the group is asking you to compromise your values. If so, speak up!

For example, if the group is taking a shortcut in an analysis that compromises the rigor of the work, and so also the integrity of your part in it, speak up!

But then how do you speak up in a way that maximizes the chances that your view will be influential? Start by showing empathy for the views you don’t hold – that actually opens the group to hearing your views.

Second, separate the topic from the people; your team members need to know you value them, even if you don’t agree with them about the topic.

I encourage you to click through to this short article, which provides strategies for when and how to be the voice of dissent, a valuable skill in the workplace.


Have you struggled to speak up in a professional setting when your opinion was unpopular? Share your stories and ideas in the comments!

First Impressions

Category : PROspective

from Dr. Timothy Lash: 

Everyone feels more or less comfortable talking one-to-one or in small groups, sometimes depending on how well you already know the group. Early in my career, I tended to keep to myself, or to talk with only one or two people already familiar to me. Even today, that’s my comfort zone.

Also early in my career, I had a chance to see two ends of the spectrum. The woman who owned the small company where I worked was always at ease; she could talk with anyone and win them over. A senior colleague in the same company had a much harder time; he came across as aloof and distant. Once I got to know him, I learned that he was warm and funny and knew a lot about a lot, even outside of our work area. All the same, I could see that in most professional settings, where people did not know one another well, she was having much more influence than him.

I realized that I would never be like her, but that I could take advantage of my strengths to be more like her. I prepared. I practiced having conversation starter questions (not weather, sports, or “how are you”), I learned what I could about the people I would meet in advance, and I made an effort to get better.

This article has some of the same themes. The founder of Ritz Carlton says that people make a decision about you in the first nine seconds after they meet you. They may eventually change their mind, but it’s hard to overcome a poor first impression.

You can influence that first impression by being prepared. Smile, say hello, and ask one or two slightly different questions, which you have prepared in advance so they will come easily to you. Most importantly, practice. Put yourself in situations that stretch your comfort zone now, early in your career or as a student, and hone a skill that will be useful throughout your career.