NR-717 Week 1 Framing the Policy Problem: How to Write It

What NR-717 Week 1 asks for

A quality director we worked with brought us a chart audit she had run across 240 records at a federally qualified health center. Her spreadsheet had a column headed noncompliant, and 84 rows carried a check in it: patients with diabetes who had not returned for the retinal screening ordered at their last visit. Her draft opened by saying that patient nonadherence was driving preventable vision loss in her population. Then she read the free-text notes attached to twenty of those rows. Eleven mentioned the same thing in different words. The ophthalmology partner was eleven miles away, the referral required a separate appointment on a weekday morning, and the county bus route that served the clinic did not run there. The audit had not found noncompliance. It had found a transportation and referral-design problem written down 84 times in a column nobody had read as a policy signal.

That is the move the opening stage of this course exists to teach. Problem definition is not a preamble to the real analysis; it is the analysis with the most leverage, because whoever defines the problem has already narrowed the set of solutions a reader will consider. Define it as adherence and every downstream recommendation is a reminder call, a pamphlet, a teaching moment. Define it as access geometry and the recommendation set opens onto contracting, site placement, telehealth authorization, transportation benefit design and referral protocols. Same 84 patients, two entirely different papers, and only one of them is a health policy paper.

The opening submission in a course of this shape usually asks for a written statement of a population health problem you intend to carry through the session, with some early argument about why it is a problem of policy rather than only of care delivery. Sections often pair that with an introductory discussion post. Where yours does, write it as final copy from the first keystroke, because posts do not reopen once submitted in Canvas and an opening post is where a grader forms a first estimate of your register.

Doctoral altitude matters from this first page. You are a practice-doctorate student, which means your work translates existing evidence and existing policy instruments into a change at a real site or in a real jurisdiction. You are not being asked to generate new knowledge about whether transportation affects screening completion. That literature exists. You are being asked to name a specific problem in a specific bounded population, show that it is tractable through a lever somebody actually controls, and write it so the person holding that lever recognizes their own authority in your sentence.

The NR-717 Week 1 method, step by step

Six moves that turn a clinical frustration into a defined policy problem.

1. Open the rubric and reduce every row to its governing verb

   Copy each scoring row into a blank file as a heading and strip it to the verb it turns on. Describe, analyze, evaluate and justify are four different depths, and a row carrying justify is telling you that a defended choice, not a summary, is what earns the points.

2. State the population with a countable boundary before you state the problem

   Who, where, in what window, counted from which source. Adults with diabetes at one clinic during one calendar year is a population. The diabetic community is a phrase. The boundary you write here governs every rate you will report for the rest of the session, so fix it now and keep it fixed.

3. Write the problem three ways and choose the one with a policy lever

   Draft the same problem as a behavior problem, as a delivery-system problem and as a policy problem. Read all three, then ask of each: who could sign something tomorrow that would change this? The version with a named signatory is the version this course is asking for.

4. Attach a magnitude with its denominator and its source

   A problem that has not been sized is an opinion. Say how many, out of how many, over what period, taken from which record system or public dataset. Eighty-four of 240 audited records over twelve months is a magnitude a reader can weigh. High rates of nonadherence is not.

5. Name who bears the burden and who bears the cost

   These are often different parties, and the gap between them is usually where the political difficulty lives. Patients bear the vision loss; the health system bears some downstream cost; the payer bears another share; the county bears the transportation decision. Writing that distribution explicitly is doctoral work and it sets up the stakeholder analysis you will need later in the session.

6. Close the statement with the decision you want made

   Even in an opening piece, end with the shape of the ask. Not the full recommendation, which you have not yet defended, but the class of action and the level of government or governance it would sit at. A problem statement that leaves the reader unsure what kind of answer is being sought has not finished its job.

A layout and word budget for a policy problem statement

The frame our tutors keep beside an opening policy-problem submission, sized for roughly 1,200 to 1,500 words. It is our own outline rather than anything the university issues, and your week's rubric outranks it wherever the two disagree. Scale the targets proportionally if your assigned length differs.

Evidence craft for policy problem definition

Separate your own data from published data in the sentence itself. A doctoral policy paper usually runs on two evidence streams: a local count you produced or extracted, and published literature or public statistics that establish the pattern is not unique to you. Readers need to know which is which without checking the reference list, so write from a chart audit of 240 records at the site or according to national survey estimates as the opening clause rather than merging both into an unattributed rate.

Every number carries a base, a window and a source. This is the habit that most separates strong from weak writing at this stage. A rate without a denominator cannot be compared to anything, and a rate without a window cannot be shown to have moved later in the session. Write 84 of 240 audited records over the 2025 calendar year, extracted from the electronic record on a fixed query, and the reader can audit you.

Name policy instruments by their actual type. Statute, regulation, payment rule, accreditation standard, organizational policy and clinical protocol are six different things with six different change processes and six different signatories. Using policy as a catch-all noun is the fastest way to signal that you have not yet mapped where the authority sits, and it will cost you when you reach the analysis stages.

Keep the patient story as illustration and de-identify it. A single record can make a structural argument legible, and it is legitimate to use one, but strip anything identifying and keep the sequence right: claim first, evidence second, illustration third. Reversed, the paragraph reads as an anecdote with a citation attached, and policy graders mark that ordering consistently.

Five mistakes that cost points in this week's territory

• A problem defined so broadly that nothing follows from it. Health disparities in America is a subject heading. It has no denominator, no jurisdiction and no signatory, so no analysis can be built on it.
• Smuggling the solution into the problem statement. Writing that the clinic lacks a mobile screening unit defines the problem as the absence of your preferred answer and forecloses the options comparison you owe later.
• Behavior framing left unexamined. Nonadherence, noncompliance and lack of health literacy are conclusions about people. If you use them, you have to defend them against the structural explanation, and usually you cannot.
• Numbers with no base. A percentage with no denominator, no window and no source is unweighable, and in a course built on outcomes it forfeits the row it was meant to earn.
• Skipping the authority question. If you cannot name the office, board or body that could act, you have written a description of a hardship rather than a policy problem.

Before you submit

• The population has explicit inclusion rules, a time window and a named data source
• The magnitude appears as a count over a base, not as an adjective
• The structural cause is named and the behavior explanation is addressed rather than ignored
• Burden, cost and authority are attributed to specific parties
• Each policy instrument mentioned is named by type rather than called policy
• The closing paragraph states what kind of decision you want and at what level
• Every reference appears in the text and every in-text citation appears in the list

Questions students ask about this stage

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