Teaching Of Epidemiology Research Articles

Historical perspective of progress and achievement on three-dimensional construction of epidemiological textbooks in the past 70 years in China

Since the founding of the People's Republic of China, the epidemiological textbooks in China have gone through an all-round development consistently, from nothing to something, from paper to multimedia. After the reform and opening up, especially after the 18th National Congress of the Communist Party of China (CPC), in order to meet the needs of training multi-level public health talents, a group of epidemiologists, represented by professor Qian Yuping, Wu Xike, Li Liming, Zhan Siyan, et al, have always devoting themselves to the construction of epidemiological textbooks, so that the theory, teaching and scientific research of epidemiology had their own series of specialized textbooks. For nearly 20 years, epidemiological textbooks are obviously updated and improved under the convergence of new technology and media. Digital resources, such as CD, Mooc and electronic schoolbag, together with traditional paper textbooks, perfectly contribute to the modern comprehensive three-dimensional epidemiological textbooks and lay a solid foundation for talent cultivation, discipline construction, scientific research and disease prevention and control.

Sparking interest in public health amongst future doctors to tackle our NHS sustainability crisis.

This article was migrated. The article was marked as recommended. The new NHS 'Long Term Plan' has a particular focus on the public health issues of disease prevention and reducing health inequalities. However, medical students often perceive public health as abstract and irrelevant to clinical practice. We believe students need to be encouraged to appreciate wider public health issues and ultimately be able to apply clinical and public health tools to achieve change for patients and populations. Our aim is for all medical graduates to be able to apply public health and evidence-based principles to their chosen specialties. In the undergraduate curriculum, we hope to extend problem-, case-, and simulation-based learning into public health education, emphasise the context around statistics and epidemiology teaching, and make the teaching more relevant, tangible and enjoyable. Intercalated BSc students will gain an interdisciplinary perspective by joining Master of Public Health (MPH) students to learn about the prevention and control of disease and the promotion of health and wellbeing. They will also have opportunities to join the new Health Intelligence Team (H.I.T.), on a voluntary reserve list to support Public Health Wales in the event of real investigations. We will evaluate these strategies, and we hope that medical educators worldwide will share their experience of innovative approaches to public health and evidence-based medicine teaching in response to this article, so that public health teaching may be improved.

The Future of Teaching Epidemiology.

The rapid pace of technological advancements and the corresponding societal innovations and adaptations make it difficult to predict how teaching epidemiology will look in the coming decades. We discuss changes in the teaching of epidemiology that are currently unfolding. First, typical epidemiology curricula often lack formal instruction in important components of causal thinking, such as the formulation of well-defined research questions. We address gaps related to causal thinking, communication about our science, and interpretation of study results, and we make suggestions of specific content to close such gaps. Second, digital technology increasingly influences epidemiology instruction. We discuss classroom and online teaching modalities in terms of challenges and advantages.

Teaching on the Continuum: Epidemiology Education From High School Through Graduate School.

Epidemiology education is increasingly recognized as a core science necessary for career preparation throughout the health sector, and graduate epidemiology instruction is continually being reevaluated to ensure students receive appropriate training. Recent work has also focused on the potential for epidemiology to be formally incorporated as a stand-alone discipline in undergraduate education and even integrated into wide-scale high-school science learning. As epidemiology educators, however, we face a tremendous challenge in that we should appreciate differences in students' instructional needs and goals (e.g., concepts and skills) at each educational level. In this article we propose an epidemiology learning continuum for students from high school through graduate school. We call for a student-centered instructional approach to best hone learners' grasp of concepts and skills. Furthermore, we propose scaffolded learning to help epidemiology students to develop more advanced insights and abilities as they progress in the field. This approach will not only best serve the discipline but also is well-aligned with the Association of Schools and Programs of Public Health's "Framing the Future" initiative for public health education for the 21st century.

High School Epidemiology: Helping Students Practice Science Through Guided Inquiry and Authentic Learning Strategies

A call has been made over the last decade for the expansion of epidemiology coursework into high schools in the United States. Epidemiology instruction has been shown to increase student scientific and health literacy, promote critical thinking skills, enhance students’ perception of public health as both practical and relevant, and empower students as independent, lifelong learners. Epidemiology is also a flexible science with relevance to students from diverse backgrounds, skill levels, and interests. While there has been tremendous growth in undergraduate public health education, we have yet to witness the mainstream adoption of epidemiology into high school coursework. In this article, I propose the formal integration of epidemiology into high school curricula to help students practice science as it relates to public health. I posit that epidemiology is a flexible science discipline with real-world significance to students from diverse backgrounds, skill levels, and interests. Also, teaching epidemiology through guided inquiry and authentic learning strategies can intrinsically motivate and empower students to address health-related problems in their local communities. Moreover, epidemiology instruction at the high school level can meet student learning needs, teacher instructional objectives, administrative mandates, and community interests. In essence, epidemiology instruction at the high school level can hone fundamental skills in preparation for health and science careers and promote important public health awareness and interest among adolescents.

Directed Acyclic Graphs: Alternative tool for causal inference in epidemiology and biostatistics research and teaching

The issue of causation is one of the major challenges for epidemiologists who aim to understand the association between an exposure and an outcome to explain disease patterns and potentially provide a basis for intervention. Suitably designed experimental studies can offer robust evidence of the causal relationships. The experimental studies, however, are not popular, difficult or even unethical and impossible to conduct; it would be desirable if there is a methodology for reducing bias or strengthening the causal inferences drawn from observational studies. The traditional approach of estimating causal effects in such studies is to adjust for a set of variables judged to be confounders by including them in a multiple regression. However, which variables should be adjusted for as confounders in a regression model has long been a controversial issue in epidemiology. From my observation, the adjustments using only “statistical artifacts” methods such as the p-value<0.2 in univariate analysis, stepwise (forward/backward) are widely used in research and teaching in Epidemiology and Statistics but without appropriated notice on the biological or clinical relationships between exposure and outcome which may induce the bias in estimating causal effects. In this mini-review, we introduce an interesting method, namely Directed Acyclic Graphs (DAGs), which can be used to reduce the bias in estimating causal effects; it is also a good application for Epidemiology and Biostatistics teaching.

Research on reform of epidemiology teaching

Epidemiology is a traditional subject mainly based on principles and concepts, and its teaching method needs further improving to meet the requirement of the new trend of education reform. Lecture-based teaching, problem-based teaching, case-based teaching, and internet based teaching, such as flip class, massive open online course and micro-lecture, all have its own unique merits in the practice of epidemiology teaching. So the combination of traditional teaching and online teaching is the most promising mode. "Rain class" , a mixed mode, is an efficient tool to present the epidemiology case more actually in class. Thus, teaching design and application of "rain class" are worth research.

Clinical and epidemiological teaching of dengue through simulated practice.

to describe the experience of clinical teaching on dengue and the practice of epidemiological surveillance using problematization methodology. report of experience on educational activity with undergraduate nursing students, held in March 2016, at a public university in the city of São Paulo, conceived in four stages: dialogic lecture, active search of Aedes aegypti, case study and simulation of nursing consultation to individuals with dengue. The activity allowed to retrieve previous knowledge about the disease, respond to exercises that addressed different clinical situations and epidemiological surveillance, including in situ evaluation of possible mosquito outbreaks, and discuss the need to expand prevention and health of the individual and the community, the impact of the media in the dissemination of cases and the coping difficulties experienced in the different levels of attention. the methodology adopted enabled qualified training of students to cope with dengue.

Public Health Education: Teaching Epidemiology in High School Classrooms.

Epidemiology instruction has expanded at the undergraduate level in part because it increases student critical thinking and scientific literacy, promotes students' perception of public health as both practical and relevant, and empowers students as independent, lifelong learners. Why then are more high schools not adopting epidemiology as a course requirement for students? Although prior iterations of high school epidemiology courses are noteworthy for incorporating active and participatory learning, embedding them into existing and continually shifting curricula is challenging and time-consuming, especially for teachers not trained in the field. It also may be argued that currently available epidemiology teaching resources emphasize content rather than thinking skills and therefore do not optimally promote students' personal engagement with, and in-depth understanding of, the mission and goals of public health. I propose a new framework for high school epidemiology that draws from progressive education ideology, including three critical elements: empowerment, authenticity, and transfer. I provide multiple examples to show how this framework has been used across a wide array of settings to hone epidemiology thinking skills in high school students.

Exploration and practice in the construction of curriculum on epidemiology in preventive medicine

Epidemiology is one of main courses for undergraduate students majoring in preventive medicine. There are some limitations in the traditional epidemiology teaching, which is usually characterized in indoctrinated education: "lectured by the teachers and listened by the students." In Zhejiang University, staff of the epidemiology division tried to explore a new teaching mode as 'student-centered, teacher-leading, question-based, and combining with literature discussion and course practice.' After practicing for two years, students were inspired in learning initiatives, with teaching effectiveness obviously improved.

Combined Application of Study Design and Case-based Learning Comprehensive Model in Epidemiology Teaching

This paper aims to conduct the SD-CBL (study design with the case based learning, SD-CBL) in Epidemiologyteaching and evaluate its effect. Students from five classes were recruited, and a combined comprehensive teachingmodel of SD-CBL was used in the “Injury Epidemiology” chapter, while other chapters in “Epidemiology”curriculum were using a teaching model of case based learning (CBL) only or single PowerPoint (ppt) teaching (itwas considered as a traditional teaching in many universities). In the final of the semester, the effects of these threeteaching models were compared in different majors and different students source. We found that SD-CBLcomprehensive teaching model was better than ppt only and CBL teaching methods (P<0.001, P=0.007), and thesignificant differences were found in the increased scoring rate between different majors and different studentssource (P<0.001, P=0.015). Thus, we concluded that the SD-CBL teaching model is effective and worth to promotein “Epidemiology” teaching, especial in chapters of epidemiology application. Moreover, it is recommended toconduct SD-CBL teaching model in students, who are major in medicine and have good science basis.

Ethics, big data and computing in epidemiology and public health

PurposeThis article reflects on the activities of the Ethics Committee of the American College of Epidemiology (ACE). Members of the Ethics Committee identified an opportunity to elaborate on knowledge gained since the inception of the original Ethics Guidelines published by the ACE Ethics and Standards of Practice Committee in 2000. MethodsThe ACE Ethics Committee presented a symposium session at the 2016 Epidemiology Congress of the Americas in Miami on the evolving complexities of ethics and epidemiology as it pertains to “big data.” This article presents a summary and further discussion of that symposium session. ResultsThree topic areas were presented: the policy implications of big data and computing, the fallacy of “secondary” data sources, and the duty of citizens to contribute to big data. A balanced perspective is needed that provides safeguards for individuals but also furthers research to improve population health. Our in-depth review offers next steps for teaching of ethics and epidemiology, as well as for epidemiological research, public health practice, and health policy. ConclusionsTo address contemporary topics in the area of ethics and epidemiology, the Ethics Committee hosted a symposium session on the timely topic of big data. Technological advancements in clinical medicine and genetic epidemiology research coupled with rapid advancements in data networks, storage, and computation at a lower cost are resulting in the growth of huge data repositories. Big data increases concerns about data integrity; informed consent; protection of individual privacy, confidentiality, and harm; data reidentification; and the reporting of faulty inferences.

G-computation of average treatment effects on the treated and the untreated

BackgroundAverage treatment effects on the treated (ATT) and the untreated (ATU) are useful when there is interest in: the evaluation of the effects of treatments or interventions on those who received them, the presence of treatment heterogeneity, or the projection of potential outcomes in a target (sub-) population. In this paper we illustrate the steps for estimating ATT and ATU using g-computation implemented via Monte Carlo simulation.MethodsTo obtain marginal effect estimates for ATT and ATU we used a three-step approach: fitting a model for the outcome, generating potential outcome variables for ATT and ATU separately, and regressing each potential outcome variable on treatment intervention.ResultsThe estimates for ATT, ATU and average treatment effect (ATE) were of similar magnitude, with ATE being in between ATT and ATU as expected. In our illustrative example, the effect (risk difference [RD]) of a higher education on angina among the participants who indeed have at least a high school education (ATT) was −0.019 (95% CI: −0.040, −0.007) and that among those who have less than a high school education in India (ATU) was −0.012 (95% CI: −0.036, 0.010).ConclusionsThe g-computation algorithm is a powerful way of estimating standardized estimates like the ATT and ATU. Its use should be encouraged in modern epidemiologic teaching and practice.

Curriculum development for a module on noncommunicable diseases for the master of public health program.

As the burden of noncommunicable diseases (NCDs) has been rising globally, various educational programs have introduced chronic disease epidemiology teaching, which is now a component of most of the Master of Public Health (MPH) programs. However, the process of curriculum development for these courses has not been adequately documented for use by educators planning such courses. A detailed process of curriculum development based on David Kern's six-step approach was undertaken for a 2-week course on NCDs, as part of the MPH program of a tertiary institution in South India. The processes were documented so that the method of curriculum development for such a course could be made available for educators across this field. The course on NCDs was carried out over 73 learning hours (2 weeks) for a group of MPH students including medical, dental, allied health, and nursing graduates. Evaluation of the revised curriculum at the end of the 2 weeks revealed that mean scores for knowledge and confidence in skills increased by 50% (11.1-16.6, t-test, P < 0.001) and 79% (3.3-5.9, t-test, P = 0.002), respectively, from baseline scores. The revised curriculum was effective in improving knowledge and confidence in epidemiological skills. The documented process of curricular development using standard methods if made publicly available can be of use to those involved in planning similar educational programs for students of public health.

Evaluation of Online Graduate Epidemiology Instruction and Student Outcomes

In the last two decades, online learning has transformed the field of higher education. Also during this time, institutions of higher education have seen increases in their adult learner populations. The flexibility and accessibility of an online education model is often particularly appealing to adult learners, who bring unique needs, expectations, and learning styles to their educational experiences. Using Kolb's Learning Style Inventory and Knowles' andragogy model as theoretical frameworks, this study evaluates an online graduate course in epidemiology in terms of the demographics, learning styles, satisfaction, and achievement of students. Comparing the online course to the same, land-based course that was offered concurrently, we found no differences between students' learning styles, satisfaction, and overall achievement. However, students in the land-based class were more likely to be matriculated into a degree program (p<0.005), more likely to be full-time students (p<0.002), and more likely to work part-time or not at all (p<0.002). These findings provide evidence that student preferences for method of content delivery are correlated to lifestyle factors and not age, previous experiences, or learning styles.

Evaluation on effectiveness of prevention in clinical epidemiology teaching for the students in clinical medicine

Objective To study the teaching effect of prevention in clinical epidemiology teaching. Methods 187 clinical medical students of Grade 2010 from China Medical University were selected as the research objectives. 2 teaching hours of prevention content was increased in the clinical epidemiology teaching, and the anonymous questionnaire survey was used to assess the teaching effectiveness. A total of 187 questionnaires were issued and 187 valid questionnaires were collected. All the data were analyzed by SPSS 16.0. Results 82.9%(155 people)of the students believed that the addition of preventive content was necessary, 40.1%(75 people)of the students believed that there was a significant increase in the content of the prevention. For the understanding of the content, only 11.2%(21 people)of the students said they had a complete understanding of the class, but after teaching 51.3%(96 people)of the students expressed a clear understanding of the content. 82.4%(154 people)of the students thought that the teaching contents of prevention was tightly combined with the clinical, and 74.9%(140 people)of the students thought that 2 hours setting was appropriate. Students' demands for prevent content also included: 1)how to stren-gthen prevention in daily life; 2)tumor disease prevention, including current international popular tumor vaccine; 3)of emergent public health event instance; 4)occupational disease prevention measures, etc. Conclusion Increasing the contents of prevention in the clinical epidemiology teaching has made students of clinical medicine change their clinical concept and realize the key role of prevention in clinical treatment. At the same time, this study understands students' needs for the content of prevention, and provides a basis for the setting and optimization of clinical epidemiology course in the future. Key words: Clinical epidemiology; Prevention medicine; Effect evaluation

Random amplified polymorphic DNA PCR in the teaching of molecular epidemiology.

In this article, we describe a basic practical laboratory designed for fifth-year undergraduate students of Microbiology as part of the Epidemiology course. This practice provides the students with the tools for molecular epidemiological analysis of pathogenic microorganisms using a rapid and simple PCR technique. The aim of this work was to assay RAPD-PCR technique in order to infer possible epidemiological relationships. The activity gives students an appreciation of the value of applying a simple molecular biological method as RAPD-PCR to a discipline-specific question. It comprises a three-session laboratory module to genetically assay DNAs from strains isolated from a food outbreak. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(4):391-396, 2016.

Causality and causal inference in epidemiology: the need for a pluralistic approach.

Causal inference based on a restricted version of the potential outcomes approach reasoning is assuming an increasingly prominent place in the teaching and practice of epidemiology. The proposed concepts and methods are useful for particular problems, but it would be of concern if the theory and practice of the complete field of epidemiology were to become restricted to this single approach to causal inference. Our concerns are that this theory restricts the questions that epidemiologists may ask and the study designs that they may consider. It also restricts the evidence that may be considered acceptable to assess causality, and thereby the evidence that may be considered acceptable for scientific and public health decision making. These restrictions are based on a particular conceptual framework for thinking about causality. In Section 1, we describe the characteristics of the restricted potential outcomes approach (RPOA) and show that there is a methodological movement which advocates these principles, not just for solving particular problems, but as ideals for which epidemiology as a whole should strive. In Section 2, we seek to show that the limitation of epidemiology to one particular view of the nature of causality is problematic. In Section 3, we argue that the RPOA is also problematic with regard to the assessment of causality. We argue that it threatens to restrict study design choice, to wrongly discredit the results of types of observational studies that have been very useful in the past and to damage the teaching of epidemiological reasoning. Finally, in Section 4 we set out what we regard as a more reasonable ‘working hypothesis’ as to the nature of causality and its assessment: pragmatic pluralism.

Clinical epidemiology in developing countries: Current situation and suggestions for the Indian context

BackgroundIn India, epidemiological services are well developed and epidemiology teaching is very much part of curriculum from undergraduate to doctorate level of studies. In spite of all the initiatives to sensitize physicians towards clinical epidemiology (CE), this academic discipline is still not popular as it should be. The development of CE teaching and the present situation along with way forward are discussed in this article. ObjectivesThis review article is aimed to describe the evolution of CE in India and critically look into the concept and scope of CE and evidence-based medicine (EBM) in the Indian setting. MethodsThis paper is a review of the status of ‘clinical epidemiology – popularization’ in India and the scope for further progress towards this direction. ResultsThe development of CE has taken a new pace after the introduction of EBM. Both CE and EBM are propagated by INCLEN-trained faculty mostly among medical students and teachers. The paper also looks into the linkages between public health epidemiology and CE in the context of involvement of clinical epidemiologists in public health programs. ConclusionsAfter discussing the directions for future, the paper proposes the inception of CE unit at each medical college and also the objectives and structure of such a unit. The article concludes emphasizing the need of public health orientation of CE, the importance of promotion of epidemiology in developing countries through capacity building, and allocation of dedicated funds towards popularization of CE. There is also an urgent need for replication and scale-up of clinical epidemiology unit (CEU) model to other medical colleges.

Critical Appraisal Skills Among Canadian Obstetrics and Gynaecology Residents: How Do They Fare?

Evidence-based medicine has become the standard of care in clinical practice. In this study, our objectives were to (1) determine the type of epidemiology and/or biostatistical training being given in Canadian obstetrics and gynaecology post-graduate programs, (2) determine obstetrics and gynaecology residents' level of confidence with critical appraisal, and (3) assess knowledge of fundamental biostatistical and epidemiological principles among Canadian obstetrics and gynaecology trainees. During a national standardized in-training examination, all Canadian obstetrics and gynaecology residents were invited to complete an anonymous cross-sectional survey to determine their levels of confidence with critical appraisal. Fifteen critical appraisal questions were integrated into the standardized examination to assess critical appraisal skills objectively. Primary outcomes were the residents' level of confidence interpreting biostatistical results and applying research findings to clinical practice, their desire for more biostatistics/epidemiological training in residency, and their performance on knowledge questions. A total of 301 of 355 residents completed the survey (response rate=84.8%). Most (76.7%) had little/no confidence interpreting research statistics. Confidence was significantly higher in those with increased seniority (OR=1.93), in those who had taken a previous epidemiology/statistics course (OR=2.65), and in those who had prior publications (OR=1.82). Many (68%) had little/no confidence applying research findings to clinical practice. Confidence increased significantly with increasing training year (P<0.001) and with formal epidemiology training during residency (OR=2.01). The mean score of the 355 residents on the knowledge assessment questions was 69.8%. Increasing seniority was associated with improved overall test performance (P=0.02). Poorer performance topics included analytical study method (9.9%), study design (36.9%), and sample size (42.0%). Most (84.4%) wanted more epidemiology teaching. Canadian obstetrics and gynaecology residents may have the biostatistical and epidemiological knowledge to interpret results published in the literature, but lack confidence applying these skills in clinical settings. Most residents want additional training in these areas, and residency programs should include training in formal curriculums to improve their confidence and prepare them for a lifelong practice of evidence-based medicine.