School of Public Health and Community Medicine

Ensuring competency attainment in Epidemiology and Biostatistics among MPH students

Glenda Lawrence – UNSW

Priscilla Robinson – La Trobe

Matthew Knuiman – UWA

OverviewIntroduction – GL

Overview of current PH competencies design – PR

Examples of teaching approaches

Biostatistics – MK

Epidemiology combined with biostatistics – GL

Overview of epi/biostats core content and assessments in MPH programs in Australia - GL

Discussion

Competency in Epi and BioAs PH educators, how do we ensure competency

attainment in epidemiology and biostatistics by MPH graduates?

What are the common teaching and learning approaches, challenges, and needs?

minimal versus ideal levels of knowledge and skill in epidemiology and biostatistics among graduates of generalist public health degrees plus UG vs PG vs HDR

optimal methods of assessment

innovative strategies in learning and teaching

Assessment – formative / summative

Curriculum delivery

Curriculum development

Program graduate attributes / learning outcomes

PH competency framework

Opportunity to considerNew Australian PH competency framework currently being

developed – 21st century workforceInternational frameworks

Is guidance needed in ‘translating’ competency frameworks to course curriculum?

Assessment of attainmentExam vs more authentic practice based assessment?Could there be a collaborative approach to ensuring

competency attainment e.g. assessment item bank?Benchmarking opportunities

Priscilla RobinsonCompetency Frameworks

Matthew KnuimanCore Biostatistics Unit - UWA

UNSW approachCombined Epidemiology and Biostatistics core unit

Taught concurrently to internal students face-to-face and external students online

Pre-semester workshop – includes intro SPSS tutorial

Weekly 2 hour lecture – recorded on Echo360

Weekly learning activities aligned to learning outcomesSPSS ‘how to’ videos for each module’s learning activities

Weekly optional 3 hour ‘clinic’ - one-to-one help by tutors

Weekly face to face tutorials; online tutors for externals

‘de-Greeked’ biostats

Students220 students in S1 2014

66% external (part-time)

External students time poor; often more experienced in epi and biostats than internal students

Many fearful initially, particularly of stats and SPSS

Often pleased with own development across the 12 weeks of the course

Course contentEpi Biostats

Measures of frequencyIncidence, prevalence,

age specific and standardisation

Measures of AssociationRR, OR, AR, PAR etc

Study designs Study validitySelection biasMeasurement errorConfounding & effect modCritical appraisal of

published papers – cohort, RCT, case-control

Screening tests and programs

Synthesis of evidence – systematic reviews and meta-analysis

Presenting dataSummary descriptive

statistics and data variationNormal & other

distributionsPrecision and confidence

intervalsHypothesis testing and

inferential statisticsMeansProportionsIndependent/pairedNon-normal data

Correlation & regressionSample size estimation &

testing

Other topicsTaught in Foundations in PH unit

Basic demography

Routinely collected data

Surveillance

Outbreak investigation

Why teach epi/biostats in one course?

Helps make the relationship between the two disciplines explicit for students (de-siloing)

Learning activities and assessment tasks used to integrate epi and stats knowledge and skills

Most students now embrace combined teaching (compared to 2008 when first run)

Some complain of workload, but fewer now (expect 10 hours per week – UNSW standard)

Evaluation UNSW standard questionnaire + focus groups + webinar +

solicited de-identified feedback

High overall student satisfaction

98% satisfied – 49% in the strongly agree category

Feedback varies considerably for external vs internal studentsdifferent levels of proficiency – external students generally achieve higher

marks

external students very time poor – selective in use of resources e.g. often don’t listen to lectures but read and complete LAs

Students like 2 assignments – HATE exam (but many achieve high marks) Is an exam a realistic way of assessing competence / achievement?

Seen by staff to help address issue of plagiarism/collusion

Student quotes“I generally really enjoyed the structure and content of the

course and was surprised that I did so, as was fearful of the subject and so put it off until my second last course! I actually think it was a useful and practical course and have already found myself applying it to my work.” EXTERNAL STUDENT 2014

“I thought the assignments were pretty consistent with the course content and weekly learning activities. Having more smaller assessments might make the course less stressful (40% exam is huge!).” EXTERNAL STUDENT 2014

The best part I enjoyed as an external student were the podcasts as these allowed contact with facilitators. Another area that I found important was the discussion groups because these also encouraged instant feedback from lecturers and students alike.

Course notes - brilliant! So well-ordered, succinct and yet thorough. To be honest I only read the lecture slides if I didn't understand the course notes and only listened to the lecture if I still didn't understand.SPSS videos a life saver -some things just can't be explained in writing.Discussion forums great when responses quick, which was most of the time.

Overview of Australian MPH coursesScanned websites of 14 universities for available

information on MPH epi and biostats units

All teach topics listed in competencies in intro coursesVary in some topics such as demography, multiple regression

Most use SPSS to teach hands-on data analysis

Most teach epi and biostats in separate courses

Many offer both face-to-face and online options

Most assess LOs using assignments plus open book exam in both epi and stats~35% to 70% of the course

Discussion pointsAs PH educators, how do we ensure competency attainment in

epidemiology and biostatistics by MPH graduates?

What are the common teaching and learning approaches, challenges, and needs?

Consider

minimal versus ideal levels of knowledge and skill in epidemiology and biostatistics among graduates of generalist public health degrees plus UG vs PG vs HDR

optimal methods of assessment – exam vs other ‘authentic’ approaches

shared bank of assessment items (collaborative approaches)?

innovative strategies in learning and teaching

Opportunity to considerNew Australian PH competency framework currently being

developed – 21st century workforceInternational frameworks

Is guidance needed in ‘translating’ competency frameworks to course curriculum?

Assessment of attainmentExam vs more authentic practice based assessment?Could there be a collaborative approach to ensuring

competency attainment e.g. assessment item bank?Benchmarking opportunities

Acknowledgements

UNSW colleaguesLois MeyerAndrew HayenBayzidur RahmanAnita Heywood