Module - Introduction to Epidemiology (SBI202)

STP

Aim of this module

The aim of this rotation is to provide trainees with an overview of communicable and non-communicable disease epidemiology. They will be introduced to a range of epidemiological concepts, including measures of disease frequency and association, study design, bias and confounding. The work of epidemiologists impacts on populations and individuals within populations, including the prevention and control of disease and associated morbidity. The information provided by epidemiologists also supports commissioners of health services to enable them to better prioritise and allocate resources and underpin health promotion activities. 

This module will provide the trainee with an introduction to epidemiology and its impact on patients, patient care and populations. They will understand and apply their knowledge of communicable and non-communicable disease epidemiology in the work base where epidemiological concepts are used to inform public health action. They will understand the role of epidemiology and the clinical scientist in: surveillance and monitoring of diseases; interpreting epidemiological surveillance data; and investigating outbreaks to guide interventions aimed at protecting and improving the public’s health.

Epidemiology examines the distribution of disease in populations and underlying causes. Examples of these include lead poisoning cases in children associated with ingestion of paint; food borne outbreaks involving bacterial or viral agents associated with poor food hygiene practices; clusters of cancers; the association between obesity and health-related outcomes.

Work-based learning outcomes


  1. Generate a report describing and evaluating the attributes of a surveillance system.
  2. Generate an epidemiological report analysing and interpreting surveillance data.
  3. Present a critical appraisal of a peer-reviewed analytical study, discussing potential biases and their impact on the findings.
  4. Participate in and document the steps that are taken to investigate an outbreak.

Work-based Competencies


Learning outcome Title Knowledge
1 1

Identify a surveillance system and its objectives.

  • The purpose of surveillance and surveillance system evaluation.
  • Surveillance system attributes, e.g. completeness, timeliness, usefulness, representativeness, sensitivity, specificity.
  • Guidelines for conducting a surveillance system evaluation.
  • The public health importance of the clinical/health-related event under surveillance.
  • The purpose and operation of the surveillance system and resources (financial, personnel and other resources) needed to operate the surveillance system.
  • Surveillance system attributes and how to select attributes for evaluation.
  • The rationale for surveillance and evaluate the strengths and weaknesses of different approaches.
  • The surveillance cycle: set objectives, data collection, data analysis, interpretation, action, evaluation.
  • Population under surveillance.
  • Types of surveillance, including: (i) active surveillance; (ii) passive surveillance; (iii) sentinel surveillance; (iv) syndromic surveillance.
  • Disease registration systems.
  • Cancer registration (as an example of disease registration).
2 1

Identify all potential attributes of this surveillance system.

  • The purpose of surveillance and surveillance system evaluation.
  • Surveillance system attributes, e.g. completeness, timeliness, usefulness, representativeness, sensitivity, specificity.
  • Guidelines for conducting a surveillance system evaluation.
  • The public health importance of the clinical/health-related event under surveillance.
  • The purpose and operation of the surveillance system and resources (financial, personnel and other resources) needed to operate the surveillance system.
  • Surveillance system attributes and how to select attributes for evaluation.
  • The rationale for surveillance and evaluate the strengths and weaknesses of different approaches.
  • The surveillance cycle: set objectives, data collection, data analysis, interpretation, action, evaluation.
  • Population under surveillance.
  • Types of surveillance, including: (i) active surveillance; (ii) passive surveillance; (iii) sentinel surveillance; (iv) syndromic surveillance.
  • Disease registration systems.
  • Cancer registration (as an example of disease registration).
3 1

Select and justify relevant attributes in consultation, and evaluate the system.

  • The purpose of surveillance and surveillance system evaluation.
  • Surveillance system attributes, e.g. completeness, timeliness, usefulness, representativeness, sensitivity, specificity.
  • Guidelines for conducting a surveillance system evaluation.
  • The public health importance of the clinical/health-related event under surveillance.
  • The purpose and operation of the surveillance system and resources (financial, personnel and other resources) needed to operate the surveillance system.
  • Surveillance system attributes and how to select attributes for evaluation.
  • The rationale for surveillance and evaluate the strengths and weaknesses of different approaches.
  • The surveillance cycle: set objectives, data collection, data analysis, interpretation, action, evaluation.
  • Population under surveillance.
  • Types of surveillance, including: (i) active surveillance; (ii) passive surveillance; (iii) sentinel surveillance; (iv) syndromic surveillance.
  • Disease registration systems.
  • Cancer registration (as an example of disease registration).
4 1

Prepare a surveillance system evaluation report and make recommendations based on your findings.

  • Typical structure of a surveillance system evaluation report.
  • Common errors in writing a surveillance system evaluation report.
5 1

Present and defend the report at a departmental meeting.

  • How to prepare a presentation.
  • Giving an oral presentation.
  • Responding to questions.
  • Critical reflective practice.
6 2

Identify a surveillance system and extract data from it.

  • The public health importance of the clinical/health-related event under surveillance.
  • Population under surveillance.
  • Types of surveillance including: (i) active surveillance; (ii) passive surveillance; (iii) sentinel surveillance; (iv) syndromic surveillance.
  • Disease registration systems.
  • Cancer registration (as an example of disease registration).
  • How to distinguish key features of communicable, non-communicable and environmental epidemiology.
7 2

Analyse surveillance data (descriptive epidemiology).

  • Types of data.
  • Time, place, person.
  • Frequencies and distributions.
  • The epidemiological methods available to analyse the data:
    • summary statistics, i.e. mean, median, mode, measures of spread
    • prevalence and incidence
    • rates (crude, specific and standardised)
    • risk adjustment.
8 2

Interpret the results of the analysis and prepare a report detailing the findings exercising professional judgement.

  • How to interpret an analysis of surveillance data.
  • Hypothesis generation.
  • Frameworks for report writing.
  • The importance of being able to be able to practise as an autonomous professional and exercise professional judgement.
  • Personal responsibility and the importance of being able to justify decisions.
9 3

Identify a peer-reviewed analytic epidemiological study for review.

  • How to perform a literature search.
  • Critical appraisal of scientific literature.
  • Epidemiological study designs and their measures of association.
10 3

Critically appraise the peer-reviewed manuscript, focusing on potential biases and how these may impact on the findings.

  • The analytical methods employed in the study.
  • Potential study biases, confounding and chance and their impact on measures of association:
    • selection bias
    • information bias
    • observer bias
    • loss to follow-up
    • misclassification
    • confounding and chance.
11 3

Present and defend the critical appraisal, e.g. at a journal club

  • How to prepare a presentation.
  • Giving an oral presentation.
  • Responding to questions.
  • Critical reflective practice.
12 4

Attend outbreak control team meetings.

  • The principles of outbreak investigation.
  • How to establish the existence of the outbreak:
    • identification of an outbreak using surveillance data
    • confirmation of diagnosis.
  • How to establish a hypothesis related to the mode of occurrence.
    • Contact cases in attempt to establish possible exposures associated with disease
    • Analysis of data collected from cases
  • How to test the hypotheses:
    • creation of data collection instruments, e.g. questionnaires
    • selection of suitable control population to compare cases with
    • the principles of epidemiological studies available to test hypotheses, e.g. case-control and cohort studies.
  • How to conduct an environmental and/or microbiological investigation.
  • How to control the outbreak and prevent further occurrences.
  • Social, institutional and political background to outbreak control.
  • Need for timeliness to enhance preventive impact of control measures.
  • How to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team.
13 4

Support the outbreak control team during the investigation.

  • The principles of outbreak investigation.
  • How to establish the existence of the outbreak:
    • identification of an outbreak using surveillance data
    • confirmation of diagnosis.
  • How to establish a hypothesis related to the mode of occurrence.
    • Contact cases in attempt to establish possible exposures associated with disease
    • Analysis of data collected from cases
  • How to test the hypotheses:
    • creation of data collection instruments, e.g. questionnaires
    • selection of suitable control population to compare cases with
    • the principles of epidemiological studies available to test hypotheses, e.g. case-control and cohort studies.
  • How to conduct an environmental and/or microbiological investigation.
  • How to control the outbreak and prevent further occurrences.
  • Social, institutional and political background to outbreak control.
  • Need for timeliness to enhance preventive impact of control measures.
  • How to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team.
14 4

Critically reflect on and document the steps undertaken in the investigation that you have been involved in.

  • How to write an investigation report to share experience with the public health and scientific community.

Work-based assessment


Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title