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Centers for Disease Control and Prevention June 9-13, 2008
Teach Epidemiology
Welcome to
Young Epidemiology Scholars Professional Development Workshop
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YES Professional Development Workshop
Teach Epidemiology
Handout
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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Broadcast Studios
YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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Emergency Operation Center
YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
Parking LotChallenges &
Solutions
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Challenges / Solutions Parking Lot
YES Professional Development Workshop
Teach Epidemiology
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YES Professional Development Workshop
Teach Epidemiology
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Epidemiology is …
… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the
control of health problems.
… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the
control of health problems.
YES Professional Development Workshop
Teach Epidemiology
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Workshop Goal
Teach Epidemiology
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1.
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Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy.
Empowers students to make more informed personal health-related decisions.
Increases students’ media literacy and their understanding of public health messages.
Increases students’ understanding of the basis for determining risk.
Improves students’ mathematical and scientific literacy.
Expands students’ understanding of scientific methods and develops their critical thinking skills.
Provides students with another mechanism for exploring important, real world questions about their health and the health of others.
Introduces students to an array of career paths related to the public’s health.
Top 8 Reasons to Teach / Learn about Epidemiology
Handout
Teach Epidemiology
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Workshop Goal
Teach Epidemiology
Teach Epidemiology
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30Teach Epidemiology
Teach Epidemiology
Mark’s Teach Epidemiology Story
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Mark’s Teach Epidemiology Story
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Mark’s Teach Epidemiology Story
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Mark’s Teach Epidemiology Story
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Mark’s Teach Epidemiology Story
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Teach Epidemiology
Teach Epidemiology
Teach Epidemiology Stories
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Teach Epidemiology
Teach Epidemiology
Teach Epidemiology Stories
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Teach Epidemiology
Teach Epidemiology
Teach Epidemiology Stories
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Young Epidemiology Scholars Professional Development Workshop Centers for Disease Control and Prevention, June 9-13, 2008
Welcome to
Teach Epidemiology
Teach Epidemiology
Your Teach Epidemiology Stories
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YES Professional Development Workshop
Teach Epidemiology
Parking Lot
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Backward Design
Pedagogical Basis
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Teach Epidemiology
42Teach Epidemiology
Enduring Understandings
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
43Teach Epidemiology
Enduring Understandings
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
44Teach Epidemiology
Enduring Understandings
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
45Teach Epidemiology
Enduring Understandings
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
46Teach Epidemiology
Enduring Understandings
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
47Teach Epidemiology
Enduring Understandings
Enduring Epidemiological Understandings
… the big ideas that reside at the heart of epidemiology and have lasting value outside the classroom.
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Handout
National Research Council , Learning and Understanding
Teach Epidemiology
Enduring Epidemiological Understandings
Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”
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Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”
National Research Council , Learning and Understanding
Teach Epidemiology
Enduring Epidemiological Understandings
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Teaching Epidemiology
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Teaching Epidemiology
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Scholarship
Creativity
Teaching Epidemiology
Interpret
Teach Epidemiology
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Teaching EpidemiologyHandout
Teach Epidemiology
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Stand Alone / Pick One Off the Shelf
Teaching Epidemiology
Teach Epidemiology
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Teaching Epidemiology
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Teaching Epidemiology
Handout
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Teaching Epidemiology
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Teaching Epidemiology
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Teaching Epidemiology
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Teaching Epidemiology Groups
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Group 4: Case Control - (Class 1, pages 16-21)
Group 5: TV and Aggressive Acts – (pages 1-33)
Group 6: Testing Ephedra – (pages 20-29)
Group 1: Cross-Sectional Studies – (pages 35-39)
Group 2: Ecological Studies – (Part 1)
Group 3: Confounding – (pages 32-36)
Group 4: Bias I – (pages 25-29)
Group 5: Bias II – (pages 30-32)
Group 6: Alpine Fizz – (Procedures 2, 4, and 5)
Group 1: Casualties of War – (Questions 11-21)Group 2: Teenage Births – (Class 1, pages 6-12)Group 3: Slave Trade – (Worksheet 1)
Teaching Epidemiology
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YES Professional Development Workshop
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YES Professional Development Workshop
Stephen B. Thacker, MD, MScDirector, Office of Workforce and Career Development
Assistant Surgeon General (Ret.)USPHS
Teach Epidemiology
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YES Professional Development Workshop
Dr. Stephen B. Thacker, a federal epidemiologist, in August 1976 with Thomas A. Payne,
whose fever spiked at 107.4 degrees.
Teach Epidemiology
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Enduring Understandings
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June 9, 2008
Diane Marie M. St. George, PhD
Teach Epidemiology
Young Epidemiology Scholars Professional Development Workshop
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5 “W” Questions
What?What?
Who?Who?
Where?Where?
When?When?
Why?Why?
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When investigating a crime, police detectives attempt to answer the 5 “W” questions.
Detectives want to know “whodunit” so that they can stop the crime from happening again.
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When investigating disease occurrence, epidemiologists attempt to answer the 5 “W”
questions.
Epidemiologists want to know “whatdunit” so that they can stop
or slow down the disease occurrence.
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5 “W” Questions
What?What? Health condition: disease, wellness, Health condition: disease, wellness, injury, disabilityinjury, disability
Who?Who? Person: age, gender, race/ethnicity, Person: age, gender, race/ethnicity, religion, diet, behaviorsreligion, diet, behaviors
Where?Where? Place: rurality, country, cityPlace: rurality, country, city
When?When? Time: annual cycles, long-term trends, Time: annual cycles, long-term trends, time of daytime of day
Why?Why? 1. Generate hypotheses1. Generate hypotheses
2. Analytic epidemiology2. Analytic epidemiology
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Snow on Cholera
The “father” of EpidemiologyThe “father” of Epidemiology Classic Epidemiologic Investigation, 1854Classic Epidemiologic Investigation, 1854 At the time, the predominant theory of At the time, the predominant theory of
disease causation was the miasma theory—disease causation was the miasma theory—disease came from bad airdisease came from bad air
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http://www.ph.ucla.edu/epi/snow/outbreak/
outbreakUNC.html
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Snow on Cholera
Which of the Ws appeared to be the main focus of Which of the Ws appeared to be the main focus of this investigation?this investigation?
Other studiesOther studies At 2 Emerson Place, on 3At 2 Emerson Place, on 3rdrd August, the wife of August, the wife of
an engineer, aged 30, cholera 2 days, an engineer, aged 30, cholera 2 days, Southwark and Vauxhall.Southwark and Vauxhall.
At 34 Charlotte Street, on 29At 34 Charlotte Street, on 29thth July, a July, a stockmaker, aged 29, cholera 18 hours, stockmaker, aged 29, cholera 18 hours, Lambeth.Lambeth.
Data from death registrationsData from death registrations
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Where can I find data on person, place and time?
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Surveillance
“…“…the ongoing systematic collection, analysis the ongoing systematic collection, analysis and interpretation of health data essential to and interpretation of health data essential to the planning, implementation, and the planning, implementation, and evaluation of public health practice, closely evaluation of public health practice, closely integrated with the timely dissemination of integrated with the timely dissemination of these data to those responsible for these data to those responsible for prevention and control”prevention and control”
Thacker & Berkelman, 1988Thacker & Berkelman, 1988
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Purpose of Surveillance
Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning
Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm
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Types of Surveillance Systems
Passive surveillancePassive surveillance agency waits to receive case reportsagency waits to receive case reports
Active surveillanceActive surveillance agency contacts providers, labs, etc.agency contacts providers, labs, etc.
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Surveillance Events
Outcomes:Outcomes: STDs, lead poisoning, birth STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational motor vehicle fatalities, occupational injuriesinjuries
Risk factors:Risk factors: Smoking, nutrition, screening Smoking, nutrition, screening tests, physical activitytests, physical activity
Hazards:Hazards: Pollutants, toxic chemicals Pollutants, toxic chemicals
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Sources of Surveillance Data
CDC CDC State/Local Health DepartmentState/Local Health Department Birth and Death certificatesBirth and Death certificates LaboratoriesLaboratories Hospital billing databasesHospital billing databases Providers’ officesProviders’ offices Fire incident reportsFire incident reports Others?Others?
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Sources of Surveillance Data
RegistriesRegistries State and national (SEER) cancerState and national (SEER) cancer WTC health registry 71k to be followed WTC health registry 71k to be followed
for 20 yearsfor 20 years Nagasaki and Hiroshima being followed Nagasaki and Hiroshima being followed
since the late 1950ssince the late 1950s
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Activity Each team of teachers receives a case studyEach team of teachers receives a case study
What patterns do you see? Who? What? What patterns do you see? Who? What? Where? When?Where? When?
Why do you think the patterns appear Why do you think the patterns appear that way? (Generate a that way? (Generate a hypothesis/hypotheses)hypothesis/hypotheses)
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Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National
Survey of Children's Health, 2003
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2007
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Source: Centers for Disease Control and Prevention. National Center for Health Statistics. Health Data for All Ages. http://www.cdc.gov/nchs/health_data_for_all_ages.htm.
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Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: Preliminary
data for 2005. Health E-Stats. Sept 2007.
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Source: WHO World Health Statistics 2008
The CIS countries are Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, the Republic of Moldova, the Russian Federation, and Ukraine.
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Remember that epidemiology is “the study of the Remember that epidemiology is “the study of the distributiondistribution and and determinantsdeterminants of health-related of health-related states or events in specified populations and the states or events in specified populations and the application of this study to the control of health application of this study to the control of health problems”. problems”. Descriptive epidemiologyDescriptive epidemiology
Describe the distribution of a health Describe the distribution of a health conditioncondition
Generate hypotheses about determinants of Generate hypotheses about determinants of diseasedisease
Analytic epidemiologyAnalytic epidemiologyTest hypotheses about Test hypotheses about determinants of of
diseasedisease
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YES Professional Development Workshop
Teach Epidemiology
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105Teach Epidemiology
Group 4: Case Control - (Class 1, pages 16-21) Group 5: TV and Aggressive Acts – (pages 1-33)
Group 6: Testing Ephedra – (pages 20-29)
Group 1: Cross-Sectional Studies – (pages 35-39)
Group 2: Ecological Studies – (Part 1)
Group 3: Confounding – (pages 32-36)
Group 4: Bias I – (pages 25-29)
Group 5: Bias II – (pages 30-32)
Group 6: Alpine Fizz – (Procedures 2, 4, and 5)
Group 1: Casualties of War – (Questions 11-21)Group 2: Teenage Births – (Class 1, pages 6-12)Group 3: Slave Trade – (Worksheet 1)
Teaching Epidemiology
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Rules
1. Teach epidemiology
2. As a group, create a 20-minute lesson during which we will develop a deeper understanding of an enduring epidemiological understanding.
3. Focus on the portion of the unit that is assigned. Use that portion of the unit as the starting point for creating your 20-minute lesson.
4. When teaching assume the foundational epidemiological knowledge from the preceding days of the workshop.
5. Try to get us to uncover the enduring epidemiological understanding. Try to only tell us something when absolutely necessary.
6. End each lesson by placing it in the context of the appropriate enduring epidemiological understanding.
7. Be certain that the lesson is taught in 20 minutes or less.
8. Teach epidemiology.
Teach Epidemiology
Teaching Epidemiology
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They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first,
and they can distinguish between foundational concepts and
elaborations or illustrations of those ideas.
They realize where people are likely to face difficulties developing their own comprehension,
and they can use that understanding to simplify
and clarify complex topics for others, tell the right story, or raise a powerfully provocative question.
Ken Bain, What the Best College Teachers Do
Teach Epidemiology
Teaching Epidemiology
Metacognition
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To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle
entailed in transforming practice.”
Teach Epidemiology
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YES Professional Development Workshop
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Broadcast Studios
YES Professional Development Workshop
Teach Epidemiology
Emergency Operation Center
Groups 1 & 2 Groups 3 & 4 Groups 5 & 6
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http://www.bmj.com/epidem/epid.html