Download uk fetp core learning objectives

UK Field Epidemiology
Training Programme
Core Learning Objectives
Version 9
July 2012_v9
1
Table of Contents
1. KNOWLEDGE OF EPIDEMIOLOGICAL AND STATISTICAL CONCEPTS (MANDATORY)....................................... 4
2. PLAN, DEVELOP, AND CONDUCT AN EPIDEMIOLOGICAL STUDY (MANDATORY) ............................... 111
3. CONDUCT AN EPIDEMIOLOGICAL INVESTIGATION IN AN ACUTE OUTBREAK OR INCIDENT (MANDATORY)
................................................................................................................................................ 188
4. DESIGN AND IMPLEMENT, ANALYSE OR EVALUATE A SURVEILLANCE SYSTEM (MANDATORY) .......... 233
5. TRAIN OTHER PUBLIC HEALTH PROFESSIONALS (MANDATORY) .................................................... 299
6. COMMUNICATION (MANDATORY) ............................................................................................... 333
7. LABORATORY ISSUES (MANDATORY) ......................................................................................... 388
8. VACCINATION EPIDEMIOLOGY (MANDATORY) .............................................................................. 411
9. ENVIRONMENTAL EPIDEMIOLOGY (MANDATORY)......................................................................... 444
10. EPIDEMIOLOGY IN HEALTHCARE SETTINGS (MANDATORY) ......................................................... 490
11. EPIDEMIOLOGY IN EMERGENCY SITUATIONS (OPTIONAL) ........................................................... 545
12. ADVANCED METHODS FOR USE IN FIELD EPIDEMIOLOGY.............................................................. 59

MULTIVARIABLE ANALYSIS (MANDATORY) .................................................................................................. 58

TIME SERIES ANALYSIS AND RELATED METHODS (OPTIONAL) .............................................................. 584

SAMPLING METHOD (MANDATORY)............................................................................................................ 587
July 2012_v9
2
UK FETP CORE LEARNING OBJECTIVES
The following learning objectives for the UK FETP have been developed from
those established by the European Programme in Intervention Epidemiology
Training (EPIET). The FETP learning objectives ensure that by completion of
the programme, Fellows will have the knowledge, skills and abilities perform
field epidemiology work effectively, and will have attained the set of
competencies that have agreed as core for field epidemiologists in the
European Union. 1
The following individuals have been involved in the development of the
objectives:
Naomi Boxall
Sam Bracebridge
Paul Cleary
Vivien Cleary
Barry Cookson
Susan Hopkins
Irene Kreis
Giovanni Leonardi
Deirdre Lewis
Helen Maguire
Trish Mannes
Ruth Ruggles
Chris Williams
Yvonne Young
1
http://www.ecdc.europa.eu/en/publications/Publications/0801_TED_Core_Competencies_for_Public_H
ealth_Epidemiologists.pdf
July 2012_v9
3
1. Knowledge of epidemiological and statistical concepts (mandatory)
There is an assumption the fellows should have knowledge of most of the concepts below at entry to the FETP. However, the concepts will be
revised during the Introductory Course.
Topic/ task
Apply basic
biostatistics
FETP learning objectives
Be able to apply:
1. scales of measurement (nominal, ordinal, interval, and ratio)
2. differences in the analysis of continuous and discrete data
3. Calculating measures of central tendency (mean, median, mode)
4. Calculating measures of dispersion (range, variance, standard
deviation, standard error of the mean)
5. Discuss in what setting the various measures of central tendency
and dispersion are used to epidemiological studies and
surveillance data
Maps to ECDC competency
42. Apply basic concepts of
probability
43. Calculate and interpret point
estimates and confidence
intervals of measures of central
tendency and dispersion
How met (eg)
Field work :

Training
others

Communic
ation
44. Calculate and interpret point
estimates and confidence
intervals of measures of disease
frequency
45. Calculate and interpret point
estimates and confidence
intervals of measures of
association and impact
46. Calculate and interpret
significance tests
73. Mentor peers or junior
epidemiologists
74. Assist others to clarify thinking,
create consensus, and develop
ideas into actionable plans
75. Train peers/colleagues
July 2012_v9
4
Perform basic
descriptive
epidemiology
Measures of
disease
occurrence

Prevalence

Incidence
Time trends
6. Demonstrate understanding of the different measures of disease
occurrence and their appropriate application.
18. Perform descriptive analysis of
surveillance data
7.
26. Describe the outbreak in terms of
person, place and time
Calculate and interpret basic measures of disease occurrence
including prevalence, incidence risk, and incidence rate.
8. Plot, describe and interpret disease occurrence over time.
9. Demonstrate understanding of the appropriate use of common study
designs
Recognising the
application of
different study
types:
10. Demonstrate understanding of strengths and weaknesses of each
type of study design in the context of field epidemiology.
Randomised
control trial
11 Identify the most appropriate measures of frequency and effect to
calculate for each study type.
July 2012_v9
Field work:

Surveillan
ce

Outbreak

Research

Training
others

Communic
ation
18. Perform descriptive analysis of
surveillance data
Module
19. Interpret disease and public
health events trends from time
series analysis

Surveillan
ce

Research
28. Conduct analytical
epidemiological investigation to
identify the source
31. Write a study protocol using
investigation techniques
consistent with the public health
problem
Field work:
Module
Field work:

Outbreak

Research

Training
5
Cohort study
design
32. Conduct epidemiological studies
others
Case control
study design
Cross-sectional
design
Ecological studies
Case-cohort
design
Case crossover
design
Identify and
minimise role of
bias in
epidemiological
studies
12. Demonstrate understanding of the difference between random error 20. Identify key findings from
and systematic error (epidemiological bias).
surveillance data analysis and
draw conclusions
13. Demonstrate understanding of the sources of bias in
epidemiological studies including measurement error, selection
28. Conduct analytical
bias, and confounding
epidemiological investigation to
identify the source
14. Understand and apply methods for controlling sources of bias at
study design phase.
31. Write a study protocol using
investigation techniques
consistent with the public health
problem
32. Conduct epidemiological studies
33. Report and present results of a
study
Modules
Field work:

Surveillan
ce

Research

Outbreak
Communicatio
n (project
review
module/
journal club)
39. Identify, review and assess
relevant literature and other
evidence
52. Draw conclusions from the results
of analysis
July 2012_v9
6
Sampling
methods
Questionnaire
design
15. Demonstrate understanding of basic principles of sample
size/power calculation.
16. Demonstrate understanding of the principles of good questionnaire
design for field epidemiology
47. Select an appropriate sampling
strategy
28. Conduct analytical
epidemiological investigation to
identify the source
31. Write a study protocol using
investigation techniques
consistent with the public health
problem
32. Conduct epidemiological studies
76. Respect and adhere to ethical
principles regarding human
welfare
Module
Field work:

Outbreak

Research
Field work:

Outbreak

Research

Surveillan
ce

Training
others

Lecture
77. Follow ethics principles and
guidelines for planning studies,
conducting research, and
collecting disseminating and
using data
78. Apply relevant laws to data
collection, management,
dissemination and use of
information
79. Respect and adhere to ethical
July 2012_v9
7
principles regarding data
protection and confidentiality
regarding any information
obtained as part of the
professional activity
Apply basic
analytical
epidemiology:
17. Demonstrate understanding of how to identify and address
confounding and effect modification in the analysis of
epidemiological studies
28. Conduct analytical
epidemiological investigation to
identify the source
Univariate
analysis
18. Demonstrate understanding of the appropriate application of
standardisation as a method for adjustment for confounding.
Stratified analysis
19. Demonstrate understanding of the appropriate application and
interpretation of basic measures of effect (odds ratios, relative
risks, risk difference, NNT)
31. Write a study protocol using
investigation techniques
consistent with the public health
problem
Non-parametric
methods of
analysis
Module
Field work:

Outbreak

Research

Teaching
others
32. Conduct epidemiological studies
45. Calculate and interpret point
estimates and confidence
intervals of measures of
association and impact
46. Calculate and interpret
significance tests
51. Use software packages for
statistical analysis (measures of
association, testing, and logistic
regression)
52. Draw conclusions from the results
of analysis
Interpret statistical 20. Demonstrate understanding of the relevance of commonly used
probability distributions.
analysis in terms
of inference and
21. Demonstrate understanding of the meaning of type 1 & type 2
probability
errors.
July 2012_v9
28. Conduct analytical
epidemiological investigation to
identify the source
31. Write a study protocol using
Field work:

Outbreak

Research
8
distributions:
22. Demonstrate understanding of the principles of statistical inference
Significance
testing
23. Demonstrate understanding and interpret confidence intervals and
p values for odds ratios and relative risks.
Bias
Confounding and
effect modification
Standardisation
Measures of
effect
Measures of
population impact
investigation techniques
consistent with the public health
problem
32. Conduct epidemiological studies
24. Demonstrate understanding of and interpret measures of
population impact including attributable risk, preventive fraction and 33. Report and present results of a
population attributable risk.
study
25. Calculate and interpret point estimates and confidence intervals of
measures of central tendency and dispersion
26. Calculate and interpret point estimates and confidence intervals of
measures of disease frequency
27. Calculate and interpret point estimates and confidence intervals of
measures of association and impact
28. Calculate and interpret significance tests
29. Calculate directly standardised rates and SMR/SIRs.

Teaching
Communicatio
n (project
review
module)
39. Identify, review and assess
relevant literature and other
evidence
45. Calculate and interpret point
estimates and confidence
intervals of measures of
association and impact
46. Calculate and interpret
significance tests
51. Use software packages for
statistical analysis (measures of
association, testing, and logistic
regression)
52. Draw conclusions from the results
of analysis
Causality
July 2012_v9
30. Demonstrate understanding of the Bradford-Hill criteria for
assessing causality in the context of epidemiological reasoning
1.
Use current knowledge of
epidemiology of diseases to
guide public health or
epidemiological practice
Field work:
2.
Provide epidemiological input to
develop measurable relevant
objectives of public health
programmes
3.
Use knowledge of specific

Research

Outbreak

Communic
ation
9
sociological and cultural factors in
the population to conduct studies
and recommend public health
actions relevant for the affected
community
12. Identify an appropriate public
health intervention based on
surveillance data
34. Recommend evidence-based
interventions in response to
epidemiological findings
55. Write a report of an
epidemiological investigation for
decision makers
Knowledge and
competence in
use of common
software
packages
required by
epidemiologists
Demonstrate knowledge and competence in use of common software
packages used by epidemiologists including at least one in each of the
following categories:
31. Field epidemiology packages (EpiData)
32. Other statistical analysis packages (EpiData Analysis, STATA,
SPSS, R, SAS or other)
33. Databases (MS Access or other database software)
34. Graphical software (MS Excel)
35. GIS software
36. Reference management tool (Endnote/Reference
Manager/Zotero)
37. Literature databases
July 2012_v9
48. Use internet sources to conduct
literature search
Field work:

Research

50. Use database software packages

for entering and managing data
Outbreak
49. Use web-enabled databases
Surveillan
ce
51. Use software packages for
statistical analysis (measures of
association, testing, and logistic
regression)
52. Draw conclusions from the results
of analysis
53. Use software for writing, editing
and creating presentations
10
2. Plan, develop, and conduct an epidemiological study (mandatory)
The objective of this activity is to acquire the skills necessary to plan, conduct and analyse an epidemiological study and to interpret and
communicate its results
It is recommended that fellows participate in all stages of a study. Although this may not always be possible within two years, the fellow should
attempt to contribute to as many stages as possible:

Identify a problem of public health importance;

Review literature;

Identify and write study question and the hypothesis to be tested;

Choose the study design and study population;

Choose appropriate methodology;

Develop a plan of analysis;

Write a detailed protocol (obtain a review of the protocol from the host institute supervisor and EPIET coordinators);

Seek financial support if necessary;

Conduct a pilot study and, if necessary, make modifications;

Constitute and brief the study team;

Manage a team;

Obtain ethical approval;

Collect and analyse data;

Interpret the results;

Disseminate and communicate the information;
July 2012_v9
11

Write a scientific report and/or a scientific article
To achieve the research objective the fellows need to produce a final protocol or a final research report or submit a manuscript to a peer-reviewed
journal.
Conduct an epidemiological study
Topic/ task
Identify a problem of public
health importance
FETP learning objectives
38. Conduct a literature review using
appropriate databases in a
systematic fashion
39. Use a variety of health intelligence
to define the problem
Maps to ECDC competency
1.
Use current knowledge of epidemiology of diseases to
guide public health or epidemiological practice
2.
Provide epidemiological input to develop measurable
relevant objectives of public health programmes
3.
Use knowledge of specific sociological and cultural
factors in the population to conduct studies and
recommend public health actions relevant for the
affected community
4.
Understand and analyse legal public health policy
documents at local, national and European level
How met (eg)
Field work:

Literature
review

Review of
surveillance
outputs
13. Identify sources of information about potential public
health threats
14. Conduct risk assessments: verify, using critical thinking,
if a public health problem exists and describe its
magnitude
15. Identify surveillance data needs for risk assessments of
public health threats
39. Identify, review and assess relevant literature and other
evidence
48. Use internet sources to conduct literature search
July 2012_v9
12
49. Use web-enabled databases
Networking and consulting
40. Demonstrate consultation with
colleagues at all stages of the
planning, delivery and completion of
the study
60. Incorporate interpersonal skills in communication with
colleagues and with the other audiences
Field work
69. Be an effective team member, adopting the role needed
to contribute constructively to the accomplishment of
Topic/ task by the group (including leadership)
70. Promote collaborations, partnerships and team building to
accomplish epidemiology programme objectives
71. Develop community partnerships to support
epidemiological investigations
72. Mutually identify those interests that are shared, opposed
or different with the other party to achieve good
collaborations and conflict management
Write a detailed protocol
41. Generate a study hypothesis and
define a specific study question
13. Identify sources of information about potential public
health threats
Field work
42. Select and justify an appropriate study 31. Write a study protocol using investigation techniques
design
consistent with the public health problem
43. Select appropriate study population
and select an appropriate sample
47. Select an appropriate sampling strategy
44. Identify data required and appropriate
method of data collection
45. Develop tools for data collection
46. Develop plan for data cleaning, data
analysis, statistical analysis
Consider ethical and data
protection principles, and
data logistics
July 2012_v9
47. Explicitly consider ethical principles
regarding human welfare including
privacy, confidentiality and informed
76. Respect and adhere to ethical principles regarding human Field work
welfare
77. Follow ethics principles and guidelines for planning
13
consent
48. Apply for ethical approval where
necessary
studies, conducting research, and collecting disseminating
and using data
78. Apply relevant laws to data collection, management,
dissemination and use of information
49. Demonstrate awareness of legislation
relevant to data collection,
80. Handle conflicts of interests
management, dissemination and use
of information including Caldicott and
Data Protection Act
50. Recognise, declare, and appropriately
manage conflicts of interest
51. Identify data resource requirements
Obtain a detailed review of
the protocol
52. Demonstrate that you have sought
and taken advice from appropriate
stakeholders
69. Be an effective team member, adopting the role needed
to contribute constructively to the accomplishment of
Topic/ task by the group (including leadership)
Field work:
70. Promote collaborations, partnerships and team building to
accomplish epidemiology programme objectives
71. Develop community partnerships to support
epidemiological investigations
72. Mutually identify those interests that are shared, opposed
or different with the other party to achieve good
collaborations and conflict management
Seek financial support if
necessary
53. Identify sources of available funding
54. Understand grant application process
66. Manage available resources (staff, time, budget, etc)
effectively
Field work:
74. Assist others to clarify thinking, create consensus, and
develop ideas into actionable plans
Field work:
55. Complete grant application where
necessary
Pilot study
56. Conduct a pilot study if required
Establish and train the study
57. Establish a team with the appropriate 64. Plan, prioritise and schedule Topic/ task in a project
July 2012_v9
Field work:
14
team if required
skill mix
75. Train peers or colleagues
58. Coordinate the team and provide
appropriate briefing and training
Collect data
59. Design a data collection tool, e.g.
questionnaire
60. Design and set up a database
maximising data quality according to
principles of information governance
and data security
32. Conduct epidemiological studies
Field work:
50. Use database software packages for entering and
managing data
51. Use software packages for statistical analysis (measures
of association, testing, and logistic regression)
76. Respect and adhere to ethical principles regarding human
welfare
77. Follow ethics principles and guidelines for planning
studies, conducting research, and collecting disseminating
and using data
78. Apply relevant laws to data collection, management,
dissemination and use of information
79. Respect and adhere to ethical principles regarding data
protection and confidentiality regarding any information
obtained as part of the professional activity
Analyse the data
61. Export and import data between
software packages if necessary
62. Analyse a specific data-set using a
statistical package including
descriptive analysis, univariate
analysis, and multivariable analysis
where appropriate, taking into
account confounding and effect
modification
32. Conduct epidemiological studies
Field work:
50. Use database software packages for entering and
managing data
51. Use software packages for statistical analysis (measures
of association, testing, and logistic regression)
63. Demonstrate an audit trail for analysis
Interpret the results
July 2012_v9
64. Demonstrate ability to draw
46. Calculate and interpret significance tests
Field work:
15
appropriate inferences from an
52. Draw conclusions from the results of analysis
analysis, accounting for issues such
as bias, confounding, and their public
health importance
Learning from the project
Report results
65. Conduct a project debrief, including
scientific and technical issues,
logistics, training, and other
management
65. Monitor progress and quality against specific targets,
adjust schedules and make changes if necessary
66. Present and interpret results to a
variety of audiences
5. Use epidemiological findings to plan public health
67. Summarise results for decision
makers
6.
68. Write a report of an epidemiological
investigation for decision makers
7.
69. Recommend evidence based
interventions in response to
epidemiological findings
Field work:
74. Assist others to clarify thinking, create consensus, and
develop ideas into actionable plans
Field work:
programmes
8.
Implement public health programmes: translate policy
into public health practice
Identify effective health promotion measures for specific
problems
Identify appropriate health prevention measures for
specific problems
30. Report and present results of an investigation
33. Report and present results of a study
34. Recommend evidence-based interventions in response to
epidemiological findings
40. Develop evidence based guidelines/ recommendations for
surveillance, prevention and control of communicable
diseases and other acute public health events
41. Identify appropriate target groups for guidelines or
recommendations
53. Use software for writing, editing and creating
presentations
54. Apply the basic principles of risk communication,
adjusting the message when presenting results of an
July 2012_v9
16
investigation to different audiences: media, general public,
professionals and policy makers
Planning and use of
resources
70. Plan, prioritise and schedule tasks in
a project
71. Monitor progress and quality against
specific targets, adjust schedules
and make changes if necessary
72. Manage available resources (staff,
time, budget, etc) effectively
73. Prepare a progress report
July 2012_v9
64. Plan, prioritise and schedule Topic/ task in a project
Field work:
65. Monitor progress and quality against specific targets,
adjust schedules and make changes if necessary
66. Manage available resources (staff, time, budget, etc)
effectively
67. Conduct epidemiological activities within the financial
and operational planning context
68. Prepare an activity report
17
3. Conduct an epidemiological investigation in an acute outbreak or incident (mandatory)
The training objectives are to expose fellows to administrative, managerial, operational and methodological aspects of outbreak investigations.
Ideally, fellows will have the opportunity to investigate different types of outbreaks (e.g. food borne, environmental, point common source,
person-to-person transmission) during their fellowship.
The following classical approach to outbreak investigation can be used as a rough guide and as a basis for evaluating the acquisition of
experience and skills in outbreak investigation:

Obtain preliminary information:
–
Description of public health problem, how it was discovered
–
Epidemiological information gathered
–
Nature of problem and urgency of addressing it
–
Plan for future action
–
Establish what level of control or investigation is necessary
–
Major emphasis on control, minor emphasis on investigation
–
Emphasis both on investigation and control
–
More emphasis on investigation than control
–
Emphasis on investigation (research purposes)
If requested and decided, make a site visit.

Create or participate in the creation of the outbreak control team;

Conduct an on-site investigation;

Confirm the outbreak, diagnosis, case definition;
July 2012_v9
18

Count cases and orient the data according to time, place and person characteristics;

Develop hypothesis compatible with descriptive data and with the suspected source and the vehicle;

Test hypothesis, verify biological plausibility and compatibility of epidemiological results with other information;

Develop recommendations for preventive and control measures, verify that control measures are effective;

Write a report and communicate results and recommendations. If appropriate, write a scientific article.
To achieve the outbreak objective the fellow needs to produce at least one final outbreak report or submit a manuscript to a peer-reviewed journal.
Conduct an epidemiological investigation in an acute outbreak or incident
Topic/ task
FETP learning objectives
Maps to Core competency
Respond to initial signal or
alert
74. Respond in and out of working hours
to a report of a potential incident or
outbreak
13. Identify sources of information about
potential public health threats
75. Be familiar with transmission
dynamics of infectious diseases
Demonstrate appropriate risk
assessment by obtaining preliminary
information:
76. Description of the public health
problem and how it was discovered
77. Establish epidemiological information
gathered to date
78. Establish the case definition,
diagnosis, & ensure appropriate
investigations have been instigated
July 2012_v9
How met (eg)
Field work
Introductory module
14. Conduct risk assessments: verify,
using critical thinking, if a public
health problem exists and describe
its magnitude
15. Identify surveillance data needs for
risk assessments of public health
threats
25. Create a case definition and adjust
it as necessary during the
investigation
35. Be familiar with transmission
dynamics of infectious diseases
19
79. Confirm the outbreak
80. Establish the urgency of addressing
the problem
81. Establish a plan for further action
and confirm with supervisor
Understand the outbreak
response mechanisms
82. Demonstrate awareness of policies
and plans relating to outbreak and
incident management
67. Conduct epidemiological activities
within the financial and operational
planning context
Field work:
Outbreak control
83. Establish what level of control or
investigation is necessary
34. Recommend evidence-based
interventions in response to
epidemiological findings
Field work
84. Recommend appropriate evidence
based measures to control the
outbreak
Prepare for investigation
85. Demonstrate the need for
epidemiological investigation and
document this in a briefing to an
outbreak control team
Introductory module
29. Recommend appropriate evidence
based measures to control the
outbreak
54. Apply the basic principles of risk
communication, adjusting the
message when presenting results of
an investigation to different
audiences: media, general public,
professionals and policy makers
Field work
Introductory module
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
Making a significant
contribution to an
epidemiological
investigation of an
outbreak
July 2012_v9
86. Be part of an outbreak control
committee
61. Analyse and synthesise main points
in a speech
87. Lead the epidemiological
investigation of an outbreak, e.g.
chairing or managing the
epidemiological investigation team
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
Field work
Introductory module
66. Manage available resources (staff,
20
time, budget, etc) effectively
71. Develop community partnerships to
support epidemiological
investigations
72. Mutually identify those interests that
are shared, opposed or different
with the other party to achieve good
collaborations and conflict
management
Conduct the investigation
88. Undertake a descriptive
epidemiological analysis including an
epidemic curve: count cases and
orient data according to time, place
and person
89. Generate hypothesis and decide if
analytical study is appropriate
Write an epidemiological investigation
protocol including:
90. the steps of the investigation
91. laboratory techniques
92. environmental procedures
93. epidemiological methodology
resource, ethical and information
governance considerations
94. Undertake a site visit if appropriate
95. Identify data required and appropriate
method of data collection
96. Develop tools for data collection (eg
EpiData, web-based questionnaire)
July 2012_v9
36. Interpret the diagnostic and
epidemiological significance of
reports from laboratory tests
37. Be familiar with different methods
for diagnosis and typing, including
molecular tests
Field work
Introductory module
Computer tools for outbreak investigation
module
Multivariable analysis module
38. Communicate effectively with the
laboratory team
27. Generate hypothesis about the
cause and/or risk factors of the
outbreak
28. Conduct analytical epidemiological
investigation to identify the source
29. Recommend appropriate evidence
based measures to control the
outbreak
77. Follow ethics principles and
guidelines for planning studies,
conducting research, and collecting
disseminating and using data
78. Apply relevant laws to data
21
97. Develop plan for data cleaning, data
analysis, statistical analysis
Report on the investigation
98.
Undertake analytical study and
verify biological plausibility and
compatibility of epidemiological
findings with other information
99.
Write a press release
100. Contribute to a management
briefing or SITREP if required
101. Contribute to writing the outbreak
report, and lead on writing the
epidemiological investigation
102. Conduct, and report on, a project
debrief, including scientific and
technical issues, logistics, training,
and other management
collection, management,
dissemination and use of
information
7. Identify effective health promotion
Field work
measures for specific problems
8. Identify appropriate health
prevention measures for specific
problems
30. Report and present results of an
investigation
58. Write a press release
59. Produce documents, reports, letters,
meeting minutes, etc
68. Prepare an activity report
July 2012_v9
22
4. Design and implement, analyse or evaluate a surveillance system (mandatory)
The objective of this activity is to acquire skills and experience in the planning process, implementation, data analysis and evaluation of a
disease surveillance system.
New system
The fellow may be involved in any of the following steps:

Design the surveillance system (public health importance, action/intervention available, objectives of the system, case definition,
indicators, data collection, source of information, transmission of information, software and hardware, data analysis, feedback
procedures, recipients, use of information);

Develop a case report form and obtain clearance from appropriate individuals or offices;

Obtain support for the surveillance system from the individuals who will be responsible for ensuring that the system is implemented;

Conduct a pilot study if necessary;

Supervise data collection and collation.

Analyse the data, selecting appropriate methods.

Provide the results of the analysis to appropriate individuals choosing the appropriate mode of communication.

If the findings of the surveillance system indicate the need for prevention or control measures, or further investigation, make appropriate
recommendations.

Develop a framework to evaluate the surveillance system using standard criteria.
Day-to day surveillance activities
The fellow may be involved in any of the following steps:

Check incoming surveillance reports for plausibility and collection of missing information;

Conduct regular data analysis of surveillance data;
July 2012_v9
23

Interpret current trends in the surveillance data and develop corresponding recommendations;

Participate in regular feedback of surveillance data to stakeholders;

Write a scientific report using the analysed data;

If the findings of the surveillance system indicate the need for prevention or control measures, or further investigation, make appropriate
recommendations for the improvement of the surveillance system (such as new questionnaires, better feedback).
Evaluation of an existing surveillance system
In most circumstances this training objective will be achieved through data analysis and evaluation of an existing surveillance system.
The following criteria can be used to assess the system:

Describe the public health importance of the health event, and the public health strategy;

Describe the system:
–
List the objectives
–
Describe the health event
–
State the case definition
–
Draw a flow chart of the system
–
Describe the components and operational modes of the system
–
Assess usefulness by indicating action taken as a result of the data from the surveillance system

Evaluate the system for each of the following criteria: Simplicity, flexibility, acceptability, sensitivity, positive predictive value,
representativeness, timeliness;

Describe the resources used to operate the system;

List conclusions and recommendations.
July 2012_v9
24
To achieve the surveillance objective the fellow needs to produce a final protocol (to set up a surveillance system) or a final surveillance
(evaluation) report or submit a surveillance manuscript to a peer-reviewed journal.
Implement or evaluate and operate a surveillance system
Topic/ task
FETP learning objectives
103. To define and document the public
health importance of the
surveillance system.
Maps to ECDC competency
9.
Evaluate the impact of an intervention on population
health
How met (e.g.)
Field work:
Surveillance
13. Identify sources of information about potential public
health threats
14. Conduct risk assessments: verify, using critical
thinking, if a public health problem exists and describe
its magnitude
21. Evaluate surveillance systems
22. Recognise the need for and set up a new surveillance
system
General
69. Be an effective team member, adopting the role
needed to contribute constructively to the
accomplishment of Topic/ task by the group (including
leadership)
70. Promote collaborations, partnerships and team building
to accomplish epidemiology programme objective
Plan method
July 2012_v9
104. State the objectives of the
surveillance system
105. List the surveillance indicators
used
15. Identify surveillance data needs for risk assessments
of public health threats
Field work:

Surveillance

Outbreak
25

106. Describe the data and data
categories
Research
107. Describe the type of surveillance
21. Evaluate surveillance systems
Field work:
108. Describe data sources
22. Recognise the need for and set up a new surveillance
system

Surveillance

Outbreak

Research
109. Draw a comprehensive flow chart
110. Describe system attributes
Describe the surveillance
system
24. Be familiar with laws on surveillance and reporting of
communicable diseases at national, EU level and
globally (International Health Regulations)
36. Interpret the diagnostic and epidemiological
significance of reports from laboratory tests
37. Be familiar with different methods for diagnosis and
typing, including molecular tests
38. Communicate effectively with the laboratory team
111. Describe and manage surveillance
data bases
112. Use appropriate data analyses
Analyse surveillance data
16. Run a surveillance system
Field work:
17. Conduct surveillance data management

Surveillance

Research
18. Perform descriptive analysis of surveillance data
113. Demonstrate understanding of the
19. Interpret disease and public health events trends from
purpose of time series analysis and
time series analysis
related methods in public health
surveillance
20. Identify key findings from surveillance data analysis
and draw conclusions
114. Demonstrate understanding of
fundamental terms and concepts
52. Draw conclusions from the results of analysis
relevant to time series analysis,
including trend, seasonality, serial
dependence, stationarity
Module: TSA (optional)
115. Aggregate data for time series
analysis
July 2012_v9
26
116. Describe and summarise time
series data, including the use of
smoothing techniques such as
moving averages
117. Describe system attributes,
prioritise those critical for specific
surveillance objectives and assess
system attributes as appropriate
Evaluate surveillance
system
21. Evaluate surveillance systems
Field work:

Surveillance
118. Understand utility of, prerequisites
for and where possible perform a
capture-recapture study
119. Assess feedback procedures
120. Analyse use of information
Operate surveillance
system
121. Actively participate in the operation 10. Measure health outcomes to guide decision making in Field work:
and management of a surveillance
prevention strategy
 Surveillance
system
49. Use web-enabled databases
122. Perform routine analysis of
43. Calculate and interpret point estimates and confidence
surveillance data
intervals of measures of central tendency and
123. Write regular surveillance reports
dispersion
for stakeholders / those who need
44. Calculate and interpret point estimates and confidence
to know
intervals of measures of disease frequency
124. Implement improvements to the
50. Use database software packages for entering and
system
managing data
51. Use software packages for statistical analysis
(measures of association, testing, and logistic
regression)
52. Draw conclusions from the results of analysis
July 2012_v9
27
125. Provide feedback to stakeholders
126. Write a formal report with
recommendations
Output
53. Use software for writing, editing and creating
presentations
Field work:

Surveillance
54. Apply the basic principles of risk communication,
adjusting the message when presenting results of an
investigation to different audiences: media, general
public, professionals and policy makers

Communications
60. Incorporate interpersonal skills in communication with
colleagues and with the other audiences
61. Analyse and synthesise main points in a speech
127. Demonstrate an understanding of
24. Be familiar with laws on surveillance and reporting of
the UK statutory notification system
communicable diseases at national, EU level and
for infectious diseases (NOIDS)
globally (International Health Regulations)
Public health law
July 2012_v9
128. Demonstrate an understanding of
International Health Regulations
(2008)
Field work:

Surveillance

Communication

Research

Outbreak
28
5. Train other public health professionals (mandatory)
During the two-year programme, it is recommended that fellows from the EPIET and EPIET-associated programmes participate in the teaching
of other individuals both in teaching institutions and in the field.
The objective of this participation in training other individuals is to acquire skills and experience in:

Preparing a teaching session or a case study;

Selecting the main messages and the lecture level depending on the audience;

being fully prepared for a teaching session so that you can facilitate learning and respond flexibly to the learners’ needs
To achieve the teaching objective the fellow needs to have developed, delivered, and evaluated at least one teaching session on field
epidemiology
Train public health professionals
Topic/ task
FETP learning objectives
129. Conduct a learning needs
assessment
130. Use this to plan and provide
learning opportunities
Identify learning needs
Maps to Core competency
60. Incorporate interpersonal skills
incommunication with
colleagues and with the other
audiences
How met (eg)
Field work:

Teaching / training
Communication
62. Provide objective feedback
(descriptive, rather than
judgmental)
73. Mentor peers or colleagues
74. Assist others to clarify thinking,
create consensus, and develop
ideas into actionable plans
75. Train peers or colleagues
July 2012_v9
29
131. Demonstrate knowledge of the
intended audience and their
learning needs
132. Define and document aims and
intended learning outcomes for
session
133. Develop and use resources and
teaching methods appropriate to
the audience informed by the
needs assessment
Prepare and deliver a teaching
session
134. Demonstrate the ability to
facilitate a teaching session and
to respond to the group’s needs
135. Evaluate the teaching session
using an appropriate tool.
136. Demonstrate ability to respond
to evaluation comments in
planning for future sessions
53. Use software for writing, editing
and creating presentations
60. Incorporate interpersonal skills
in communication with
colleagues and with the other
audiences
Field work:

Teaching / training
Communication
61. Analyse and synthesise main
points in a speech
63. Use communication
technologies (videoconference,
teleconference, e-mail, etc.)
effectively
74. Assist others to clarify thinking,
create consensus, and develop
ideas into actionable plans
75. Train peers or colleagues
Demonstrate the above skills by
preparing and delivering:
137. a formal lecture
138. an interactive training session
(e.g. seminar/ workshop/ small
group teaching)
139. a case study
Plan, organise and evaluate a course
140. Demonstrate knowledge of the
intended audience and their
learning needs
141. Define aims and intended
learning outcomes for the
July 2012_v9
60. Incorporate interpersonal skills
in communication with
colleagues and with the other
audiences
Field work:

Teaching / training
Communication
63. Use communication
30
course
142. Develop the course outline and
timetable identifying key
stakeholders to collaborate as
required
Identify and manage the resources
needed for delivery of the course
which may include:
143. the budget required
144. key individuals to participate in
organisation and
delivery(including administrative,
technical, and professional
input)
145. teaching resources and
methods appropriate to the
audience
146. venues
147. refreshments etc
148. Evaluate the course using an
appropriate tool.
149. Demonstrate ability to respond
to evaluation comments in
planning for future courses
Mentorship
150. Mentor first year fellows or work
colleagues
151. Assist colleagues to clarify
July 2012_v9
technologies (videoconference,
teleconference, e-mail, etc.)
effectively
64. Plan, prioritise and schedule
Topic/ task in a project
65. Monitor progress and quality
against specific targets, adjust
schedules and make changes if
necessary
66. Manage available resources
(staff, time, budget, etc)
effectively
68. Prepare an activity report
70. Promote collaborations,
partnerships and team building
to accomplish epidemiology
programme objectives
72. Mutually identify those interests
that are shared, opposed or
different with the other party to
achieve good collaborations and
conflict management
74. Assist others to clarify thinking,
create consensus, and develop
ideas into actionable plans
75. Train peers or colleagues
62. Provide objective feedback
(descriptive, rather than
judgmental)
Field work:

Teaching / training
31
thinking, create consensus, and
develop ideas into actionable
plans
73. Mentor peers or colleagues
Communication
74. Assist others to clarify thinking,
create consensus, and develop
ideas into actionable plans
75. Train peers or colleagues
July 2012_v9
32
6. Communication (mandatory)
During the two-year programme, fellows should:

Submit abstracts to the HPA/ ESCAIDE conference

Prepare a scientific report/paper:
–
Field investigation (outbreak) report
–
Short article in an epidemiological bulletin
–
Scientific paper for peer-reviewed journal (as first author)
–
Make an oral scientific presentation at an international conference.

Appraise a scientific article (peer review)

Write a formal health briefing

Communicate with the media:
–
Be involved in the preparation of a press release;
–
Respond to journalists’ interview (newspaper, radio or TV);
Prepare a questions/answers briefing (frequently asked questions) document.
July 2012_v9
33
Communication with the scientific community and the public
Topic/ task
Outbreak investigations
Conferences
FETP learning objectives
Maps to Core competency
152. Write a field investigation
(outbreak) report
30. Report and present results of an
investigation
153. Write a short article for an
epidemiological bulletin
33. Report and present results of a
study
154. Write and submit an abstract for
a national/ international
conference
53. Use software for writing, editing
and creating presentations
155. Prepare and present a poster
for a national/ international
conference
156. Prepare and present an oral
presentation for a national/
international conference or other
formal presentation
How met (eg)
Field work
Field work
54. Apply the basic principles of risk
communication, adjusting the
message when presenting
results of an investigation to
different audiences: media,
general public, professionals
and policy makers
57. Write an abstract
61. Analyse and synthesise main
points in a speech
157. Review manuscript (peer
review)
158. Present at journal club
Appraise publication
60. Incorporate interpersonal skills
in communication with
colleagues and with the other
audiences
Field work :

Journal club

Appraise colleagues publications
61. Analyse and synthesise main
points in a speech
62. Provide objective feedback
(descriptive, rather than
judgmental)
74. Assist others to clarify thinking,
create consensus, and develop
July 2012_v9
34
ideas into actionable plans
159. Identify the audience, and select
an appropriate journal for
potential publication
160. Develop a paper according to
the publication guidelines of the
journal
161. Produce a high-level outline of
the manuscript
Publish in peer-reviewed journals
54. Apply the basic principles of risk
communication, adjusting the
message when presenting
results of an investigation to
different audiences: media,
general public, professionals
and policy makers
Field work
56. Write an article for a scientific
journal
162. Produce a matrix with main
results, conclusions and
recommendations
163. Obtain review and approval of
draft paper
164. Edit a manuscript after internal
review
165. Obtain approval to submit for
publication
166. Submit to peer reviewed journal
167. Undergo editorial process
168. Demonstrate understanding the
communications process within
the host organisation
Communicate with public and media
169. Draft a letter or Frequently
Asked Questions (FAQ) for the
public
170. Demonstrate understanding
expectations of media towards
public health professionals
July 2012_v9
54. Apply the basic principles of risk
communication, adjusting the
message when presenting
results of an investigation to
different audiences: media,
general public, professionals
and policy makers
Field work
58. Write a press release
59. Produce documents, reports,
35
171. Demonstrate understanding of
how to communicate the
principles of public health risk
letters, meeting minutes, etc
172. Synthesise information and
select the content of the public
health message
173. Write a press statement
174. Undertake a radio or TV
interview (may be simulated)
Formal public health briefings (within
and external to the organisation)
175. Demonstrate understanding the
purpose of briefings and the
target audience
34. Recommend evidence-based
interventions in response to
epidemiological findings
176. Demonstrate understanding
how briefings are cascaded
within the host organisation
55. Write a report of an
epidemiological investigation for
decision makers
Field work
177. Prepare a briefing note (or
SITREP)
178. Provide constructive feedback
179. Demonstrate effective team
membership
180. Chair meetings effectively
Communication with colleagues
60. Incorporate interpersonal skills
in communication with
colleagues and with the other
audiences
Field work
Project review module
62. Provide objective feedback
(descriptive, rather than
judgmental)
69. Be an effective team member,
adopting the role needed to
contribute constructively to the
accomplishment of Topic/ task
by the group (including
leadership)
July 2012_v9
36
70. Promote collaborations,
partnerships and team building
to accomplish epidemiology
programme objectives
71. Develop community
partnerships to support
epidemiological investigations
72. Mutually identify those interests
that are shared, opposed or
different with the other party to
achieve good collaborations and
conflict management
July 2012_v9
37
7. Laboratory issues (mandatory)
The objective of these activities is to acquire the skills necessary to plan, conduct, analyse and interpret the results of laboratory investigations
and communicate their results.
Use laboratory investigations and resources to support field epidemiology activities
Topic/ task
Understand the general aspects of
health protection interaction with
laboratories
FETP learning objectives
Maps to ECDC competency
Demonstrate knowledge and
understanding of the importance and
limitations of laboratory investigations
in:
38. Communicate effectively with the
laboratory team
How met (e.g.)
Laboratory module
Field work:

Surveillance
181. Surveillance

Outbreak
182. Outbreak / incident investigation

Research
183. Applied research
184. Interact between clinical,
laboratory and health protection
services
185. Identify the key contact
personnel for laboratory
investigations
Coordinate laboratory and
epidemiological investigations
including test selection and sampling
July 2012_v9
186. Consult with laboratory based
professionals to determine
investigations needed.
37. Be familiar with different
methods for diagnosis and
typing, including molecular tests
187. Consult with laboratory based
professionals to determine the
sampling strategy and number
of samples required.
38. Communicate effectively with the
laboratory team
Laboratory module
Field work:

Surveillance

Outbreak

Research
38
188. Describe key laboratory
investigations relevant to
selected syndromes and / or
suspected pathogens / agents
189. Identify situations where
molecular, or other, typing
methods should be used
Define a sampling strategy related to
affected organ/ physiopathology,
pathogen or agent under
investigation including:
190. sampling method
191. number of samples needed
192. equipment and transport
required
193. consideration of the appropriate
use of resources.
194. Demonstrate awareness of the
risk categories of diagnostic
samples and the appropriate
use of PPE and safe specimen
collection, labelling and
transport, including identification
of outbreak specimens
Analysis and interpretation of
laboratory data
July 2012_v9
195. Analyse and interpret laboratory
data and to identify issues of
public health importance.
36. Interpret the diagnostic and
epidemiological significance of
reports from laboratory tests
This ability will include consideration
of:
37. Be familiar with different
methods for diagnosis and
Laboratory module
Field work:

Surveillance

Outbreak
39
196. sensitivity, specificity, positive
predictive value (PPV) and
negative predictive value (NPV)
typing, including molecular tests

Research
38. Communicate effectively with
the laboratory team
197. context
198. frequency and prevalence of
disease
199. host issues
200. Consult with laboratory based
professionals (including
veterinary, environmental,
human biological) on the
analysis and interpretation of
data
July 2012_v9
40
8. Vaccination epidemiology (mandatory)
The purpose of these learning activities is to be introduced to the epidemiological methods for the evaluation of vaccines and vaccination
programmes.

Know clinical and epidemiological characteristics of main vaccine preventable diseases and their current level of control in Europe;

List possible aims, methods of delivery and effects of vaccination programmes;

Use epidemiological and public health principles for the design of vaccination programmes incl. introduction of new vaccines;

Evaluate vaccination programmes, using data on surveillance, vaccine uptake, vaccine safety, immune status and seroepidemiology,
vaccine effectiveness, outbreak investigation;

Understand the role of risk perception and communication in relation to vaccination programmes;

Know key aspects of vaccine related immunology• Describe key aspects of vaccine development, production, licensure, supply and
delivery;

Understand epidemiological concepts of clinical vaccine trial design including vaccine efficacy;

Become familiar with modelling and economic evaluation of vaccination programmes;

Know European and global VPD networks and disease control targets
Topic/ task
FETP learning objectives
General
201. Understand main aspects of
vaccine related biology and
immunology, vaccine development,
vaccine production, supply and
delivery
Vaccine trials
202. Identify key elements in vaccine trial
design including vaccine efficacy
July 2012_v9
Maps to ECDC competencies
35. Be familiar with transmission
dynamics of infectious diseases
How met (e.g.)
Vaccine preventable diseases module
Vaccine preventable diseases module
Field work (where appropriate)
41
203. Know key characteristics of vaccine
preventable diseases and their
current level of control in Europe
204. Apply outbreak investigation
methods for vaccine preventable
diseases
1. Use current knowledge of
epidemiology of diseases to guide
public health or epidemiological
practice
35. Be familiar with transmission
dynamics of infectious diseases
25. Create a case definition and adjust it
as necessary during the investigation
26. Describe the outbreak in terms of
person, place and time
Epidemiology of
vaccine-preventable
diseases in Europe
27. Generate hypothesis about the cause
and/or risk factors of the outbreak
28. Conduct analytical epidemiological
investigation to identify the source
29. Recommend appropriate evidence
based measures to control the
outbreak
30. Report and present results of an
investigation
205. Describe possible aims, methods
of delivery and effects of
vaccination programmes
Vaccination
programmes
206. Describe public health principles
for the design of vaccination
programmes including introduction
of new vaccines;
207. Evaluate a vaccination programme
using:

July 2012_v9
Disease surveillance
5. Use epidemiological findings to plan
public health programmes
Vaccine preventable diseases module
Field work (where appropriate)
6. Implement public health programmes:
translate policy into public health
practice
7. Identify effective health promotion
measures for specific problems
8. Identify appropriate health prevention
measures for specific problems
9. Evaluate the impact of an intervention
42

Vaccine uptake

Vaccine safety
208. Estimate vaccine effectiveness
209. Appraise different immunisation
strategies
210. Appraise principles of risk
perception and communication
regarding vaccination programmes
211. Describe and apply the principle of
modelling techniques in designing
intervention programmes
July 2012_v9
on population health
10. Measure health outcomes to guide
decision making in prevention
strategy
11. Use evaluation results of programme
progress towards objectives and
outcomes in further programme
planning and modification
54. Apply the basic principles of risk
communication, adjusting the
message whenpresenting results of
an investigation to different
audiences: media, general
public,professionals and policy
makers
43
9. Environmental epidemiology (mandatory)
The purpose of these learning activities is to be introduced to environmental epidemiology study methods and application.

Gain an understanding of environmental exposure assessment

Gain an understanding of special study designs in environmental epidemiology and application to environmental investigation

Be able to undertake a health risk assessment, and translate epidemiological measures into information relevant to public health policy
makers and the public

Be able to investigate disease clusters

Gain an understanding of routine environmental surveillance data and its uses

Gain an understanding of the utility of geographical information systems as a tool used in environmental epidemiology
Topic/ task
FETP learning objectives
212. Compare the study designs used in
environmental epidemiology
213. Examine how to conduct and interpret
and ecological study
Investigating
environmental hazards
214. Examine how to conduct and interpret
a cross sectional study
215. Examine how to conduct and interpret
a prospective cohort study (links to
multivariable analysis module)
216. Assess the application of time-series
analysis in environmental
epidemiology (links to time series
July 2012_v9
Maps to ECDC competencies
How met (e.g.)
31. Write a study protocol using
investigation techniques
consistent with the public health
problem
Module

Incident investigation
32. Conduct epidemiological studies

Journal club
Field work:
33. Report and present results of a
study
34. Recommend evidence-based
interventions in response to
epidemiological findings
19. Interpret disease and public
health events trends from time
44
analysis module)
217. Discuss the importance of exposure
assessment
218. Illustrate the methods used to
estimate exposure
Estimation of exposure
and problems of
measurement
219. Discuss the strengths and limitations
of different exposure assessment
strategies
220. Compare source receptor pathways
and exposure routes
221. Describe where to find data on
environmental exposures
series analysis
13. Identify sources of information
about potential public health
threats
14. Conduct risk assessments: verify,
using critical thinking, if a public
health problem
exists and describe its magnitude
15. Identify surveillance data needs
for risk assessments of public
health threats
222. Discuss the role of toxicology in the
estimation of exposure: when it is
useful, sampling strategy, and
communication of results
Analysis of health and
exposure data using
GIS
223. Discuss the uses of GIS in
environmental epidemiology studies
18. Perform descriptive analysis of
surveillance data
224. Undertake descriptive analysis using
GIS software (mapping cases, rates
of illness, exposure data)
26. Describe the outbreak in terms of
person, place and time
225. Choose where to seek expert advice
on the applications of GIS in
environmental studies
Disease cluster
investigation, analysis
and management
226. Conduct a disease cluster
investigation
27. Generate hypothesis about the
cause and/or risk factors of the
outbreak
13. Identify sources of information
about potential public health
threats
Module (case study)
14. Conduct risk assessments: verify,
July 2012_v9
45
using critical thinking, if a public
health problem
exists and describe its magnitude
15. Identify surveillance data needs
for risk assessments of public
health threats
20. Identify key findings from
surveillance data analysis and
draw conclusions
25. Create a case definition and
adjust it as necessary during the
investigation
26. Describe the outbreak in terms of
person, place and time
27. Generate hypothesis about the
cause and/or risk factors of the
outbreak
28. Conduct analytical epidemiological
investigation to identify the source
29. Recommend appropriate
evidence based measures to
control the outbreak
30. Report and present results of an
investigation
32. Conduct epidemiological studies
33. Report and present results of a
study
34. Recommend evidence-based
interventions in response to
July 2012_v9
46
epidemiological findings
227. Describe the fundamentals of
environmental health surveillance
(environmental public health tracking)
228. Describe the purpose of time series
analysis and related methods in public
health surveillance
Fundamentals of
surveillance for
environmental health
229. Define fundamental terms and
concepts relevant to time series
analysis, including trend, seasonality,
serial dependence, stationarity (not
mandatory)
230. Aggregate data for time series
analysis (not mandatory)
231. Describe and summarise time series
data, including the use of smoothing
techniques such as moving averages
(not mandatory)
16. Run a surveillance system
Module
17. Conduct surveillance data
management
18. Perform descriptive analysis of
surveillance data
19. Interpret disease and public
health events trends from time
series analysis
20. Identify key findings from
surveillance data analysis and
draw conclusions
21. Evaluate surveillance systems
22. Recognise the need for and set
up a new surveillance system
23. Use event-based surveillance,
also called epidemic intelligence,
to detect health threats
52. Draw conclusions from the results
of analysis
Risk assessment and
management
July 2012_v9
232. Undertake a health risk assessment
(including hazards identification, risk
characterisation, risk management)
13. Identify sources of information
about potential public health
threats
233. Risk communication: translate
epidemiological measures into
information relevant to public health
14. Conduct risk assessments: verify,
using critical thinking, if a public
health problem exists and
describe its magnitude
Module (case study)
47
policy makers and to the public
15. Identify surveillance data needs
for risk assessments of public
health threats
234. Describe the methods used to control
exposure to environmental hazards
Prevention and control
of exposures to
environmental hazards
Legislation and
regulation
235. Discuss legislation and regulation for
air pollution and land contamination,
and planning
7.
Identify effective health promotion
measures for specific problems
8.
Identify appropriate health
prevention measures for specific
problems
Module
Module
236. Discuss regulations covering public
and occupational ionising exposure
237. Describe major incident command and
control structures
Environmental public
health emergencies
54. Apply the basic principles of risk
communication, adjusting the
message when presenting results
of an investigation to different
audiences: media, general
public,professionals and policy
makers
5. Use epidemiological findings to
plan public health programmes
Module
Field training (where possible)
238. Describe national radiation
emergency response arrangements
239. Identify key partner agencies and
organisations in environmental
emergencies
July 2012_v9
48
10. Epidemiology in healthcare settings (mandatory)
The purpose of these learning activities is to be introduced to the concepts of control of infection and the epidemiological methods used in
healthcare settings.

Understand the roles and responsibilities of the microbiologist, the Infection Control Team (infection control doctor, infection control
nurse) and Director of Infection Prevention and Control (DIPC)

Gain an understanding of surveillance systems used in healthcare settings

Understand the principles of infection control

Gain an understanding of the epidemiology of pathogens commonly found in healthcare settings

Apply epidemiological methods to outbreak investigation in healthcare settings
Fellows will be expected to spend time attached to a healthcare facility to gain practical experience of the learning activities above, in
addition to attending the taught module.
Topic/ task
FETP learning objectives
240. Be aware of hospital hygiene
systems(e.g. waste, water,
aerobiology, disinfection and
sterilisation)
Infection prevention and
control
July 2012_v9
Maps to ECDC competencies
4. Understand and analyse legal public
health policy documents at local,
national and European level
241. Describe appropriate application
and management of isolation
measures
11. Use evaluation results of programme
progress towards objectives and
outcomes in further programme
planning and modification
242. Review infection prevention and
control policies
39. Identify, review and assess relevant
literature and other evidence
How met (e.g.)
Field work (hospital site visit practical)
49
243. Present your review of infection
prevention and control policies
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
61. Analyse and synthesise main points
in a speech
71. Develop community partnerships to
support epidemiological
investigations
244. Demonstrate an understanding of
hospital structure, function and
governance
245. Demonstrate an understanding of
the roles, responsibilities, structure
and function of the Infection
Prevention and Control Team
(IPCT) [including interactions
between nursing, medical,
laboratory, and pharmacy staff]
Hospital structure &
function
246. Demonstrate an understanding of
the roles, responsibilities, structure
and functions of IPCT and hospital
epidemiology in terms of: isolation
and diagnosis of multi drug
resistant (MDR) organisms, control
of infection, antimicrobial
stewardship, data preparation and
use
40. Develop evidence based guidelines/
recommendations for surveillance,
prevention and control of
communicable diseases and other
acute public health events
Field work (hospital site visit practical)
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
61. Analyse and synthesise main points
in a speech
71. Develop community partnerships to
support epidemiological
investigations
247. Demonstrate an understanding of
the advantages and disadvantages
of ward types and hospital areas
(including: co-location of wards and
services, theatre sterile services
July 2012_v9
50
unit (TSSU), endoscopy, ICU, A&E,
radiology) and patient movement
248. Demonstrate an understanding of
buildings and technical controls for:
Legionella, food and water testing,
endoscopy disinfectors, positive
and negative ventilation, HEPA
filters, ultra-clean air, theatre and
specialist area commissioning,
theatre sterile supplies unit (TSSU)
249. List main organisms causing HCAI
Healthcare Associated
Infections (HCAI)
Antimicrobial resistance
(AMR)
250. Understand HCW and related
issues (i.e. needlestick
injuries/reporting, immunisation,
risk assessments, principles of
HACCP, regulations)
251. Demonstrate knowledge of
antimicrobial resistance, including:
old, new and emerging issues,
epidemiology of AMR in different
organisms, mechanisms and
genetics, challenges, solutions and
guidelines for prevention and
control
252. Understand how antimicrobial
resistance data is used to inform
prevention and control of HCAI and
antimicrobial stewardship relating
July 2012_v9
13. Identify sources of information about
potential public health threats
36. Interpret the diagnostic and
epidemiological significance of
reports from laboratory tests

249: Modules- HCAI. Lab4Epi

250: Field work (hospital site visit
practical)
37. Be familiar with different methods for
diagnosis and typing, including
molecular tests
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
251: Lab4Epi Module:
252: Field work (hospital site visit
practical)
61. Analyse and synthesise main points
in a speech
71. Develop community partnerships to
support epidemiological
investigations
253: HCAI module
51
to antimicrobial resistance
254: Field work (hospital site visit
practical)
253. Understand the use of
antimicrobial consumption datasets
and their use
254. Demonstrate an understanding of
methods for assessing compliance
with antimicrobial stewardship
arrangements
255. Understand surveillance,
organism/condition systems,
outbreak control systems,
statistical process control, ,
interactions with patient
administration systems
Hospital epidemiology
256. Understand the contribution of the
laboratory to infection control and
healthcare epidemiology (ICHE)
including: local and reference
laboratories, organism
identification, antibiotic testing,
media for isolation, disinfectant
testing and typing methods
257. Apply epidemiological methods in
outbreak investigations
21. Evaluate surveillance systems
22. Recognise the need for and set up a
new surveillance system
23. Use event-based surveillance, also
called epidemic intelligence, to detect
health threats
255: HCAI module
256: Lab4Epi module
257: HCAI module/ field outbreaks
29. Recommend appropriate evidence
based measures to control the
outbreak
36. Interpret the diagnostic and
epidemiological significance of
reports from laboratory tests
37. Be familiar with different methods for
diagnosis and typing, including
molecular tests
38. Communicate effectively with the
laboratory team
60. Incorporate interpersonal skills in
communication with colleagues and
with the other audiences
61. Analyse and synthesise main points
July 2012_v9
52
in a speech
July 2012_v9
53
11. Epidemiology in emergency situations (optional)
The purpose of these learning objectives is to understand the response to Complex Emergency Situation (CES), mass gathering and natural
disaster contexts.

Prepare for a CES international mission;

Identify priorities in CES;

Conduct a rapid health assessment;

Be familiar with sampling methods;

Use GPS for mapping, compass and appropriate methods for counting population;

Plan and conduct a mortality and nutritional surveys in CES;

Write, interpret and use situation reports in CES;

Establish a health information system;

Know and use relevant indicators to measure and monitor the health status of a population in CES;

Identify source of information and implement data collection to monitor intervention;

Understand the component of the response to severe epidemics (e.g. Haemorrhagic fevers);

Understand case finding, case management, contact tracing, social mobilisation, use of laboratory requirements and PPE

Adapt surveillance principles to a mass gathering context

Identify relevant indicators for mass gathering situations
July 2012_v9
54
Topic/ task
FETP learning objectives
258. Identify public health priorities in
CES
259. Implement a surveillance system
for CES
General
Maps to ECDC competencies
How met (e.g.)
1. Use current knowledge of
epidemiology of diseases to guide
public health or epidemiological
practice
Emergency Epidemiology module
3. Use knowledge of specific
sociological and cultural factors in the
population to conduct studies and
recommend public health actions
relevant for the affected community
Emergency Epidemiology module
Field work (where applicable)
260. Be familiar with security issues in
CES
261. Know the role of different agencies
in the coordination of CES
262. Prepare for a CES international
mission
263. Identify elements of stress
management
264. Identify key elements of social
mobilisation
265. Implement case finding and
management, contact tracing, and
use of PPE
Response to severe
epidemics
266. Identify basic laboratory
requirements in the field
Field work (where applicable)
25. Create a case definition and adjust it
as necessary during the investigation
26. Describe the outbreak in terms of
person, place and time
29. Recommend appropriate evidence
based measures to control the
outbreak
36. Interpret the diagnostic and
epidemiological significance of
July 2012_v9
55
reports from laboratory tests
37. Be familiar with different methods for
diagnosis and typing, including
molecular tests
38. Communicate effectively with the
laboratory team
267. Use rapid assessment in the early
phase
13. Identify sources of information about
potential public health threats
268. Use methods for estimating
population size
14. Conduct risk assessments: verify,
using critical thinking, if a public
health problem exists and describe its
magnitude
269. Define methods for estimating
health indicators
270. Design a health survey
271. Use relevant indicators to monitor
intervention
Rapid assessment
techniques
272. Write situation reports
Emergency Epidemiology module
Field work (where applicable)
15. Identify surveillance data needs for
risk assessments of public health
threats
22. Recognise the need for and set up a
new surveillance system
23. Use event-based surveillance, also
called epidemic intelligence, to detect
health threats
24. Be familiar with laws on surveillance
and reporting of communicable
diseases at national, EU level and
globally (International Health
Regulations)
47. Select an appropriate sampling
strategy
54. Apply the basic principles of risk
communication, adjusting the
July 2012_v9
56
message when presenting results of
an investigation to different
audiences: media, general public,
professionals and policy makers
55. Write a report of an epidemiological
investigation for decision makers
273. Adapt surveillance principles to a
mass gathering context
13. Identify sources of information about
potential public health threats
274. Identify relevant indicators for
mass gathering situations
14. Conduct risk assessments: verify,
using critical thinking, if a public
health problem exists and describe its
magnitude
275. Establish report and feedback
routes to stakeholders in mass
gathering situations
Emergency Epidemiology module
Field work (where applicable)
15. Identify surveillance data needs for
risk assessments of public health
threats
22. Recognise the need for and set up a
new surveillance system
Mass gathering
23. Use event-based surveillance, also
called epidemic intelligence, to detect
health threats
24. Be familiar with laws on surveillance
and reporting of communicable
diseases at national, EU level and
globally (International Health
Regulations)
47. Select an appropriate sampling
strategy
54. Apply the basic principles of risk
communication, adjusting the
July 2012_v9
57
message when presenting results of
an investigation to different
audiences: media, general public,
professionals and policy makers
55. Write a report of an epidemiological
investigation for decision makers
12. Advanced methods for use in field epidemiology
Multivariable analysis (mandatory)
The objective of this activity is to acquire the skills necessary to plan, conduct, and analyse data using more complex methods so that the effect
of a number of variables, and the interaction between them, can be interpreted.

Understand the principles of multivariable analysis and its role in field epidemiology

Distinguish different types of multivariable analysis (linear, logistic, Poisson...)

Understand in which analysis situations to use which multivariable analysis

Interpret correctly the results of the different regression models: the meaning of the parameters, and the corresponding inferences.

Deal with confounding and interactions in a logistic regression analysis, interpret correctly the coefficients of each term.

Build an optimal regression model

Use conditional logistic regression

Use Poisson Regression

Get familiar with the concepts of survival analysis
July 2012_v9
58
Topic/ task
FETP learning objectives
276. Demonstrate understanding of the
purpose of multivariable analysis in field
epidemiology
28. Conduct analytical
epidemiological investigation
to identify the source
277. Demonstrate understanding of
fundamental terms and concepts relevant
to multivariable analysis
50. Use database software
packages for entering and
managing data
278. Demonstrate the ability to prepare data
for multivariable analysis
51. Use software packages for
statistical analysis (measures
of association, testing, and
logistic regression)
279. Be able to select an appropriate
multivariable analytical method
appropriate for the nature of the outcome
variable
General
Maps to ECDC competencies
How met (e.g.)
Multivariable analysis module
Field work:

Outbreak

Research
Teaching
52. Draw conclusions from the
results of analysis
280. Demonstrate basic consideration of
issues of power and sample size relating
to multivariable analysis
Demonstrate the ability to identify and address
the following issues in multivariable analysis
281. Confounding
282. Interaction
283. Missing data
284. Outliers
285. Multicollinearity
286. Demonstrate understanding of the
principles of model selection
July 2012_v9
59
287. Demonstrate understanding of the
assumptions underlying linear models
288. Demonstrate the ability to construct an
appropriate linear regression model for a
data set using statistical software
Linear models for continuous
data
289. Demonstrate the ability to draw
appropriate inferences from a multiple
linear regression model (hypothesis
testing, confidence intervals)
290. Demonstrate ability to assess the
goodness of fit of a multiple linear
regression model and to check
underlying assumptions
Logistic regression for
dichotomous data
43. Calculate and interpret point
estimates and confidence
intervals of measures of
central tendency and
dispersion
Multivariable analysis module
Field work:

Research

Teaching
46. Calculate and interpret
significance tests
51. Use software packages for
statistical analysis (measures
of association, testing, and
logistic regression)
52. Draw conclusions from the
results of analysis
291. Demonstrate the ability to construct an
appropriate logistic or conditional logistic
regression model for a data set using
statistical software
45. Calculate and interpret point
estimates and confidence
intervals of measures of
association and impact
292. Demonstrate the ability to draw
appropriate inferences from a logistic or
conditional logistic regression model
(hypothesis testing, confidence intervals)
46. Calculate and interpret
significance tests
51. Use software packages for
statistical analysis (measures
of association, testing, and
logistic regression)
Multivariable analysis module
Field work:

Outbreak

Research

Teaching
52. Draw conclusions from the
results of analysis
Poisson regression for count
data
July 2012_v9
293. Demonstrate the ability to construct an
appropriate Poisson regression model for
a data set using statistical software
294. Demonstrate the ability to draw
appropriate inferences from a Poisson
regression model (hypothesis testing,
44. Calculate and interpret point
estimates and confidence
intervals of measures of
disease frequency
46. Calculate and interpret
Multivariable analysis module
Field work:

Outbreak

Research
60
confidence intervals)
significance tests
Teaching
51. Use software packages for
statistical analysis (measures
of association, testing, and
logistic regression)
52. Draw conclusions from the
results of analysis
295. Demonstrate understanding of the
fundamental terms and concepts of
survival analysis
Survival analysis (including Cox
regression)
296. Demonstrate the ability to summarise
time-to-event data by constructing a life
table and plotting Kaplan-Meier curves
using statistical software
297. Demonstrate the ability to construct an
appropriate Cox proportional hazards
model for a data set using statistical
software
46. Calculate and interpret
significance tests
51. Use software packages for
statistical analysis (measures
of association, testing, and
logistic regression)
Multivariable analysis module
Field work:

Research
Teaching
52. Draw conclusions from the
results of analysis
298. Demonstrate the ability to draw
appropriate inferences from a Cox
proportional hazards model (hypothesis
testing, confidence intervals)
Mathematical modelling of
transmission of infectious
diseases
Communication
July 2012_v9
299. Understand the applications of
mathematical modelling
300. Understand the principles of model
building
301. Report methods, results, findings,
caveats and conclusions and in
appropriate language for an outbreak
report or journal article
35. Be familiar with transmission
dynamics of infectious
diseases
Multivariable analysis module
30. Report and present results of
an investigation
Field work:
33. Report and present results of
a study

Outbreak
Communication
61
52. Draw conclusions from the
results of analysis
55. Write a report of an
epidemiological investigation
for decision makers
56. Write an article for a scientific
journal
57. Write an abstract
July 2012_v9
62
Time series analysis and related methods (optional)
The objective of this activity is to acquire the skills necessary to plan and analyse data to identify trend patterns, generate models that can be
used to represent time series data and generate predictions, and use modeling and forecasting techniques based on linear regression.

List the basic epidemiological applications of a time series (TS) and how time series analysis can be used to interpret disease
dynamics;

Understand the theoretical principles that govern a time series;

Learn how to prepare data for time series analysis, convert date formats, plot data, simple descriptive techniques, detect and analyse
outliers, deal with missing values, perform stratified analysis, moving average and other smoothing techniques, regression models;

Use appropriate commands in STATA to decompose the time series into its different components;

Understand the concept of stationarity and application of transformations, the use of filters;

Create and analyse periodograms and correlograms;

Use autocorrelation and spectral analysis;

Use one time series to analyse another;

Forecast, predict, and set thresholds for outbreak detection.
Topic/ task
Descriptive analysis
(mandatory: covered in
other sections)
FETP learning objectives
302. Demonstrate understanding of the
purpose of time series analysis and
related methods in public health
surveillance
303. Demonstrate understanding of
fundamental terms and concepts
relevant to time series analysis,
including trend, seasonality, serial
July 2012_v9
Maps to ECDC competencies
17. Conduct surveillance data
management
18. Perform descriptive analysis of
surveillance data
19. Interpret disease and public health
events trends from time series
analysis
How met (e.g.)
TSA Module
Field work:

Surveillance

Research
63
dependence, stationarity
304. Aggregate data for time series
analysis
305. Describe and summarise time
series data, including the use of
smoothing techniques such as
moving averages
Analysis of TS
306. Perform seasonal decomposition
of a time series
307. Produce and interpret
periodograms
308. Use spectral analysis
309. Assess cross-correlation between
two time series
310. Use exceedance detection
algorithms
20. Identify key findings from surveillance
data analysis and draw conclusions
52. Draw conclusions from the results of
analysis
19. Interpret disease and public health
events trends from time series
analysis
20. Identify key findings from surveillance
data analysis and draw conclusions
TSA Module
Field work:

Surveillance

Research
23. Use event-based surveillance, also
called epidemic intelligence, to detect
health threats
52. Draw conclusions from the results of
analysis
311. Use statistical process control
methods
ARIMA modelling (Box
& Jenkins)
312. Demonstrate the ability to produce
and interpret plots of
autocorrelation and partial
autocorrelation functions
313. Demonstrate the ability to
construct an appropriate time
series model for a data set using
statistical software
19. Interpret disease and public health
events trends from time series
analysis
20. Identify key findings from surveillance
data analysis and draw conclusions
TSA Module
Field work:

Surveillance

Research
52. Draw conclusions from the results of
analysis
314. Demonstrate the ability to draw
appropriate inferences from a time
series model (hypothesis testing,
July 2012_v9
64
confidence intervals, forecasting)
Communication
315. Report methods, results,
conclusions and caveats in
appropriate language for a report
or journal article
33. Report and present results of a study
52. Draw conclusions from the results of
analysis
55. Write a report of an epidemiological
investigation for decision makers
Field work:

Surveillance

Research

Communication
56. Write an article for a scientific journal
57. Write an abstract
July 2012_v9
65
Sampling methods (mandatory)
The objective of this activity is to acquire the skills necessary to sample populations

Understand the concepts of population, sample, parameters, estimates;

Describe the methodologies used for selecting a random sample from the population;

Specify algorithms and formulas used for obtaining estimates of the population parameters from the sample data and for
estimating the reliability of these population estimates.

Choose the most appropriate sampling design according to the study question and the available information;

Determine the sample size needed for reliable estimates, according to the sampling design;

Use appropriate methods and/or software to take random samples according to the sampling design;

Compute estimated population parameters and their variance according to the sampling design;
Topic/ task
Establish sampling plan
Implement survey taking
sampling strategy into
account
FETP learning objectives
How met (e.g.)
316. Appraise different sampling
strategies (strengths and
limitations)
31. Write a study protocol using
investigation techniques consistent
with the public health problem
317. Plan calculation of point estimates
and confidence intervals according
to sampling plan
39. Identify, review and assess relevant
literature and other evidence
318. Choose appropriate sampling
strategy depending on study
question and circumstances
43. Calculate and interpret point
Sampling methods module
44. Calculate and interpret point
estimates and confidence intervals of
measures of disease frequency
Field work:
319. Calculate sample size for different
sampling methods
320. Use appropriate computer tools for
July 2012_v9
Maps to ECDC competencies
45. Calculate and interpret point
estimates and confidence intervals of
Sampling methods module
Field work:

Research

Incident investigation

Emergency situations

Research

Incident investigation
66
sampling and data analysis
measures of association and impact
321. Calculate point estimates and
confidence intervals
46. Calculate and interpret significance
tests
322. Use complex sampling calculations
47. Select an appropriate sampling
strategy

Emergency situations
51. Use software packages for statistical
analysis (measures of association,
testing, and logistic regression)
323. Report sampling scheme in simple
terms (report, manuscript)
Report methods
55. Write a report of an epidemiological
investigation for decision makers
Field work:
56. Write an article for a scientific journal

Research
57. Write an abstract

Incident investigation

Emergency situations
58. Write a press release
July 2012_v9
Sampling methods module
67