Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
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