Competencies for Applied Epidemiologists in Governmental Public Health Agencies
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Transcript of Competencies for Applied Epidemiologists in Governmental Public Health Agencies
Competencies Competencies for Applied Epidemiologists for Applied Epidemiologists
in Governmental Public in Governmental Public Health AgenciesHealth Agencies
Centers for Disease Control and Prevention
Council of State and Territorial Epidemiologists
OrOrApplied Epidemiology Competencies Applied Epidemiology Competencies
(AECs)(AECs) for short! for short!
Overview
Background Goals and Rationale Methods Organization of the Competencies Validation of the Competencies Applied Epidemiology Competencies Uses and Dissemination
Background
Definition of Epidemiology
Epidemiology is “the study of the distribution and determinants of health-related states and events in specific populations, and the application of this study to control of health problems.”*
Epidemiology is one of the core sciences of public health
*Last JM. A Dictionary of Epidemiology. 4th edition. New York: Oxford University Press, 2001:62.
Definition of Epidemiologist
A person who investigates the occurrence of disease, injury or other health-related conditions or events in populations to describe the distribution of disease or risk factors for disease occurrence for the purpose of population-based prevention and control. — CSTE Workforce Summit, January 2004
Definition of Competency
A competency is an action-oriented statement that delineates essential knowledge, skills, and abilities in the performance of work responsibilities.
A competencies is describable and observable.
— Center for Public Health Practice, Rollins School of Public Health, 2002
Problem
Insufficient number of public health epidemiologists
“Epidemiologists” without adequate training
Lack of clear career ladders for epidemiologists
Independent, uncoordinated efforts to define the field
National efforts focused only on academic epidemiology
Goals and Rationale
Goals and Objectives of the AECs Goal to improve the practice of epidemiology in public
health agencies.
Objectives to create a comprehensive list of competencies that: Define the discipline of applied epidemiology; and Describe what knowledge, skills, and abilities four
levels of practicing epidemiologists working in government public health agencies should have to accomplish required tasks.
Rationale for Competency Development
Standardization of skill levels for hiring
Method to evaluate, reward, and promote workers
Road map for training existing workforce
Guidelines for academia
Improved ability to define the field
Utility for future certification processes
Methods
Competency Development Method Reviewed existing competencies/framework
Expert Panel—cross-cutting representation Subgroups:
Leadership group
Review panel
Consultant/editor
Assessment and validation Summer 2005—Tier 2 Competencies
Early 2006—Tier 1, 2, 3a and 3b Competencies
Quantitative and qualitative comments
Four Tiers of Practice
Tier 1—entry level or basicTier 2—mid-levelTier 3a—supervisoryTier 3b—senior scientist
Differentiating Between Tiers Example: Surveillance Evaluation Tier 1 (entry-level or basic epidemiologist):
Support evaluation of surveillance systems
Tier 2 (mid-level epidemiologist/team leader):
Conduct evaluation of surveillance systems
Tier 3 (senior-level epidemiologist):
a. Supervisor/Manager—Ensure evaluation
of surveillance systems b. Senior Scientist (PhD)—Design and conduct
evaluation of surveillance systems
Organization of the Competencies
Competency Framework for Public Health Professionals
1. Assessment and Analysis
2. Basic Public Health Sciences
3. Communication
4. Community Dimensions of Practice
5. Cultural Competency
6. Financial and Operational Planning and Management
7. Leadership and Systems Thinking
8. Policy Development/Program Planning
Source: Council on Linkages between Academia and Public Health Practice
Competency Construct
I. Skill Domain Area 1. Competency A
Subcompetency Sub-subcompetency/learning objective Sub-subcompetency/learning objective
Subcompetency Subcompetency
2. Competency B Subcompetency Subcompetency
Skill Domain 1: Assessment and AnalysisTier 2 Competencies Identify public health problems Conduct surveillance Investigate acute and chronic conditions Apply good ethical/legal principles to study design and data
collection, dissemination, and use Manage data Analyze data Summarize results, and draw conclusions Recommend evidence-based interventions and control measures Evaluate programs
Skill Domain1:Assessment and AnalysisTier 2 Competencies Identify public health problems Conduct surveillance Investigate acute and chronic conditions Apply good ethical/legal principles to study design and data
collection, dissemination, and use Manage data Analyze data Summarize results and draw conclusions Recommend evidence-based interventions and control measures Evaluate programs
Example: Assessment and Analysis
Tier 2 Subcompetencies Conduct surveillance
Design surveillance for particular public health problem
Identify surveillance data needs Implement new or revise existing surveillance
system Identify key findingsConduct evaluation of surveillance systems
Example: Assessment and AnalysisTier 2 Subcompetencies
Conduct surveillanceDesign surveillance for particular public health
problem Identify surveillance data needs Implement new or revise existing surveillance
system Identify key findingsConduct evaluation of surveillance systems
Example: Assessment and Analysis Tier 2 Sub-subcompetencies
Identify surveillance data needs Create case definition Describe sources, quality and limitations of surveillance data Define data elements to be collected or reported Identify mechanisms to transfer data from source to public
health agency Define timeliness required for data collection Determine frequency of reporting Describe potential uses of data to inform surveillance system
design Define functional requirements of supporting information
system
Validation of the Competencies
Validation Process 2005: Web survey for Tier 2 only
76%–98% of respondents supported competencies 2006: Web survey of complete competency set, Tiers 1–3
Three states targeted for >75% participation 80% of respondents self-identified as Tier 1 and 2 75% worked in state or local agencies
Review panel reviewed comments and recommended appropriate changes
Limitations to Validation Process Surveys not systematic Respondents self-reported tier level and other
identifying data, thus room for bias Questions asked about only the major
competencies in each skill domain No subcompetency or sub-subcompetencies
evaluated in survey
Does Everyone Have to Be Competent in ALL Competencies?
Yes and No
(it depends)
an epidemiologist’s favorite answer!
Does Everyone Have to Be Competent in ALL Competencies?
Mastery of the competencies develops over a continuum of applied epidemiology practice, not a single point in an individual’s career
Infectious disease, chronic disease, maternal and child health, and environmental epidemiology may emphasize different competency areas
Applied Epidemiology Competencies
…It’s about time!
Competency Skill Domains
1. Assessment and Analysis
2. Basic Public Health Sciences
3. Communication
4. Community Dimensions of Practice
5. Cultural Competency
6. Financial and Operational Planning and Management
7. Leadership and Systems Thinking
8. Policy Development
1: Assessment and AnalysisTier 2 Competencies
Identify public health problems Conduct surveillance Investigate acute and chronic conditions Apply good ethical/legal principles to study design and data
collection, dissemination, and use Manage data Analyze data Summarize results, and draw conclusions Recommend evidence-based interventions and control measures Evaluate programs
2: Basic Public Health SciencesTier 2 Competencies
Use knowledge of causes of disease to guide epidemiologic practice
Use laboratory resources to support epidemiologic activities
Apply principles of informatics, including data collection, processing, and analysis, in support of epidemiologic investigations
3: CommunicationTier 2 Competencies
Prepare written and oral reports and presentations that communicate necessary information to professional audiences, policy makers, and the general public
Demonstrate the basic principles of risk communication Incorporate interpersonal skills in communication with
agency personnel, colleagues, and the public Use effective communication technologies
4: Community Dimensions of PracticeTier 2 Competencies
Provide epidemiologic input into epidemiologic studies, public health programs, and community public health planning processes at the state, local, or tribal level
Participate in development of community partnerships to support epidemiologic investigations
5: Cultural CompetencyTier 2 Competencies
Describe population by various parameters Establish relationships with groups of special concern Design surveillance systems to include underrepresented groups Conduct investigations using languages and approaches tailored to
population Use standard population categories or subcategories when
performing data analysis Use knowledge of specific sociocultural factors in the population to
interpret findings Recommend public health actions that would be relevant to the
affected community
6: Financial and Operational Planning and Management Tier 2 Competencies Conduct epidemiologic activities within the financial and
operational plan of the agency Assist in developing fiscally sound budget Implement operational and financial plans Assist in preparing proposals for extramural funding Use management skills Use skills that foster collaborations, strong partnerships, and team
building to accomplish epidemiology program objectives
7: Leadership and Systems ThinkingTier 2 Competencies Support epidemiologic perspective in agency strategic planning
process
Promote organization’s vision
Use performance measures to evaluate and improve program
Promote ethical conduct
Promote workforce development
Prepare for emergency response
8: Policy Development Tier 2 Competencies
Bring epidemiologic perspective in development and analysis of public health policies
Uses and Dissemination
Intended Uses of the Competencies Practitioners
Assess current skills Create career development plans Plan specific training and educational
activities
Intended Uses of the Competencies Employers
Create career ladders for employees Develop position descriptions and job qualifications Develop training plans for employees Assess epidemiologic capacity of an organization
Educators Design education programs that meet needs of
public health agencies Incorporate critical elements of epidemiologic
practice into existing coursework
Dissemination Oral presentations at meetings
Downloadable documents: CSTE website: www.cste.org/competencies.asp
CDC website: www.cdc.gov/od/owcd/cdd/aec/
Quick reference fact sheets One-page executive summary and complete preface document
Fact sheets for each tier
Dissemination Online competency toolkit for users
PowerPoint presentations
Interactive quiz
Engage users in the field of epidemiology
Introduce users to the AECs
Epidemiology position descriptions
Training resource guide
AEC brochure
Evaluation checklists
Dissemination
Special Issue of Public Health Reports: Competency-Based Epidemiologic Training in Public Health Practice March/April 2008
Commentaries on the need for competencies and their uses
Development of the AECs
Competency-based applied epidemiology training
Innovative partnerships between academia and practice
Evaluation of epidemiology training programs
Dissemination
Public Health Literature
Editorial: Professional Competencies for Applied Epidemiologists: A Roadmap to a More Effective Epidemiologic Workforce
by Guthrie S. Birkhead, MD and Denise Koo, MD, MPH
Journal of Public Health Management & PracticeNovember/December 2006 Volume 12 Number 6 Pages 501 - 504
Online Resources:
www.cdc.gov/od/owcd/cdd/aec/ www.cste.org/competencies.asp
Complete competency documents One page competency summaries by tier Competency toolkit
Competency self-assessment Summary of training resources Competency PowerPoint slide sets Sample position descriptions Publications related to competencies
Contents of the toolkit also available from CSTE:770-458-3811
The Driving Force of the AECs:Leadership Group
Conveners:Denise Koo, MD, MPH—Centers for Disease Control and PreventionMatt Boulton, MD, MPH—University of Michigan School of Public Health
and CSTE
Co-Chairs:Gus Birkhead, MD, MPH—New York State Department of Health and CSTEKathy Miner, PhD, MPH, CHES—Rollins School of Public Health, Emory
University
Consultant and Editor:Jac Davies, MPH—CSTE Consultant and Editor, formerly with Washington
State Department of Health
The Driving Force of the AECs:Expert Panelists Kaye Bender, RN, PhD, FAAN—University of Mississippi Medical Center School of Nursing Roger H. Bernier, PhD, MPH—Centers for Disease Control and Prevention Mike Crutcher, MD, MPH—Oklahoma State Dept Health Richard Dicker, MD, MSc—Centers for Disease Control and Prevention Gail Hansen, DVM, MPH—Kansas Department of Health and Environment Richard Hopkins, MD, MSPH—Centers for Disease Control and Prevention Sara Huston, PhD—North Carolina Division of Public Health Miriam Link-Mullison, MS, RD—Jackson County Health Department Hal Morgenstern, PhD—University of Michigan School of Public Health Lloyd Novick, MD, MPH—Onondaga County (New York) Department of Health Len Paulozzi, MD, MPH—Centers for Disease Control and Prevention William M. Sappenfield, MD, MPH—Centers for Disease Control and Prevention Greg Steele, DrPH, MPH—Indiana University School of Medicine Lou Turner, DrPH, MPH—North Carolina State Laboratory of Public Health Mark E. White, MD—Centers for Disease Control and Prevention
The Driving Force of the AECs:Review and Other Panelists
Review Panelists: James Gale, MD, MS—University of Washington Kristine Gebbie, DrPH, RN,—Columbia School of Nursing Maureen Lichtveld, MD, MPH—Centers for Disease Control
and Prevention Kristine Moore, MD, MPH—University of Minnesota Art Reingold, MD—University of California at Berkeley
CSTE National Office Staff: Pat McConnon, MPH, Executive Director LaKesha Robinson, MPH Jennifer Lemmings, MPH
Partner Organizations
American Public Health Association (APHA) Association of Schools of Public Health (ASPH) Association of State and Territorial Health Officials
(ASTHO) National Association of County and City Health Officials
(NACCHO)
For more information
Contact CSTE: 770-458-3811 Visit the following websites:
www.cste.org www.cdc.gov/od/owcd/cdd/aec/