School of Public Health and Community Medicine

1. School of Public Health and Community Medicine Ensuring competency attainment in Epidemiology and Biostatistics among MPH students Glenda Lawrence – UNSW Priscilla Robinson – La Trobe Matthew Knuiman – UWA

2. Overview • Introduction – GL • Overview of current PH competencies design – PR • Examples of teaching approaches • Biostatistics – MK • Epidemiology combined with biostatistics – GL • Overview of epi/biostats core content and assessments in MPH programs in Australia - GL • Discussion

3. Competency in Epi and Bio As PH educators, how do we ensure competency attainment in epidemiology and biostatistics by MPH graduates? What are the common teaching and learning approaches, challenges, and needs? • minimal versus ideal levels of knowledge and skill in epidemiology and biostatistics among graduates of generalist public health degrees plus UG vs PG vs HDR • optimal methods of assessment • innovative strategies in learning and teaching

6. Opportunity to consider • New Australian PH competency framework currently being developed – 21st century workforce • International frameworks • Is guidance needed in ‘translating’ competency frameworks to course curriculum? • Assessment of attainment • Exam vs more authentic practice based assessment? • Could there be a collaborative approach to ensuring competency attainment e.g. assessment item bank? • Benchmarking opportunities

7. Priscilla Robinson • Competency Frameworks • Matthew Knuiman • Core Biostatistics Unit - UWA

8. UNSW approach • Combined Epidemiology and Biostatistics core unit • Taught concurrently to internal students face-to-face and external students online • Pre-semester workshop – includes intro SPSS tutorial • Weekly 2 hour lecture – recorded on Echo360 • Weekly learning activities aligned to learning outcomes • SPSS ‘how to’ videos for each module’s learning activities • Weekly optional 3 hour ‘clinic’ - one-to-one help by tutors • Weekly face to face tutorials; online tutors for externals • ‘de-Greeked’ biostats

9. Students • 220 students in S1 2014 • 66% external (part-time) • External students time poor; often more experienced in epi and biostats than internal students • Many fearful initially, particularly of stats and SPSS • Often pleased with own development across the 12 weeks of the course

10. Course content Epi Biostats Measures of frequency Incidence, prevalence, age specific and standardisation Measures of Association RR, OR, AR, PAR etc Study designs Study validity Selection bias Measurement error Confounding & effect mod Critical appraisal of published papers – cohort, RCT, case-control Screening tests and programs Synthesis of evidence – systematic reviews and meta-analysis Presenting data Summary descriptive statistics and data variation Normal & other distributions Precision and confidence intervals Hypothesis testing and inferential statistics Means Proportions Independent/paired Non-normal data Correlation & regression Sample size estimation & testing

11. Other topics • Taught in Foundations in PH unit • Basic demography • Routinely collected data • Surveillance • Outbreak investigation

12. Why teach epi/biostats in one course? • Helps make the relationship between the two disciplines explicit for students (de-siloing) • Learning activities and assessment tasks used to integrate epi and stats knowledge and skills • Most students now embrace combined teaching (compared to 2008 when first run) • Some complain of workload, but fewer now (expect 10 hours per week – UNSW standard)

13. Evaluation • UNSW standard questionnaire + focus groups + webinar + solicited de-identified feedback • High overall student satisfaction • 98% satisfied – 49% in the strongly agree category • Feedback varies considerably for external vs internal students • different levels of proficiency – external students generally achieve higher marks • external students very time poor – selective in use of resources e.g. often don’t listen to lectures but read and complete LAs • Students like 2 assignments – HATE exam (but many achieve high marks) • Is an exam a realistic way of assessing competence / achievement? • Seen by staff to help address issue of plagiarism/collusion

14. Student quotes • “I generally really enjoyed the structure and content of the course and was surprised that I did so, as was fearful of the subject and so put it off until my second last course! I actually think it was a useful and practical course and have already found myself applying it to my work.” EXTERNAL STUDENT 2014 • “I thought the assignments were pretty consistent with the course content and weekly learning activities. Having more smaller assessments might make the course less stressful (40% exam is huge!).” EXTERNAL STUDENT 2014

15. The best part I enjoyed as an external student were the podcasts as these allowed contact with facilitators. Another area that I found important was the discussion groups because these also encouraged instant feedback from lecturers and students alike. • Course notes - brilliant! So well-ordered, succinct and yet thorough. To be honest I only read the lecture slides if I didn't understand the course notes and only listened to the lecture if I still didn't understand.SPSS videos a life saver -some things just can't be explained in writing.Discussion forums great when responses quick, which was most of the time.

16. Overview of Australian MPH courses • Scanned websites of 14 universities for available information on MPH epi and biostats units • All teach topics listed in competencies in intro courses • Vary in some topics such as demography, multiple regression • Most use SPSS to teach hands-on data analysis • Most teach epi and biostats in separate courses • Many offer both face-to-face and online options • Most assess LOs using assignments plus open book exam in both epi and stats • ~35% to 70% of the course

17. Discussion points As PH educators, how do we ensure competency attainment in epidemiology and biostatistics by MPH graduates? What are the common teaching and learning approaches, challenges, and needs? Consider • minimal versus ideal levels of knowledge and skill in epidemiology and biostatistics among graduates of generalist public health degrees plus UG vs PG vs HDR • optimal methods of assessment – exam vs other ‘authentic’ approaches • shared bank of assessment items (collaborative approaches)? • innovative strategies in learning and teaching

18. Opportunity to consider • New Australian PH competency framework currently being developed – 21st century workforce • International frameworks • Is guidance needed in ‘translating’ competency frameworks to course curriculum? • Assessment of attainment • Exam vs more authentic practice based assessment? • Could there be a collaborative approach to ensuring competency attainment e.g. assessment item bank? • Benchmarking opportunities

21. Acknowledgements • UNSW colleagues • Lois Meyer • Andrew Hayen • BayzidurRahman • Anita Heywood