developing competencies for applied epidemiology apha conference, dec 12, 2005 centers for disease...
Post on 24-Dec-2015
215 Views
Preview:
TRANSCRIPT
Developing Competencies for Applied Epidemiology
APHA Conference, Dec 12, 2005
Centers for Disease Control and PreventionCouncil of State and Territorial Epidemiologists
Developing Competencies for Applied Epidemiology
Denise Koo, MD, MPH Director, Career Development Division
Office of Workforce and Career DevelopmentCenters for Disease Control and Prevention
Kathleen R. Miner, PhD, MPH, CHESAssociate Professor and Associate Dean for Applied Public Health
Rollins School of Public Health, Emory University
Guthrie Birkhead, MD, MPHDirector, Center for Community Health
New York State Dept of Health&
Council of State and Territorial Epidemiologists
Outline
Background Goals and Rationale Definition of Competency Description of Process Current Status of Competencies for
Epidemiologists Next Steps Discussion
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 Only national effort focused on academic
epidemiology
Workforce Shortages
30
1511 11
4 3
05
101520253035
# o
f S
tate
s R
ep
ort
ing
Source: State Public Health Employee Worker Shortage Report: A Civil Service Recruitment and Retention Crisis
Epidemiologic Workforce Development Context: organizational epidemiologic capacity
Define, measure, monitor key functions Definition of a public health epidemiologist Activities and duties of a PH epidemiologist Epi and non-epi competencies for epidemiologists Identification of gaps
Numbers, types, levels Skill areas
Strategic plan to recruit, (re)train, retain
“If you don’t know where you’re going, any road will get you there.”
--Lewis Carroll
Need
Definition of the epidemiology profession at various levels of practice: local, state, federal
National process to define competencies, including: Definition of a public health epidemiologist Competencies needed now and in future
Key (co-lead) partners: CSTE and CDC
Goals of Epi Competencies Process Core competencies for epidemiologists practicing
in governmental public health agencies Local, state or federal Legal mandate for public health activities
Epi and non-epi competencies for epidemiologists Expected levels of proficiency
Rationale
Definition of needed skills for hiring Method to measure, reward, promote workers Roadmap for training existing workforce Guidelines for academia Improved ability to define the field Utility for any certification process
Roles and Responsibilities
Conveners:Matt Boulton, MD, MPH--MI Dept of Health and CSTEDenise Koo, MD, MPH—Centers for Disease Control and
Prevention
Co-Chairs:Gus Birkhead, MD, MPH--NY State Dept of Health and CSTEKathy Miner, PhD, MPH, CHES--Emory University
Consultant and Editor:Jac Davies, MPH--formerly with WA State Department of
Health
Expert Panelists• Kaye Bender, RN, PhD-U MS School of Nursing• Roger Bernier, PhD, MPH--CDC National Immunization Program• Mike Crutcher, MD, MPH—OK State Dept Health and ASTHO• Hal Morgenstern, PhD—U MI SPH• Miriam Link-Mullison, MS, RD—Jackson County HD, IL and NACCHO• Greg Steele, DrPH, MPH—IN University School of Medicine• Lou Turner, DrPH—NC State Laboratory of PH• Mark White, MD—CDC Office of Global Health• Lloyd Novick, MD, MPH—Onondaga County Dept of Health and NACCHO• Sara Huston, PhD—NC DHHS• Bill Sappenfield, MD—CDC Division of Reproductive Health• Len Paulozzi, MD—CDC Injury Center• Richard Hopkins, MD, MPH—FL Dept of Health• Eddie Bresnitz, MD, MS—NJ State Dept Health• Barbara DeBuono, MD, MPH—Pfizer• Richard Dicker, MD, MSc—CDC
Review Panelists
• Kris Moore, MD, MPH--U MN• Art Reingold, MD—U CA, Berkeley SPH• Jim Gale, MD, MS—U WA SPH• Maureen Lichtveld, MD, MPH—Tulane SPH• Kristine Gebbie, RN, DrPH—Columbia
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
“For sale by owner—Encyclopedia Britannica, excellent condition. No longer needed, husband knows everything.”
U of Texas at Austin, Dept of Advertising
From Competencies to Competents
Identifying Competencies for Applied Epidemiology Professionals
“Competence, like beauty and contact lenses, is in the eye of the beholder.”
L. Peters
Characteristics of ProfessionalsProfessionals are:
defined by specific identity and scope of responsibilities (competencies);
problem solvers;
non-routine decision makers;
have a core body of knowledge;
held to ethical practice; and,
life long learners in their field.
“Hermits have no peer pressure.”
Steven Wright
Instructional/ Individual CompetenciesThey: Assess an individual’s ability to do specific
tasks. Structure professional preparation. Determine the measurement indicators. Assume measurement in the short term. Require higher levels of performance to be
built upon lower level ones.
The Anatomy of an Instructional/ Individual Competency Statement
Single Verb + Specific Content
Instructional Design
Indicators
Assessments
Bloom’s Taxonomy
KNOWLEDGE
COMPREHENSION
APPLICATION
ANALYSIS
SYNTHESIS
EVALUATION complexity
Competency FrameworkSkill Domain Area:
1. Competency A
i. Sub-competency
a. Sub-sub competency/learning objective
ii. Sub-competency
iii. Sub-competency
2. Competency B
i. Sub-competency
ii. Sub-competency
iii. Sub-competency
Levels of Practice
Tie
r 1
Tie
r 2
Tie
r 3
Competency Framework Skill Domain: Communication
1. Competency: Prepare written and oral reports and presentations that communicate epidemiologic findings to professional audiences, policy makers, and the general public.
i. Sub-competency: Identify audience, methods and content for communication of epidemiologic findings
a. Identify target audience for communication
ii. Sub-competency: Communicate epidemiologic findings to professional audiences through written reports and oral presentations.
Competency Framework Skill Domain: Leadership and Systems
Thinking
1. Competency: Promote shared vision to drive action.
i. Sub-competency: Assist in strategic planning.
a. describe process for organizational strategic planning.
b. identify internal and external issues that may impact delivery of essential public health services
Competency Framework Skill Domain: Cultural Competency
1. Competency: Describe population by race, ethnicity, culture, socioeconomics, education, professional background, age, religion, and sexual orientation
2. Competency: Establish relationships with groups of special concern.
i. Sub-competency: Study the historical context of populations’ history and past treatment by the public health system.
“There is no educational value in the second kick from a mule.”
Anon
Competency Truths
Competencies are dynamic.
Competencies foster professional identity.
Application crosses more than one generation of leadership.
"It's not true that life is one damn thing after another. It's the same
damn thing over and over."
Edna St. Vincent Millay
Competency Development Process Examination of existing competency sets
Epidemiology Public Health
Mapping of existing competencies to Core Competencies for Public Health Professionals (from Council on Linkages)
Revision of existing and creation of new competencies to address unique elements of epidemiologic practice
Competency Framework for Public Health Professionals Analytic Assessment Basic Public Health Sciences Communication Community Dimensions of Practice Cultural Competency Financial Planning and Management Leadership and Systems Thinking Policy Development/Program Planning
Source: Council on Linkages between Academia and Public Health Practice
Revision Process
Two in-person meetings, multiple conference calls Utilized web-based survey to assess expert panel’s
views on competencies and to collect specific input
Focused on crafting language that reflects unique aspects of epi practice
Recognized that COL competencies apply to all public health professionals, including epis
Recognized that competencies will differ depending on level of experience and job expectations
Intended Users Tier 1: frontline epidemiologist
New MPH/MS grad, <2 years experience
BA with at least 2 years’ experience
Tier 2: Mid-level (“journey”) epidemiologist
Master’s with 2-5 years experience; doctorate in epi; other professional degree with epi training (e.g., EIS)
May supervise epi team or unit
Tier 3: Senior epidemiologist (2 tracks)
a: supervisors/managers
b: doctoral-level senior epi scientists
Timeline Before October 04
Compile and review existing competency sets Prepare “discussion draft”
Oct 04 – 1st in-person meeting of panel Developed FIRST DRAFT of competencies focusing on
Tier 2 competencies
Dec 04 – SECOND DRAFT distributed Feb 05 – Comments on draft via web tool; THIRD
DRAFT developed from comments Mar 05 – 2nd in-person meeting
Timeline March-May 05 – Further revisions captured in 4th
draft May 05 -- Prepared 5th draft for presentation at
CSTE annual meeting in New Mexico June 05 – Posted draft on web for widespread
review and comment June-October 05 -- Developed Tier 1 and 3
competencies July 05 – ASTHO/NACCHO joint annual meeting
in Boston (informal discussions) November 05-January 06 -- additional validation December 05 – APHA
Partner Organizations Solicited for Comment American College of Epidemiology
Association of Schools of Public Health Association of Maternal and Child Health Programs Association of State/Territorial Directors of Nursing Association of American Medical Colleges Association of Teachers of Preventive Medicine Association of State and Territorial Health Officers American Public Health Association APHA Epidemiology Section Chronic Disease Directors CDC Office of Workforce and Career Development CDC Associate Director for Science National Association of Health Data Organizations National Environmental Health Association National Association of Local Boards of Health National Association of County and City Health Officials Public Health Foundation Society for Epidemiologic Research State and Territorial Injury Prevention Directors Association
Skill Domain 1: Analytic/AssessmentTier 2 Competencies Identify public health problems Conduct surveillance Investigate acute and chronic conditions Apply ethical/legal principles to study design,
data collection, dissemination, and use Manage data Analyze data Summarize results/draw conclusions Recommend interventions/control measures Evaluate programs
Example: Analytic/AssessmentSub-Competencies
Conduct surveillance Determine whether to conduct surveillance for
a particular PH problem Identify surveillance data needs Implement new or revise existing surveillance
system Interpret key findings Conduct evaluation of surveillance systems
Example: Analytic/Assessment Sub-Sub-Competencies Identify surveillance data needs
Create case definition Describe sources, quality and limitations of
surveillance data Identify mechanisms to transfer data from
source to public health agency Define timeliness required for data collection Define necessary frequency of reporting Describe potential uses of data to inform
surveillance system design
Skill Domain 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
Skill Domain 3: CommunicationTier 2 Competencies Prepare written and oral reports and
presentations that communicate epidemiologic findings 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
Employ available and suitable communication technologies
Skill Domain 4: Community Dimensions of Practice
Tier 2 Competencies Provide epidemiologic input into epidemiologic studies and community public health planning processes at the state or local level
Participate in development of community partnerships to support epidemiologic investigations
Engage the public in the public health work and decision making of the Health Department when needed using mechanisms suitable to the circumstances
Skill Domain 5: Cultural CompetencyTier 2 Competencies Describe population
Establish relationships with groups of special concern
Design surveillance systems to include under-represented groups
Conduct investigations using languages and approaches tailored to population
Use standard population categories or subcategories when performing data analysis
Skill Domain 5: Cultural CompetencyTier 2 Competencies Utilize knowledge of specific socio-cultural
factors in the population to interpret findings
Recommend public health actions that would be meaningful to the affected community
Communicate findings using mechanisms tailored to that community
Skill Domain 6: Financial and Operational Planning and ManagementTier 2 Competencies Conduct epidemiologic activity in a manner that
is aligned with financial and operational plan of the agency
Use skills that foster collaborations, strong partnerships, and team building to accomplish epidemiology program objectives
Clarify roles and responsibilities of all participants in epidemiologic activities
Skill Domain 7: Leadership and Systems Thinking
Tier 2 Competencies Promote shared vision to drive action
Conduct performance driven work
Promote ethical conduct
Promote workforce development
Prepare for emergency response
Skill Domain 8: Policy DevelopmentTier 2 Competencies Participate in development of public health
policies
Participate as a team member in evaluating policies affecting epidemiology programs
Differentiating Between Tiers Example: Surveillance Tier 1 (frontline epidemiologist):
Support evaluation of surveillance systems
Tier 2 (mid-level epidemiologist/team leader): Conduct evaluation of surveillance systems
Tier 3 (senior level): Supervisor/Manager -- Assure evaluation of
surveillance systems Senior Scientist (PhD) -- Design and conduct
evaluation of surveillance systems
Differentiating Between TiersExample: Basic Public Health Sciences Tier 1 (frontline epidemiologist):
Recognize the role of laboratory resources in epidemiologic activities
Tier 2 (mid-level epidemiologist/team leader): Use laboratory resources to support epidemiologic
activities
Tier 3 (senior level): Supervisor/Manager -- Assure the use of laboratory
resources to support epidemiologic activities Senior Scientist (PhD) -- Develop processes for using
laboratory resources to support epidemiologic activities
Differentiating Between Tiers Example: Financial and Operations Tier 1 (frontline epidemiologist):
N/A
Tier 2 (mid-level epidemiologist/team leader): Assist in preparation of proposals for extramural funding
Tier 3 (senior level): Supervisor/Manager -- Develop Requests for Proposals
for extramural funding to support additional epidemiologic activities and special projects within and outside agency
Senior Scientist (PhD) -- Prepare proposals for extramural funding, for review and input from managers
Intended Uses of Applied Epidemiology Competencies Help public health agencies:
Define skills needed when hiring epidemiologists Provide performance standards for measuring,
rewarding and promoting workers
Support education for epidemiologists by: Providing a roadmap for continuing education of
practicing epidemiologists Providing a tool for academia to target the
education of future public health epidemiologists Provide guidance to epidemiologists on career
paths and needed training
Intended Outcomes
Improve definition of the discipline
Inform development of any epidemiology certification process
Increase comparability of epidemiology positions across public health agencies
End result: public health workforce prepared to meet epidemiologic challenges
Competency Web Survey Results: 369 Respondents Self-identified as:
Tier 3 – 167 (45%)
Tier 2 – 158 (43%)
Tier 1 – 44 (12%)
Level of practice: Local – 60 (16%)
State – 198 (54%)
Federal – 86 (23%)
Academia – 15 (4%)
Other/Unknown – 10 (3%)
Survey Results: Support for Analytic/Assessment Competencies Identify public health problems (95%) Conduct surveillance (93%) Investigate acute and chronic conditions (93%) Apply ethical/legal principles to study design,
data collection, dissemination, and use (96%) Manage data (93%) Analyze data (95%) Summarize results/draw conclusions (98%) Recommend interventions/control measures
(92%) Evaluate programs (76%)
Summary of Comments General Comments
Is it realistic to expect an individual to have skills in all of these areas? Should the competencies apply to a group rather than to individuals?
Competencies should be developed for specific categories of epidemiologists (e.g. chronic disease, infectious disease, State Epidemiologists, etc)
How will competencies be measured? How will practicing epidemiologists gain the
necessary skills to meet all these competencies?
Summary of Comments General Comments
Some competencies are confusing and need to be reworded
Distinction between Tiers may not be appropriate – there is a lot of blurring between these levels, especially in local health departments
Tier definitions should allow for more on-the-job experience and not just rely on degrees
Who is really an epidemiologist? How to define a Tier 1? Should it include public health nurses, sanitarians, others?
Summary of Comments Some competencies were seen to be missing
Knowledge transfer/training of others/mentoring
Specific skills (e.g. GIS, statistical software, forensic epidemiology)
Communicating to different audiences Handling adversarial situations Creating partnerships with community groups,
other agencies, etc Budget management
Summary of Comments
Some competencies seen as not appropriate for Tier 2 epidemiologists. Questions raised about: Designing interventions Program evaluation Management-related competencies Policy development Competencies that seem specific to infectious
disease only (e.g. laboratory testing)
Next Steps
Collect comments on Tiers 1, 3 Collect comments from pilot state/local HDs Present comments to expert panel (in-person
meeting Feb/March 06) Revise competencies Disseminate competencies Present at Congress of Epidemiology, June
2006 (Seattle)
Discussion Questions Practitioners:
Does this sound like what you do?
Are these competencies helpful?
How would you use them?
Academia: Is this similar to what you teach now?
If not, will you use them to plan future courses for enrolled students?
Would your school offer continuing education in these areas?
Discussion Questions
All: Do these competencies offer opportunities for
practice and academic communities to work together to develop the applied epidemiologic workforce?
For more information, please see:www.cste.org
Thank you for your participation in the process!!
top related