1. Effective Techniques for Training
In Field Epidemiology Training Programs

2. 300 Million
There are
PowerPoint users
in the World *
estimate *

3. 30 Million
They do
Presentations
Each Day *
estimate *

4. Million
About a
Presentations are
going on right now *
estimate *

5. 50% of them are
Unbearable *
Conservative estimate *

6. Killing Each other with
LOTS of People are
Killing Each other with
Bad Presentations
NOW

8. Average Retention Rates
Did You Know?
Average Retention Rates
Lecture 5%
Reading %
Demonstrations %
Discussions %
Practice by Doing 75%
Teaching Others %

9. Do You Know?
Percentage of time participants in lecture base training are inattentive?
40%
Participants in training vs Control Group 8%

10. Do You Know? Adding visuals: 25 – 38% improvement in retention
40% reduction in time required to present a concept

11. Lecturing by itself will
What We DO Know…..
Lecturing by itself will
NEVER
lead to real learning

12. Descriptive Studies
Used to describe the distribution of disease by time, place, person
Useful for hypothesis generation
The most frequent design strategy found in the epidemiologic literature
If someone says to you “person, place and time”, the first word you should reference is “Descriptive”. Why is it important to describe an event or condition by person, place and time? We mentioned in a previous slide it used for hypothesis generation. It is a common study design in epidemiology.

13. Descriptive Epidemiology
Cases
Time
Person
Place
This slide is an illustration. Cases of disease, health condition etc can be described by person, place and time. A case can be defined as “a person in the population or study group identified as having a particular disease, health disorder, or condition under investigation”. Taken from Dictionary of Epidemiology.
Who? Where? When?

14. Example Some studies simply describe disease/health states/behaviours
prevalence of smoking
rates of lung cancer
Note:
Describing these factors does not link them
However can identify unusual distributions or correlations (e.g clusters)
These insights used to generate interesting hypothesis
For example, some descriptive studies describe disease, health states or behaviors. Ask the students to give you some examples in addition to smoking prevalence and lung cancer rates.
What you should not is that: describing these factors does not link them. We may be able to identify clusters and these results will aid with generating hypotheses.

15. Perform descriptive epidemiology: Person
Table- Number of cases by age and sex
Age (yrs)
Male
Female
Total
< 1 10 14 24
1 - 14 18 25 43 33 60 93 57 52
109
Which age group had the most cases? [30-49 year olds]
Which age group had the greatest risk of illness? [can’t say. Need denominators]
50+ 23 26 49
Total
141
177
318 15

16. Perform descriptive epidemiology: Place
Map cases
Note outlier 16

17. Perform Descriptive Epidemiology: Time
Propagated outbreak example 17

18. Develop Hypotheses Use knowledge about the subject matter
Known sources and vehicles of transmission
Clinical symptoms of disease
Seek input from multiple sources
Cases
Local health officials
Go to field, investigate environment

19. It is NOT what you tell them that counts; it is what they take away
Take the material from the “Nice to Know”
To the
“Need to Know”
Goal: Learn SOMETHING rather than being exposed to EVERYTHING

20. Make the Lecture
Your own

21. Now lets look at how this presentation can be presented to bring about interest and increase meaning.
I’m going to tell you a story about a Marmot

22. In June of 2010, we were called to this small village in Hotan China.

23. The Outbreak Investigation Team
Our team went in to respond to reports of pneumonia. 5 People had died and we were there to investigate. The team began the investigative process by using descriptive epidemiology.
The Outbreak Investigation Team

24. What is STEP 1?

25. Perform Descriptive Epidemiology: Time
Direct or indirect transmission of an infectious agent from one susceptible host to another
Can be via direct person-to-person transmission or via a vector to another host
If a source remains contaminated and susceptible individuals are exposed at different times then the outbreak peak will be less distinct and the outbreak will last longer
What does this graph tell you? 25

26. Perform Descriptive Epidemiology: Person
Table- Number of cases by age and sex
Age (yrs)
Male
Female
Total
< 1 10 14 24
1 - 14 18 25 43 33 60 93 57 52
109
First, we wanted to see which age group had the most cases? [30-49 year olds]
We knew this age group was the “working age group” and we knew this was the group we needed to talk to
50+ 23 26 49
Total
141
177
318 26

27. We went to the communities and spoke with the workers
We went to the communities and spoke with the workers. We asked these people where they worked and what they did. Once we had a good idea of the people we were working with, it was time to move on to place.

28. 3 Questions that you would have asked?

29. Perform Descriptive Epidemiology: Place
Map cases
After creating this map, we clearly saw that the majority of cases occurred in the one particular are. We decided it was time to visit this site. 29

30. When we arrived at the site, we realized the area was being cleared for building purposes. Our team began looking for any signs that may help us determine the causes of the outbreak.
Site of Cases

31. Use knowledge about the subject matter
Known sources and vehicles of transmission
Clinical symptoms of disease
Seek input from multiple sources
Cases
Local health officials
Go to field, investigate environment
noticed this dead marmot hanging in a tree and asked how it got there. The people said that these animals had been dying in the fields and when they found a dead one they would hang it in the tree. Since marmots are an animal that is often involved in plague transmission and since the disease was typical of plague pneumonai and since the first case played under this tree, the hypothesis that the plauge caused this illness was developed.

32. Evaluate How can I make this better for next time? What went well?
What did not?
Were there areas of confusion? Misunderstanding?
Debates? Discussions?
Enjoyed activities? Ineffective activities?
How can I make this better for next time?

33. Evaluate
When the horse you’re riding dies…GET OFF of it!

34. SOCO
Effective training for Field Epidemiology Training Programs MUST be Problem Based and involve a variety of activities and delivery methods