Innovative Integrated Teaching of Epidemiology
Author(s): MB Soudarssanane, A Sahai
Vol. 32, No. 1 (2007-01 - 2007-03)
It is well known that a strong knowledge in epidemiology, a
basic subject within Preventive Medicine, is very essential for
students to appreciate the steps in prevention of any disease.
Therefore, strengthening of the teaching of epidemiology is
an interesting and challenging task. Various related newer
teaching methods from the department of PSM, JIPMER,
have earlier been reported – both for theory1 and practical2,3
teachings. To impress the students about the relevance of
the subject, a newer teaching method was introduced. This
included the presentation of actual epidemiological studies,
during the class, along with discussion of the theory points
thereof, and integration of the clinical teaching departments
in such presentations. To inculcate further interest among
students, studies from the local population were chosen
for these presentations and the results thereof were
carefully highlighted to strengthen the concepts/principles
in epidemiology. Such presentations were edited (in prior
planning) to last 10 minutes each.
Material and Methods
On an average 10 to 12 theory classes are programmed for
epidemiology, in the third semester. This is also the time when
students start their clinical postings. A correlation of the steps
of decision making, regarding identification of risk factors
and causes of disease, with the related bedside discussions
would help the learning process. This idea of presenting to
students, the findings of related studies conducted in local
population, during every theory class on epidemiology, for
the various study methodologies thereof, was introduced to
a batch of 56 third semester students in July-October 2002.
To avoid repetition of presentation from the coordinating
department (PSM) and to integrate clinical departments into
the teaching of epidemiology, they were requested to present
their studies – so as to suit the requirements of the students.
During the 12 classes for III semester (one-hour duration
each), a 10-minute presentation of actual studies – conducted
within the institute – was made to the students to support,
elaborate and strengthen every class. Departments of
Medicine, Dermatology and P&SM presented respectively a
case report, case series and cross sectional study (supported
by participation by the Dean of the Institute), departments, of
Surgery, P&SM and Anesthesiology presented respectively
a case control study, a cohort study and an intervention trial.
The role of chance and tests of significance in inferences on
risk factors was elaborated by the second author. The first
author used findings from the presented studies to discuss
the role of bias and the judgment of disease causation.
Discussion on screening for disease was strengthened by
discussant points from guest faculty – the then secretarygeneral
of IAPSM and two professors from a sister medical
college. The short presentations were built within the onehour
theory discussion (occasionally two hours) of the related
study method in epidemiology. In collaboration with the
participating sister departments, these studies were initially
screened and selected by one of the authors (MBS) who was
the discussant faculty for all theory classes in epidemiology,
to suit the needs of the lecture-discussion.
Results
The presentations by various departments are given in
Table 1. These were used. as practical support for the theory
discussions. Students appreciated the findings from actual
studies. Their interest was increased as these studies were
from the local population. They were impressed by the clinical
relevance of the subject of epidemiology (and P&SM) and
appreciated the value of applied bio-statistics.
Table 1 : List of Studies Presented in the Integrated Teaching of Epidemiology
Sr.
no.
Name
of study
Study
method
Presenting
Department
Main
concepts
highlighted
1
Unusual presentation
of brain (pituitary)
tumour
Case Study
Medicine
Statements of
scientific facts
2
Mucocutaneous
manifestations
in HIV/AIDS
Case Series
Dermatology
Inferences
from percentages
3
Distribution of
Blood Pressure &
of Hypertension
in an Urban Area
Cross-sectional
study
P&SM
Interpretation of
Prevalence
measurements
4
Risk Factors in l
Duodenal Ulcer
Case Contro
Surgery
Interpretation of
Odds Ratio
5
Distribution of
Blood Pressure
and Incidence of
Hypertension in
an Urban Area
Cohort Study
P&SM
Incidence and Relative
Risk measurements
6
Effect of Fention
sulphate on heart
rate & BP
Intervention
Anesthes-
iology
Blinding;
Bias minimizing
7
Discussion on
role of chance
and tests of
significance
Statistical
tests used
in above
studies
Biometrics wing
and of P&SM
Interpretation
role of chance
8
Discussion on
role of bias
Examples
of bias
in above
P&SM
Interpretation
bias in
above of
role of bias
9
Judgment of
causation of
disease
Example from
book
P&SM
Doll and Hill
criteria
10
Concepts of
screening for
disease
Discussant
comments
Guest P&SM
disease
faculty
Test validity,
sensitivity,
specificity
and PPV
Forty-six students gave their anonymous feedback (out of
56). All of them, except one, welcomed the new teaching
method. Only one student felt that one-way theory lecture
was better and that it was not that essential to involve so
many departments. The major suggestion was to involve
students in such studies. The comments from students
were:
- brought statistical studies from a mere theoretical concept to something very practical
- application value of the topic was made evident
- that the concept can be applied in every field – apartfrom P&SM
- better form of teaching than just bookish knowledge
- concepts are made clear using a variety of real studies
- showed how epidemiology is useful in daily medical practice; how P&SM would be extended to other clinical subjects as well
- there was the required variety which attracts the attention of the students
Discussion
The Medical Council of India stresses the need for
active teaching/learning of epidemiology as an essential
requirement for training of socially oriented doctors to support
the need based health care delivery system. This philosophy
is also refl ected in the Institute Objectives of JIPMER.
Various efforts are required to translate this educational
concept into action. The integrated teaching of epidemiology,
incorporating presentation and discussion of actual studies
conducted in the local population with involvement of clinical
departments is a novel attempt in the lecture discussions
of the subject. That this innovative method has been very
successfiil is evident from the feedback of the students.
References
- Soudarssanane MB et al. Learner oriented teaching of
epidemiology. Bull of JIPMER: Vol 13,1994; 60-65
- Soudarssanane MB et al. Research as a tool to teach
epidemiology. World Health Forum: 15(1),1994; 48-50
- Soudarssanane MB, Sahai A. Innovative Field Training in
Epidemiology – Accepted for publication in Ind J Comm Med
as a brief report
Jawaharlal Institute of Postgraduate Medical Education and
Research (JIPMER) Pondicherry, India.
Received : 15.04.05
It is well known that a strong knowledge in epidemiology, a basic subject within Preventive Medicine, is very essential for students to appreciate the steps in prevention of any disease. Therefore, strengthening of the teaching of epidemiology is an interesting and challenging task. Various related newer teaching methods from the department of PSM, JIPMER, have earlier been reported – both for theory1 and practical2,3 teachings. To impress the students about the relevance of the subject, a newer teaching method was introduced. This included the presentation of actual epidemiological studies, during the class, along with discussion of the theory points thereof, and integration of the clinical teaching departments in such presentations. To inculcate further interest among students, studies from the local population were chosen for these presentations and the results thereof were carefully highlighted to strengthen the concepts/principles in epidemiology. Such presentations were edited (in prior planning) to last 10 minutes each.
Material and Methods
On an average 10 to 12 theory classes are programmed for epidemiology, in the third semester. This is also the time when students start their clinical postings. A correlation of the steps of decision making, regarding identification of risk factors and causes of disease, with the related bedside discussions would help the learning process. This idea of presenting to students, the findings of related studies conducted in local population, during every theory class on epidemiology, for the various study methodologies thereof, was introduced to a batch of 56 third semester students in July-October 2002. To avoid repetition of presentation from the coordinating department (PSM) and to integrate clinical departments into the teaching of epidemiology, they were requested to present their studies – so as to suit the requirements of the students.
During the 12 classes for III semester (one-hour duration each), a 10-minute presentation of actual studies – conducted within the institute – was made to the students to support, elaborate and strengthen every class. Departments of Medicine, Dermatology and P&SM presented respectively a case report, case series and cross sectional study (supported by participation by the Dean of the Institute), departments, of Surgery, P&SM and Anesthesiology presented respectively a case control study, a cohort study and an intervention trial. The role of chance and tests of significance in inferences on risk factors was elaborated by the second author. The first author used findings from the presented studies to discuss the role of bias and the judgment of disease causation.
Discussion on screening for disease was strengthened by discussant points from guest faculty – the then secretarygeneral of IAPSM and two professors from a sister medical college. The short presentations were built within the onehour theory discussion (occasionally two hours) of the related study method in epidemiology. In collaboration with the participating sister departments, these studies were initially screened and selected by one of the authors (MBS) who was the discussant faculty for all theory classes in epidemiology, to suit the needs of the lecture-discussion.
Results
The presentations by various departments are given in Table 1. These were used. as practical support for the theory discussions. Students appreciated the findings from actual studies. Their interest was increased as these studies were from the local population. They were impressed by the clinical relevance of the subject of epidemiology (and P&SM) and appreciated the value of applied bio-statistics.
Table 1 : List of Studies Presented in the Integrated Teaching of Epidemiology
Sr. no. |
Name of study |
Study method |
Presenting Department |
Main concepts highlighted |
---|---|---|---|---|
1 | Unusual presentation of brain (pituitary) tumour |
Case Study | Medicine | Statements of scientific facts |
2 | Mucocutaneous manifestations in HIV/AIDS |
Case Series | Dermatology | Inferences from percentages |
3 | Distribution of Blood Pressure & of Hypertension in an Urban Area |
Cross-sectional study |
P&SM | Interpretation of Prevalence measurements |
4 | Risk Factors in l Duodenal Ulcer |
Case Contro | Surgery | Interpretation of Odds Ratio |
5 | Distribution of Blood Pressure and Incidence of Hypertension in an Urban Area |
Cohort Study | P&SM | Incidence and Relative Risk measurements |
6 | Effect of Fention sulphate on heart rate & BP |
Intervention | Anesthes- iology |
Blinding; Bias minimizing |
7 | Discussion on role of chance and tests of significance |
Statistical tests used in above studies |
Biometrics wing and of P&SM |
Interpretation role of chance |
8 | Discussion on role of bias |
Examples of bias in above |
P&SM | Interpretation bias in above of role of bias |
9 | Judgment of causation of disease |
Example from book |
P&SM | Doll and Hill criteria |
10 | Concepts of screening for disease |
Discussant comments |
Guest P&SM disease faculty |
Test validity, sensitivity, specificity and PPV |
Forty-six students gave their anonymous feedback (out of 56). All of them, except one, welcomed the new teaching method. Only one student felt that one-way theory lecture was better and that it was not that essential to involve so many departments. The major suggestion was to involve students in such studies. The comments from students were:
- brought statistical studies from a mere theoretical concept to something very practical
- application value of the topic was made evident
- that the concept can be applied in every field – apartfrom P&SM
- better form of teaching than just bookish knowledge
- concepts are made clear using a variety of real studies
- showed how epidemiology is useful in daily medical practice; how P&SM would be extended to other clinical subjects as well
- there was the required variety which attracts the attention of the students
Discussion
The Medical Council of India stresses the need for active teaching/learning of epidemiology as an essential requirement for training of socially oriented doctors to support the need based health care delivery system. This philosophy is also refl ected in the Institute Objectives of JIPMER.
Various efforts are required to translate this educational concept into action. The integrated teaching of epidemiology, incorporating presentation and discussion of actual studies conducted in the local population with involvement of clinical departments is a novel attempt in the lecture discussions of the subject. That this innovative method has been very successfiil is evident from the feedback of the students.
References
- Soudarssanane MB et al. Learner oriented teaching of epidemiology. Bull of JIPMER: Vol 13,1994; 60-65
- Soudarssanane MB et al. Research as a tool to teach epidemiology. World Health Forum: 15(1),1994; 48-50
- Soudarssanane MB, Sahai A. Innovative Field Training in Epidemiology – Accepted for publication in Ind J Comm Med as a brief report
Jawaharlal Institute of Postgraduate Medical Education and
Research (JIPMER) Pondicherry, India.
Received : 15.04.05