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The Health Education Center at Lankenau Hospital100 Lancaster Avenue, Wynnewood, PA 19096
July 20-24, 2009
Teach EpidemiologyProfessional Development Workshop
Day5
Backpacks and Back Pain
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Is there an association between the hypothesized cause and the disease?
AcneNo
Acne Total
9010
9010
b
d
a
c
AcneMed
No AcneMed
100
100
Trial
Carrying heavy backpacks causes back pain.
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Back Pain
No Back Pain
Total
9010
9010
b
d
a
c
Heavy Backpacks
No Heavy Backpacks
Observational Study
Carrying heavy backpacks causes back pain.
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Exposure
Check one.
Heavy Backpack
No Heavy Backpack
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Outcome
Any memorable pain in the past two weeks.
What is back pain?
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Outcome
Check one.
Back Pain
No Back Pain
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Epi TalkObservational Studies
Observational Studies
Were you involved in assigning
exposures?
Did you observe what others had
done to themselves?
Did you record, classify, count and statistically analyze
the results?
Epidemiologic studies in which the investigator is not involved in the subjects' exposures other than to record, classify, count, and statistically analyze results.
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Carrying Heavy Backpacks Causes Back Pain.
We are all carrying out “natural experiments” on ourselves each day of our lives, as we decide what to do,
where to go, and to what to expose ourselves.
Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain
Observational Study
Selecting a HypothesisStep 1
Planning the StudySteps 2-7
Collecting DataSteps 8-13
Analyzing DataSteps 14-17
Planning the PresentationStep 18
Detectives in the Classroom - Investigation 2-5: Observational Studies
CDC
Planning the Study
Define the exposure.
Create a question to gather data about the exposure.
Create a question to gather data about the outcome.
Create an informed consent statement for participation in the observational study.
Label 2 x 2 Table Sheet.
Step 2:
Step 3:
Step 4:
Step 5:
Step 7:
Step 6:
Define the outcome in the hypothesis.
2-7
Detectives in the Classroom - Investigation 2-5: Observational Studies
Review
Epi Talk
Voluntary consent given by a person for participation in a study.
Informed Consent
Participants must know and understand the study, give consent without coercion, and know that they can withdraw at any time.
Detectives in the Classroom - Investigation 2-5: Observational Studies
Collecting Data
Read informed consent statement and remind class of right not to participate.
Have class label 2 x 2 Table Sheets.
Review what cells students “fit” into based on answers to exposure and outcome questions.
Instruct class to voluntarily and anonymously place a check in the cell that identifies their exposure and outcome for the hypothesis being tested.
Step 8:
Step 9:
Step 10:
Step 11:
Step 12:
CDC
Review exposure and outcome questions.
Detectives in the Classroom - Investigation 2-5: Observational Studies
Collecting Data
Read informed consent statement and remind class of right not to participate.
Have class label 2x2 Table Sheets.
Review what cells students “fit” into based on answers to exposure and outcome questions.
Instruct class to voluntarily and anonymously place a check in the cell that identifies their exposure and outcome for the hypothesis being tested.
Step 8:
Step 9:
Step 10:
Step 11:
Step 12:
CDC
Review exposure and outcome questions.
Detectives in the Classroom - Investigation 2-5: Observational Studies
Analyzing Data
Calculate the risks of the outcome for the exposed and unexposed groups as fractions and percents.
Calculate the relative risk.
Complete the statement.
CDC
13-17
Explain whether or not the data support the hypothesis.
Step 13:
Step 14:
Step 15:
Step 16:
Step 17:
Sort 2 x 2 Table Sheets and complete the 2 x 2 table that was labeled in step 6.
Detectives in the Classroom - Investigation 2-5: Observational Studies
IMRAD
I MRAD
= ====
Introduction MethodsResultsandDiscussion
Presentation Planning
Detectives in the Classroom - Investigation 2-5: Observational Studies
Epi TalkIMRAD
Epi Talk
Format usually followed when epidemiological studies are published in medical journals.
Introduction: Why the authors decided to do the study,
Methods: How authors did the study,
Results: What the authors found, and
Discussion: What the results mean.
Detectives in the Classroom - Investigation 2-5: Observational Studies
IMRAD
I MRAD
= ====
Introduction MethodsResultsandDiscussion
Step 18: Presentation Planning 18
Detectives in the Classroom - Investigation 2-5: Observational Studies
Presentation Rubric
Criteria Got It Getting It Will Get It Soon
Participation All participate Most participate Some participate
Use of Epi TalkAll are appropriate
and accurateMost are appropriate
and accurateSome are appropriate
and accurate
Data Collection Methods
All are thorough and accurate
Most are accurate Some are accurate
Risks, Relative Risk, and Inference
All are identified and accurate
Most are identified and accurate
Some are identified and accurate
IMRADAll are presented
and accurateMost are presented
and accurateSome are presented
and accurate
Detectives in the Classroom - Investigation 2-5: Observational Studies
• Acne• Auto injuries• Bad mood• Cavities • Cell phones• Class disruption• Chewing gum • Colds• Drinking soda• Eating breakfast• Eating candy• Eating high fat food• Eating school cafeteria food• Exercise • Foul language • Getting a good night’s sleep• Good quiz scores• Good grades• Having a quiet place to study• Head aches
Selecting a Hypothesis
• Improves performance• Indigestion• Lack of regular exercise• Listening to music while studying • Listening to rap music• Multi-vitamins• Nightmares• Overweight • Poor grades• Poor quiz scores• Practicing a sport• Seat belts • Skipping breakfast• Studying• Too much talking on the telephone• Violent behavior• Watching the evening news on TV• Watching too much TV • Watching violent movies • Wearing hats
Detectives in the Classroom - Investigation 2-5: Observational Studies
Authentic Assessment
Teach Epidemiology
Epi – Grades 6-12
• Are realistic; simulate the way a person’s understanding is tested in the real world
• Require judgment and innovation to address an unstructured problem, rather than following a set routine
• Ask students to “do” the subject rather than simply recall what was taught
• Replicate the context in which a person would be tested at work, in the community, or at home
• Are messy and murky
• Require a repertoire of knowledge and skill to be used efficiently and effectively
• Allow opportunities for rehearsal, practice, consultation, feedback, and refinement
54
National Research Council , Learning and Understanding
Teach Epidemiology
Enduring Epidemiological Understandings
Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”
55Teach Epidemiology
Enduring Epidemiological Understandings
Ken Bain, What the Best College Teachers Do
“… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.”
56
Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new
problems or unfamiliar contexts.”
National Research Council , Learning and Understanding
Teach Epidemiology
Enduring Epidemiological Understandings
57Teach Epidemiology
Enduring Epidemiological Understandings
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
Jerome Bruner, The Process of Education, 1960Jerome Bruner, The Process of Education, 1960
will
58
Multi-State Outbreak of E. coli O157:H7 Infections
from Spinach
Teach Epidemiology
Enduring Epidemiological Understandings
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
Jerome Bruner, The Process of Education, 1960Jerome Bruner, The Process of Education, 1960
will
59
Salmonella Outbreak Linked to
Raw Tomatoes
Teach Epidemiology
Enduring Epidemiological Understandings
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
Jerome Bruner, The Process of Education, 1960Jerome Bruner, The Process of Education, 1960
will
60Teach Epidemiology
Enduring Epidemiological Understandings
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
To understand something as a specific instance of a more general case … is to have learned not only a specific thing
but also a model for understanding other things like it that one may encounter.
Jerome Bruner, The Process of Education, 1960Jerome Bruner, The Process of Education, 1960
will
Teach Epidemiology
In the News
During the coming school year, participate in an online Teach Epidemiology In the News - Social Network
and teach epidemiology.
In the News Article Selection Criteria
• Popular press article and scholarly article• Potential to check other sources for information• Non-controversial topic• Age group / reading level appropriate• Consider potential for inclusion of other disciplines• Includes data and visuals• Topical, but not too great a potential to become dated
• Background• Identify standards that apply
Teach Epidemiology
Teach Epidemiology In the News - Social Network
73
Hypothesis
Total Risk Relative Risk
a b
c d
or %
or %Exposure Outcome
?Turned Up Together
Healthy People
-
Healthy People
E
E
DZ
DZ
DZ
DZ
Teach Epidemiology
Enduring Epidemiological Understandings
75
Workshop Goal
Teach Epidemiology
To increase the frequency with which epidemiology is taught to students in grades 6-12
76Teach Epidemiology
Workshop Goal
To increase the frequency with which epidemiology is taught to students in grades 6-12
Teach Epidemiology
Innovation
… an idea, practice or object that is perceived as new by an individual or other unit of adoption.
Everett M. Rogers, Diffusion of Innovations
Workshop Goal
Diffusion
The process by which an innovation is communicated through certain channels over time among the members of a social system
(with the aim being to maximize the exposure and reach of innovations, strategies, or programs.)
Everett M. Rogers, Diffusion of Innovations
Teach Epidemiology
Workshop Goal
80
1.
2.
3.
4.
5.
6.
7.
8.
.
Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy.
Empowers students to make more informed personal health-related decisions.
Increases students’ media literacy and their understanding of public health messages.
Increases students’ understanding of the basis for determining risk.
Improves students’ mathematical and scientific literacy.
Expands students’ understanding of scientific methods and develops their critical thinking skills.
Provides students with another mechanism for exploring important, real world questions about their health and the health of others.
Introduces students to an array of career paths related to the public’s health.
Top 8 Reasons to Teach / Learn about Epidemiology
Teach Epidemiology
82
Explore Public Health Career Paths
http://www.asph.org/document.cfm?page=1038
Teach Epidemiology
What do you mean - Teach Epidemiology?
83
Leverage the Young Epidemiology Scholars Competition
http://www.collegeboard.com/yes/
Teach Epidemiology
What do you mean - Teach Epidemiology?
84
Leverage the Science Olympiad Competition
http://soinc.org/
Teach Epidemiology
What do you mean - Teach Epidemiology?
85
Show and Discuss Is Epidemiology in Your Future?
http://www.rwjf.org/pr/product.jsp?id=26931#content
Teach Epidemiology
What do you mean - Teach Epidemiology?
86
Infuse Epidemiology into Existing Lesson about Something Else
Teach Epidemiology
What do you mean - Teach Epidemiology?
87
Teaching Existing Epidemiology Lessons
http://www.collegeboard.com/yes/ft/iu/units.html
Teach Epidemiology
What do you mean - Teach Epidemiology?
88
Teaching Existing Epidemiology Lessons
http://ccnmtl.columbia.edu/projects/epiville/
Teach Epidemiology
What do you mean - Teach Epidemiology?
89
Teaching Existing Epidemiology Lessons
http://www.diseasedetectives.org/
Teach Epidemiology
What do you mean - Teach Epidemiology?
90
Teaching Existing Epidemiology Lessons
http://www.cdc.gov/excite/
Teach Epidemiology
What do you mean - Teach Epidemiology?
91
Teaching Existing Epidemiology Lessons
http://www2a.cdc.gov/epicasestudies/
Teach Epidemiology
What do you mean - Teach Epidemiology?
92
Teaching Existing Epidemiology Lessons
http://www.cdc.gov/excite/ScienceAmbassador/ScienceAmbassador.htm
Teach Epidemiology
What do you mean - Teach Epidemiology?
93
Teaching Existing Epidemiology Lessons
http://www.buffetbusters.ca/
Teach Epidemiology
What do you mean - Teach Epidemiology?
94
Teaching Existing Epidemiology Lessons
http://www.montclair.edu/Detectives/
Teach Epidemiology
What do you mean - Teach Epidemiology?
95
Teaching Existing Epidemiology Lessons
http://www.montclair.edu/drugepi/
Teach Epidemiology
What do you mean - Teach Epidemiology?
96
View a News Item from an Epidemiologic Perspective
http://www.nationalacademies.org/headlines/
Teach Epidemiology
What do you mean - Teach Epidemiology?
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