How To Become A Hospital Epidemiologist
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1 Program Description for students entering graduate program prior to January 2008 MSc with specialization in Hospital Epidemiology Offered by the Departments of Community Health Sciences and Microbiology/Infectious Diseases, University of Calgary I. PROGRAM JUSTIFICATION: Hospital Epidemiology/Infection Control is an area of applied research that is relatively new. The mandate is translating research into practice through education and consultation with staff, through policy and procedure development. Three interrelated activities are used to improve patient outcomes related to hospital-acquired infections: 1) service (ie. surveillance, outbreak investigation, planning, and consultation), 2) education and 3) research. Professional and practice standards have been developed that reflect the multiple skills needed to meet the demands of IC in an evolving health care environment. Competencies include both a theoretical and a practical understanding of 3 content areas: 1) Patient-care practices and health care systems; 2) Microbiology and infectious diseases; and 3) Epidemiology, biostatistics and applications of research. These 3 content areas require different skill sets and knowledge. No one individual can acquire the depth and scope of knowledge and skills needed for competency in all three of these content areas. Therefore, this program was developed to draw individuals from 2 content areas (Patient-care practices and health care systems; and 2) Microbiology and infectious diseases) and to provide training in epidemiology, biostatistics and applications of research for these individuals. This will provide common ground on which the knowledge and skills needed by Infection Control Professionals can be further developed and enhanced. In Canada, there are approximately 1000 Infection Control Professionals (including physicians, nurses, and other allied health professionals such as laboratory technologists) performing hospital epidemiology/infection control functions. The majority of these individuals come from nursing or medical laboratory technology backgrounds without in-depth training in microbiology or epidemiology. The directors of infection control programs may be pathologists, internists/ paediatricians, microbiologists, hospital administrators or other medical practitioners having varying levels of interest and/or knowledge in hospital epidemiology. Whereas it may have been adequate 20 years ago to carry out infection control functions with nurse practitioners, these individuals and other health care workers have recognized that in-depth training in hospital epidemiology/infection control would be highly desirable to improve effectiveness and foster self-directed activities by infection control practitioners. Currently, there are no degree-granting programs in Canada. The Canadian Hospital Infection Control Association-Canada (CHICA-Canada) and the Health Canada have supported short-term (approximately 2 weeks) courses in infection control. However, such programs fall short of producing individuals solidly
2 grounded in hospital epidemiology such that they would be valued independent contributors to hospital infection control functions. The scope and role of hospital epidemiology and infection control has broadened significantly over the last 10 years in our health system because of changes in health care delivery in Canada (ie. regionalization of health services) and new and emerging problems in infectious disease such as antimicrobial resistance and potential bioterrorism. Therefore, a second group of individuals would benefit from this training and who are needed in hospital infection control programs are persons with in-depth training in microbiology or other allied health professions such as pharmacy or medical education. To function in a hospital epidemiology /infection control role, these individuals need training which focuses on epidemiology and patient care practice. II. OBJECTIVES: The focus of graduate studies within this program will be on hospital epidemiology. The primary aim is to prepare candidates to conduct research in all areas of hospital epidemiology. Students should acquire knowledge and skills in clinical and community based epidemiology, infectious diseases, antimicrobial therapy, microbial pathogenesis, molecular epidemiology, needs assessment, health and illness behaviour, and the organization and evaluation of health care services and programs. A graduate is expected to have demonstrated: 1. A proficiency in research design and techniques appropriate to hospital epidemiology and infection control; 2. A more detailed knowledge of specific aspects of the health care system or health services research that are relevant to infection control/hospital epidemiology issues based on thesis work; 3. Knowledge of organizational, management and administrative functions relating to infection control/hospital epidemiology; and 4. A general knowledge of the structure and function of the health care system. III. PREREQUISITES A. General Requirements 1. Have attributes that are consistent with potential research ability including curiosity, initiative and creativity as well as the ability to learn, to integrate and synthesize new information and apply it to a broad range of issues; 2. Be effective in written and oral communication; and 3. Demonstrate analytical skills. 4. There are two development tracks from which individuals can enter the program: a. Bachelor of Science in Nursing (i.e., BN, BSN) or higher, or b. Bachelor of Science or higher in microbiology, cellular and microbial biology or other allied health profession. 5. One would also be expected to have completed the following courses prior to admission into the Masters' program:
3 c. Undergraduate biostatistics; d. Undergraduate microbiology B. To enter the program leading to a Master of Science, Community Health Sciences, specialization in Hospital Epidemiology, one would be expected to: 1. Have a record of proven academic performance with a minimum grade point average of 3.2 in the last two years of full-time undergraduate or graduate study; 2. Bachelor of Science in Nursing, Microbiology or other allied health profession or Bachelor of Nursing (i.e., BN or BSN) required; preference will be given to those individuals who have had training and experience in a health discipline; C. To enter the program leading to a Master of Science, Microbiology/Infectious Diseases, specialization in Hospital Epidemiology, one would be expected to: 1. Have a record of proven academic performance with a minimum grade point average of 3.2 in the last two years of full-time undergraduate or graduate study; 2. Bachelor of Science in Microbiology or Cellular and Microbial Biology required; preference will be given to those individuals who have had training and experience in a health discipline IV. PROGRAM LEADING TO A MASTER OF SCIENCE, COMMUNITY HEALTH SCIENCES OR MICROBIOLOGY AND INFECTIOUS DISEASES, SPECIALIZATION IN HOSPITAL EPIDEMIOLOGY A. Required Courses* 1.MDSC 644: Introduction to Community HealthSciences 2. Biostatistics: a) MDSC Essentials of Biostatistics (Biostatistics I) b) MDSC Biostatistics II 3. Research Methods: a) MDSC Fundamentals of Epidemiology b) MDSC ResearchMethods 4. Two of the following (Supervisor approval required): MDSC Medical Microbiology MDSC Pathogenesis of Bacterial Diseases MDSC Health Care Systems MDSC Determinants of Health (* Equivalents will be considered. To apply for an exemption, contact the Instructor of the required course and provide a course outline of the course you've taken, as well as the grade you attained.) PLUS 5. MDSC Epidemiology of Infectious Diseases 6. MDSC Hospital Epidemiology
4 Additional courses related to the student's thesis speciality area from the graduate course offering of the Department of Community Health Sciences, Department of Microbiology/Infectious Diseases or of other graduate programs may be required by the Students Supervisory Committee. V. PRACTICUM A practicum in the practical aspects of Infection Control is highly recommended for students from both development tracks especially for those students with little or no prior experience in health care. For those individuals with current or previous work experience in Infection Control, a practicum is not usually needed. Students will be offered the opportunity to practice half-time (i.e., about hours/week) in an infection control capacity for a period of 3-6 months. The student and the supervisor will mutually agree upon the requirement for a practicum and the practicum content. The objectives of the practicum are: A. To introduce the student to the realities of practicing and applying the principles infection control in a hospital environment; B. To prepare the graduate to function independently in hospitals with little or no infection control expertise; and C. To demonstrate how epidemiologic and research principles can be incorporated into practice to yield new information in the field. VI. REQUIRED ACTIVITIES A. Participation in the Health Care Research / Microbiology-Infectious Diseases Seminars; B. Participation in Community Health Sciences Graduate Students Seminars; C. Practice under supervision in developing consulting skills by consulting on small projects; D. Critical appraisal skills by reviewing research proposals and publications; E. Presentations written and oral at Departmental or at Provincial or at National or International meetings; F. Limited teaching assignments at the request of the Head of the Department of Community Health Sciences or Microbiology/Infectious Diseases; G. A thesis in the area of hospital epidemiology. H. Attendance at the Facuty of Medicine's Research Integrity Day once during graduate program. VII. RECOMMENDED COURSES One or more of the following courses are recommended: A. MDSC Health Program Planning and Evaluation B. MDSC Clinical Trials C. MDSC Health Protection D. MDSC Health Promotion E. MDSC Teaching Methods in Medical Sciences F. MDSC Curriculum Design and Evaluation in Medical Sciences G. MDSC Medical Microbiology
5 H. MDSC Pathogenesis of Bacterial Diseases I. MDSC Health Care System, or; J. MDSC Health Care in the Social Perspectives K. BTEC Biotechnology I L. BTEC Biotechnology II VIII. EXPECTED AREAS OF COMPETENCE The expected areas of competence of a graduating student will include the following: A. A strong basis in methodology as commonly applied to epidemiologic research with special reference to hospital epidemiology. The methodology will range from epidemiologic to laboratory-based techniques (i.e., molecular epidemiology). Different approaches will be emphasized depending on the background preparation of the student. For example, an individual with extensive microbiologic training could acquire skills in molecular epidemiologic studies as well as becoming proficient in general epidemiologic approaches. B. For their thesis speciality areas - a comprehensive and detailed knowledge of context as well as specialized methodology for hospital epidemiology. C. An ability to review literature critically from an epidemiologic viewpoint. D. Understanding of how epidemiology and biostatistics contribute to each other as disciplines. E. Skill in written and oral communications. F. Ability to communicate and work effectively with clinicians and researchers from a variety of disciplines: 1. Eliciting problems and issues; 2. Framing problems in scientific terms; 3. Advising on preferred research methods; 4. Advising on methods of data collection and analysis including statistically analysis; 5. Skill in interpreting findings; 6. Being forthright in criticism of the research work of self and others; G. Understanding that the determinants of health must be viewed within a broad perspective such as that of Lelond (1974), which states that health fields include human biology, the environment, life styles and health care organization; H. A willingness to explore and use other conceptual frameworks. It is anticipated that the graduate will in the future: I. Be actively involved in independent and collaborative epidemiologic and health care research in the area of hospital epidemiology. 1. Be a regular contributor to the Health Sciences Literature. 2. Demonstrate an interest in the developments in methodology that are involving in the field of hospital epidemiology. IX. OVERALL GOALS:
6 The overall goal is to produce self-directed individuals with the knowledge, skills and attitudes necessary to function efficiently and effectively in hospital epidemiology. These individuals should be able function as researchers, as well as middle managers and academic individuals in a hospital/community setting. As researchers, these individuals would be expected to apply scientific principles to the field of hospital epidemiology as well as contribute to and participate in all phases of research in the field. Such individuals should be able to fill a niche that is largely unfilled at present. Revised: March 21, 2002
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