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Vol. 172, No. 10
Book Reviews
Teaching Epidemiology: A Guide for Teachers in Epidemiology, Public Health and Clinical Medicine. Third Edition Edited by Jørn Olsen, Rodolfo Saracci, and Dimitrios Trichopoulos ISBN-13 978-0-19-923947-4, Oxford University Press, New York, New York (Telephone: 800-445-9714, Fax: 919-677-1303, E-mail:
[email protected], World Wide Web: http://www.oup.com/us), 2010, 551 pp., $79.50 Paperback Teaching Epidemiology (1) features 31 chapters by many of the epidemiologists who have shaped the field over the past 25 years. The very arrival of the third edition of this book is a testament to the growth of epidemiology as a discipline and the consequent need for the field to systematically consider how best to teach its trainees. The bulk of the material is divided into chapters about exposure and outcome epidemiology, covering a range of topics from more established fields, such as infectious disease epidemiology, to emerging areas of interest, such as climate change epidemiology. The chapters review key concepts in epidemiology, provide syllabi, point to online teaching resources, offer practical advice (such as teaching examples), and provide suggestions on methods of student evaluation. The book succeeds best in individual chapters where the author(s) lucidly present their vision for pedagogy around their assigned topic. The authors, all experienced teachers, highlight for newer teachers epidemiologic concepts that may be particularly challenging for students to grasp. For example, in a chapter on teaching an introductory epidemiology course, Rothman describes the continued challenge of moving away from a reliance on statistical significance (1, p. 84). Olsen and Basso’s chapter on study design nicely prepares readers to teach students how to differentiate between effect measure modification and confounding (1, p. 59). More pragmatically, in the clinical epidemiology chapter, Baron and Sorenson recommend building redundancy into course content, given that clinicians taking the class are likely to be interrupted by their beepers (1, p. 423). Many chapters (the chapters on nutritional epidemiology and social epidemiology are good examples) provide detailed syllabi for courses that will be invaluable for new teachers. Overall, this book stands to make a substantial contribution to the field. In the spirit of moving epidemiology’s educational mission forward and recognizing this book’s unique place in doing so, we offer some critiques that aim to generate discussion, perhaps even disagreement, and that hopefully will inform the fourth edition of this volume. Our overriding concern is that the book falls short of being a cohesive whole. Centrally the text does not articulate a clear editorial vision about how epidemiology should be taught. The editors instead allow the chapters to speak for themselves. Unfortunately, this robs the reader of the guidance and direction necessary to weave the contributions
together and ultimately benefit from the often dissonant author contributions. The lack of editorial overview becomes particularly problematic given that there are substantial interchapter disagreements on issues such as the direction of epidemiology (e.g., the role of clinical epidemiology) and how to handle statistical concepts in parallel with epidemiology. Not unexpectedly, there is also considerable overlap in concepts, resources, and approaches across the 31 chapters. For example, while measurement is appropriately discussed in detail in the nutritional epidemiology chapter, 60 pages earlier we find a separate chapter on the use of questionnaires in epidemiology. Absent an overarching editorial vision, the reader must refer to the table of contents to guide his or her use of the book. This, however, fails us for topics that do not fit cleanly into this edition’s exposure/outcome epidemiology organizational schema (e.g., registries, field studies in developing countries). An instructor looking to prepare a new course on any epidemiologic topic could benefit from reading Abramson’s chapter on teaching epidemiology inside and outside the classroom, oddly placed at the end of a section on outcome-oriented epidemiology. While the title of the book implies that the book is for teachers, it is not at all clear what type of teacher is the target audience. Indeed, it is never made explicit that the book is meant for new teachers of introductory courses until Miettinen shares with us an excerpt from a letter sent by the editors expressing their vision for the book (1, p. 48). However, the specificity of each chapter’s content pushes the contributors to present material with clearly different students in mind. For example, while the dental epidemiology syllabus is designated as appropriate for dental students, many chapters clearly aim to teach epidemiology to general public health students. It falls to Baron and Sorenson to note that ‘‘naturally the topics covered . . . will depend on the level and context in which it is taught’’ (1, p. 411). We agree, and it is that kind of insight and framing that would have helped clarify the book’s contribution and helped us (and we suspect many other readers) better grapple with the book’s content. Beyond this overarching concern, we offer below 3 more specific recommendations. First, while the chapters present ideas about courses, the book barely addresses issues surrounding epidemiology curricula. Given the growth in the field, as evidenced by
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the very diversity of the book’s chapters, ideas about how those interested in teaching the next generation of epidemiologists can aim to integrate epidemiologic knowledge into cogent curricula would have been helpful. Second, while the book’s current concluding section is called ‘‘pedagogies,’’ the presentation of issues around pedagogy is limited to a discussion of focused pragmatic issues such as computer-assisted technologies or the role of teaching assistants. Missing are perhaps more important considerations about how to approach teaching epidemiology in different settings, for new audiences, and for emerging topics. Third, the text might become more readily accessible as a resource for its audience by modifying its organizational scheme. A section that more comprehensively addresses the topics and methods relevant to any epidemiology course (e.g., study design, statistics, and questionnaire design) would be useful. Additionally, the contributors to this volume provide a wealth of electronic resources for new teachers, often overlapping and embedded within the text. This information would be more helpful to readers if it were available as a separate chapter or an index of electronic resources for epidemiology. In sum, this edition of Teaching Epidemiology successfully provides a forum for different voices about how we teach epidemiology, and, as the editors claim in their preface, the volume clearly has a focus on diversity over consensus. The different perspectives present throughout the book reflect the growth of epidemiology as a discipline with new directions in topics and approaches. We applaud the editors’ emphasis on diverse perspectives and would certainly not expect a simple answer about how best to
teach epidemiology, or even how to assess student achievement. However, we want to know what the editors think about how to teach epidemiology, how to teach it differently to different audiences, and what we should be teaching our students. We suggest that a clear editorial vision would go a long way toward making this book an invaluable asset to the field. We have set a high bar in this review. Ultimately, as teachers of epidemiology, we very much look forward to reading and benefiting from a truly essential fourth edition.
ACKNOWLEDGMENTS Conflict of interest: none declared.
REFERENCES 1. Olsen J, Saracci R, Trichopoulos D, eds. Teaching Epidemiology: A Guide for Teachers in Epidemiology, Public Health and Clinical Medicine. 3rd ed. New York, NY: Oxford University Press; 2010.
Katherine Ornstein and Sandro Galea (e-mail:
[email protected]) Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032 DOI: 10.1093/aje/kwq351; Advance Access publication October 13, 2010
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