1. 03/20161 Back to Basics, 2016 POPULATION HEALTH Dr. Nicholas Birkett School of Epidemiology, Public Health and Preventive Medicine

2. The Plan (1) “Population health” offers 16 hours of material in the B2B unit Sessions will cover a wide range of topics in –Public Health –Community Health –Occupational/Environmental health –Epidemiology/Biostatistics –Immunization/Infectious disease control 03/20162

3. 3 THE PLAN (2)

4. 03/20164 Structure Lectures with discussion & some trial MCQs. Interrupt if things aren’t clear –These sessions are for you benefit –I have no fixed agenda Covers topics included in the Toronto Notes, as well as other things Toronto Notes

5. CANMEDS roles (1) CANMEDS is a framework for medical education Developed by the Royal College of Physicians and Surgeons of Canada in 1996 Defines essential physician competencies Being integrated into medical education 03/20165

6. CANMEDS roles (2) Seven roles have been defined: –Medical Expert (central Role); –Communicator; –Collaborator; –Health Advocate; –Manager; –Scholar; –Professional 03/20166

7. CANMEDS roles (3) Population health content links to 3 main roles: –scholar; –advocate; –manager MCC now mapping all its objectives onto CanMeds roles. –Questions should be clinically relevant to a CanMeds role These may be the themes underlying some questions. –“You see a patient who is hesitant to have her child vaccinated. Which of the following would form a good example of a public health advocacy approach to address this issue?” etc. 03/20167

8. 8 MCC QE, Part I Revised objectives arose from many discussions over Public (or Population) Health competencies for physicians (much of what UOttawa covers in SIM) ‘Our’ MCC content now named Population Health, Ethics, Legal & Organizational topics (PHELO).PHELO This has absorbed some earlier CLEO and C 2 LEO topics (Culture, communication, legal, ethics, organization)C 2 LEO

9. 03/20169 MCC QE, Part I Aim is to merge population health & some CLEO objectives into main pool of questions, showing clinical relevance of prevention, etc., rather than keeping separate. Many C 2 LEO topics are included in Part II of the exam.

10. 03/201610 MCC MCQ format Questions generally include a clinical scenario One correct answer & 4 plausible distractors –No ‘except’ questions. No ’all of the above ’ –Sometimes: correct = the better answer –Management: often ‘ What is your best next step? ’ –Try to avoid ‘ factoids ’ e.g. what is the second most important cause of death in Canada? Key features – each question tests one concept

11. 03/201611 LMCC Objectives (1) We will not be able to cover every objective in detail. Sessions will be based around MCC Objectives for Qualifying Examination. Emphasis in these sessions is on core ‘ need to know ’ rather than on depth and justification

12. 03/201612 LMCC Objectives (2) Population Health Concepts of Health and Its Determinants (78-1) Assessing and Measuring Health Status at the Population Level (78-2) Interventions at the Population Level (78-3) Administration of Effective Health Programs at the Population Level (78-4) Outbreak Management (78-5) Environment (78-6) Health of Special Populations (78-7)

13. 03/201613 LMCC Objectives (3) 78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS (March 22) Define and discuss the concepts of health, wellness, illness, disease and sickness. Describe the determinants of health and how they affect the health of a population and the individuals it comprises. Lifecourse/natural history Illness behaviour Culture and spirituality

14. 03/201614 LMCC Objectives (4) 78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS Determinants of health include: –Income/social status –Social support networks –Education/literacy –Employment/working conditions –Social environments –Physical environments

15. 03/201615 LMCC Objectives (5) 78.1: CONCEPTS OF HEALTH AND ITS DETERMINANTS Determinants of health (con’t): –Personal health practices/coping skills –Healthy child development –Biology/genetic endowment –Health services –Gender –Culture

16. 03/201616 LMCC Objectives (6) 78.2: ASSESSING AND MEASURING HEALTH STATUS AT THE POPULATION LEVEL (March 14, March 31) Describe the health status of a defined population. Measure and record the factors that affect the health status of a population with respect to the principles of causation –Principles of Epidemiology, critical appraisal, causation, etc.

17. 03/201617 LMCC Objectives (7) 78.3: INTERVENTIONS AT THE POPULATION LEVEL (March 22) Understand three levels of prevention Concepts of Health Promotion, etc.. Role of physicians at the community level. Impact of public policy

18. 03/201618 LMCC Objectives (8) 78.4: ADMINISTRATION OF EFFECTIVE HEALTH PROGRAMS AT THE POPULATION LEVEL (March 24) Structure of the Canadian Health Care System Concepts of economic evaluation Quality of care assessment

19. 03/201619 LMCC Objectives (9) 78.5: OUTBREAK MANAGEMENT (March 17) Know defining characteristics of an outbreak Demonstrate essential skills in outbreak control

20. 03/201620 LMCC Objectives (10) 78.6: ENVIRONMENT (March 24) Recognize implications of environmental health at the individual and community levels Know methods of information gathering Work collaboratively with other groups Recommend to patients and groups how they can minimize risk and maximize overall function

21. 03/201621 LMCC Objectives (11) 78.7: HEALTH OF SPECIAL POPULATIONS (March 24/March 31) Specific target populations include: –First Nations, Inuit, Métis Peoples –Global health and immigration –Persons with disabilities –Homeless persons –Challenges at the extremes of the age continuum

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