Am J Epidemiol 2002; 156:190-191.
Copyright © 2002 by the
Johns Hopkins Bloomberg School of Public Health
BOOK REVIEWS |
Teaching Epidemiology, A Guide for Teachers in Epidemiology, Public Health and Clinical Medicine, Second Edition
Division of Epidemiology Department of Family and Preventive Medicine School of Medicine, University of California, San Diego, La Jolla, CA 92093-0607
Edited by J. Olsen, R. Saracci, and D. Trichopoulos ISBN 0-19-263066-0, Oxford University Press, New York, New York (Telephone: 212-726-6000, http://www.oup.com), 2001, 394 pp., $48.90 hardcover, $25.45 paperback
"Any measurement must take into account the position of the observer. There is no such thing as measurement absolute, there is only measurement relative. Relative to what is an important part of the question" (1, p. 9).
A quick computer search identifies more than 658 books in print with the word "epidemiology" in the title and over 50 introductory texts. These books usually focus on terminology, methods, and content and are designed for use by undergraduate or graduate students. The best books are those written by teachers with decades of teaching experience; these books often were designed to be used as a course syllabus. Wonderful texts in this category are Rothman’s recently published book, Epidemiology—An Introduction (2) and Gordis’ book, Epidemiology , 2nd edition (3).
The new edition of Teaching Epidemiology (4) reviewed here is a completely different type of book, more a philosophy of teaching than a resource book. There is much discussion of teaching methods, but because it is multiauthored, completely different opinions appear in different chapters, such as the statistician’s insistence on the importance of early computer-based learning (Miettinen) versus the advice to avoid the same in the first course in epidemiology (Rothman). Rothman says, "Teaching students to press buttons is no substitute for an ordered presentation of the principles and methods of epidemiology" (4, p. 64).
Many thought-provoking quotable quotes appear throughout this book. In chapter 2, "Epidemiology and Public Health," Last challenges the value of teaching aids, including PowerPoint presentations, saying that "... it is as difficult to become wise or well educated by studying handouts as it is to become wealthy collecting handouts of small change on a city street" (4, p. 28). Most chapters have suggestions about course evaluation, with several objecting to multiple-choice tests as fervently as this reviewer does. Rothman writes, "A good question is one that the student would have no idea about without the class, and which is easy to answer after the class" (4, p. 74). Several authors reinforce the value of reviewing answers after examinations, an often-missed "teaching moment."
Almost every chapter contains an introduction to its topic, a suggested course outline, the amount of time necessary to teach the information, and suggestions on ways to make the subject matter more interesting to the student. About half the book focuses on teaching the epidemiology of disease- or exposure-specific conditions, topics that are commonly addressed in other texts.
One often-neglected subject is the history of epidemiology. Sarachi begins chapter 1 by asking why this subject should be taught. This chapter provides just enough content to tease the teacher into wanting to read more. The customary focus on early British and American contributions to epidemiology is expanded to include the (often earlier) contributions of Greek, Italian, and French population scientists.
Another recently fashionable, but often neglected, topic is lifestyle and life course, neatly distinguished from each other in a wonderful chapter by McMichael and Britton. I particularly enjoyed the discussion of the oversimplification of defining lifestyle as voluntary behavior, given the strong influence of societal and cultural norms on behaviors such as diet, smoking, and physical activity. Also useful is the discussion of the challenges of research design when risks evolve over a lifetime and over the course of disease.
I particularly liked (and others will strongly object to) the chapter by Rothman, who has been challenging the conventional wisdom about analytic methods for years without becoming tedious or terrifying to the student (or the teacher). His insistence on confidence intervals in lieu of p values has finally become accepted by most epidemiologists (see the opening quote of this review, above). His text on the difference between statistical and biologic interaction is fascinating. His strong recommendations that we look at the data before we multiply adjust it makes a great deal of sense but is too often ignored. (In the same spirit, many, many years ago, Abe Lillienfeld, teacher of teachers, told me that if the association sought could not be seen in an appropriately stratified two-by-two table, perhaps it should not be subjected to logistic or linear regression.) Most "modern" epidemiologists much prefer multivariable analysis to stratification, but (when sample size permits) nothing shows effect modification quite so well.
Good teaching is an art that, like other art, takes talent and a lot of hard work.
"I cannot assume you will understand me. It is just as likely that as I invent what I want to say, you will invent what you want to hear" (1, p. 25).
This book will not teach beginners how to teach epidemiology. There is, however, much that is thought provoking for dedicated teachers who wish to improve the teaching of epidemiology.
REFERENCES
- Winterson J. Gut symmetries. London, England: Granta Books, 1997.
- Rothman KJ. Epidemiology: an introduction. Cary, NC: Oxford University Press, 2002.
- Gordis L. Epidemiology. 2nd ed. Philadelphia, PA: W. B. Saunders, 2000.
- Olsen J, Saracci R, Trichopoulos D, eds. Teaching epidemiology, a guide for teachers in epidemiology, public health and clinical medicine. 2nd ed. New York, NY: Oxford University Press, 2001.
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  W. Winkelstein Jr. From the Editor: The First Epidemiology Textbook? Am. J. Epidemiol., October 1, 2002; 156(7): 684 - 684. [Full Text] [PDF]
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