Research Methods Applied to Public Health Topics: Using Breakout Groups to Foster Problem Solving and Critical Thinking
by Jennifer Bensadoun and Alexandra Minnis, Epidemiology

Teaching issue. Students enrolled in the introductory epidemiological methods course designed for masters students in public health share a diverse range of educational and professional backgrounds. For many students the course is required, and, as a result, individuals bring varying levels of enthusiasm for epidemiology to the discussion sections. With large sections and students who represent backgrounds as distinct as laboratory-based infectious disease, public policy, and social and behavioral health, engaging students in exploring the epidemiological methods and in stimulating discussions of course material proved to be a challenge.

After the first few weeks of the semester during which we presented and practiced a range of epidemiological methods, we recognized that students perceived the methods as disparate and the methodological approaches conflicting. Many students asked us to justify the relevance of the material to the public health work they intended to pursue. We acknowledged that we needed to develop a creative teaching approach that would provide an opportunity for students to link and contextualize the material, and to identify overarching principles as well as distinct applications of epidemiology across the topical areas reflected in the public health field.

Teaching Strategy. To respond to students’ comments about the seemingly disconnected epidemiological methods and to address our concerns regarding differences in student ability we designed an interactive in-class exercise to which all students contributed. We presented three current public health questions to which epidemiology offers a research approach: the connections between cellular telephone use and brain cancer; stress and coronary heart disease; and air pollution and asthma. We divided the class into six groups, with two groups assigned to each topic. We then asked students to work in small groups to propose the best study design to examine the relationship between the proposed risk factor and disease outcome. We provided ten questions to guide their discussions that offered them the opportunity to integrate concepts that had been presented during the first four weeks of the course. After 30 minutes of discussion, each group presented their design and the justification for their choice to the class. Every member of the group was required to participate in the presentation. The two groups assigned to each topic presented their designs and then debated the strengths and weaknesses of their choices. The debates stimulated participation from the entire class. No two groups presented the same design for a given topic, which illustrated the varied ways in which epidemiology can contribute to understanding population health.

Assessment. We pursued both formal and informal mechanisms for assessing the effectiveness of our teaching approach. First, we discussed the exercise with students at the conclusion of the section and received overwhelmingly positive feedback. Second, the exercise shifted the tone of the sections significantly; students participated more freely and collaboratively. Several students even related that epidemiology had gone from being their most dreaded to most favorite course. Students clearly gained confidence in expressing their ideas and in reviewing their peers’ observations and the epidemiological studies that they read. Finally, we included questions about the discussion section structure in an anonymous mid-semester evaluation of the course. Based on the success of this teaching model, we continued to build on its structure for the duration of the semester and developed similar exercises each week that highlighted direct application of epidemiological methods.