Brownson Ross C, Samet Jonathan M, Bensyl Diana M
Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO.
Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles.
Ann Epidemiol. 2017 Feb;27(2):77-82. doi: 10.1016/j.annepidem.2016.12.002. Epub 2016 Dec 9.
To extend the reach and relevance of epidemiology for public health practice, the science needs be broadened beyond etiologic research, to link more strongly with emerging technologies and to acknowledge key societal transformations. This new focus for epidemiology and its implications for epidemiologic training can be considered in the context of macro trends affecting society, including a greater focus on upstream causes of disease, shifting demographics, the Affordable Care Act and health care system reform, globalization, changing health communication environment, growing centrality of team and transdisciplinary science, emergence of translational sciences, greater focus on accountability, big data, informatics, high-throughput technologies ("omics"), privacy changes, and the evolving funding environment. This commentary describes existing approaches to and competencies for training in epidemiology, maps macro trends with competencies, highlights an example of competency-based education in the Epidemic Intelligence Service of Centers for Disease Control and Prevention, and suggests expanded and more dynamic training approaches. A reexamination of current approaches to epidemiologic training is needed.
为了扩大流行病学在公共卫生实践中的影响力和相关性，这门科学需要超越病因学研究进行拓展，更紧密地与新兴技术相联系，并认识到关键的社会变革。在影响社会的宏观趋势背景下，可以考虑流行病学的这一新重点及其对流行病学培训的影响，这些趋势包括对疾病上游病因的更多关注、人口结构的变化、《平价医疗法案》和医疗保健系统改革、全球化、不断变化的健康传播环境、团队和跨学科科学的核心地位日益凸显、转化科学的出现、对问责制的更多关注、大数据、信息学、高通量技术（“组学”）、隐私变化以及不断演变的资助环境。本评论描述了流行病学培训的现有方法和能力，将宏观趋势与能力进行了映射，突出了疾病控制与预防中心疫情情报服务处基于能力的教育实例，并提出了扩展且更具动态性的培训方法。有必要重新审视当前的流行病学培训方法。
