Assessment of applied epidemiology competencies among the Virginia Department of Health workforce.

Epidemiology, considered the core science of public health, has been practiced in public health since its inception. Key responsibilities of epidemiologists include public health surveillance, investigation, research, planning, and evaluation with respect to the distribution of disease and health-related events and conditions among populations. The assumption is often made that those who conduct activities associated with epidemiology possess the skills of an epidemiologist. Until recently, no standards existed to measure the skills of those working as field epidemiologists. Epidemiology competencies should be established and used to assess the competency of those who work in government public health agencies. Training aimed at maximizing epidemiology competency of the applied public health workforce can then be delivered. The topic of competence among the public health workforce has been addressed by multiple authors and organizations during the past decade, with the majority of studies focusing on the workforce as a whole.1,2 Job titles are frequently an inaccurate reflection of the educational preparation or the work performed by an epidemiologist.3,4 The Epidemiology Capacity Assessment Survey conducted by the Council of State and Territorial Epidemiologists (CSTE) revealed that as of 2006, a total of 46% of epidemiologists working in state and territorial health departments were not academically trained in epidemiology.3 Although competencies are critical for the whole workforce, development of function-specific competencies and their use in assessments will help ensure that the people performing those functions possess the necessary skills and not just the title. In 2006, the Centers for Disease Control and Prevention (CDC) and CSTE released the Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs), a report partly designed to define the expected skills of applied epidemiology practitioners.4 The CDC/CSTE working group established competency and subcompetency statements centered on eight skill domains first identified by the Council on Linkages Between Academia and Public Health Practice as core competencies for the effective practice of epidemiology in a government public health setting.5 The eight skill domains are: (1) assessment and analysis, (2) basic public health sciences, (3) communication, (4) community dimensions of practice, (5) cultural competency, (6) financial and operational planning and management, (7) leadership and systems thinking skills, and (8) policy development skills. For each skill domain or core competency, multiple competency statements were subsequently developed to clarify specific skills and knowledge. The AECs provide public health entities (e.g., state, local, and tribal health departments) with a foundation for assessing the competencies of their epidemiology workforce and for identifying where gaps exist. The results of these assessments should be viewed as an opportunity to close gaps, not merely highlight them. Other authors have reinforced the value of competency through their definition, “a cluster of related knowledge, skills, and attitudes that affects a major part of one's job (a role or responsibility), that correlates with performance on the job, that can be measured against well-accepted standards, and that can be improved via training and development.”6,7 As such, the use of these epidemiology-specific competencies should increase the practitioners' skills when combined with data-driven training. The Virginia Department of Health (VDH) embraced the release of the AECs as an opportunity to conduct a baseline assessment of its epidemiology workforce. The primary objectives of the assessment were to (1) characterize the VDH epidemiology workforce in terms of capacity, experience, education, frequency of performing, and confidence in core competencies and (2) use the results to plan education and training opportunities based on the self-identified needs of the workforce relative to this standardized skill set.