Curriculum standards

Knowledge guides

LG14: Child population health

Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis, management and outcomes.

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Child health screening and surveillance
Clinical and performance indicators
Difference between service monitoring, evaluation, and research
Epidemiology in terms of disease frequency and burden, including measures and causation
Identification of population sub-groups, according to:
- age
- disability
- ethnicity, race, culture
- gender identity and gender expression
- regional and rural settings
- sexual preference
- socioeconomic status
- those with exposure to violence, abuse and neglect
Indigenous data sovereignty and shared access to data and information at a regional level
Key demographic indicators by region, and trend
Key health statistics by region and population group, and trend
Key social and economic indicators by region, and trend
Needs of children and families from special and/or priority populations:
- Aboriginal and Torres Strait Islander peoples
- children in out-of-home care and protection systems such as:
  - children in out-of-home care
  - gateway clinics
  - homeless youth (children/youth on the street)
  - juvenile justice
- LGBTQIA+
- living in regional or rural areas
- Māori and Pacific Island peoples
- refugee, asylum seeker, and migrants
- social determinants of health
- socioeconomically disadvantaged
- those with intellectual or physical disabilities
Organisational responses to serious adverse events:
- liability issues
- mediation principles
- root cause analysis
- sources of professional advice
Qualitative and quantitative data, and its collection along with statistical analysis
Research methods, data analysis tools, and quality improvement methodology
Screening programs:
- clinical and performance indicators
- clinical audit
- disease and hazard surveillance systems
Studies and their design including ethics, impact of power, limitations, and power

Drivers of health inequity across diverse population sub-groups

Access to health care:
- ancillary services
- medications
- primary care
- rural and remote settings
- screening
- tertiary care
Determinants of wellbeing and disease in infants, children, and young people, and their implications for practice, including socioeconomic status, environment, and culture
Discrimination based on race, ethnicity, gender, gender identity, or disability
Diversity of key health challenges in different population groups
Drivers of policy and program implementation as distinct research, and distinct from research
Education and health literacy as determinants of health
Effects of migration and acculturation, values, concepts of health, and diversity across different populations
Evidence base for strengthening communities through promoting health and wellbeing of infants, children, and young people
Evidence base for the promotion of wellbeing and optimal child development
Historic, social, and economic factors differentially affecting specific population groups
Importance of consumer and stakeholder input
Intersectionality
Modifiable risk factors and strategies to address these, including:
- breast feeding
- drug and alcohol issues
- immunisation status
- injury
- obesity
Populations or settings at increased risk, including:
- Aboriginal and Torres Strait Islander, Māori, and Pacific Island peoples
- disabled
- LGBQTIA+
- lower socioeconomic status
- migrants
- rural and remote
Racism, including institutional racism
Social determinants of health
Syndemic theory:
- adverse interactions between diseases and social conditions; clustering of adversity by person, place, or time

Common research methodologies and designs, such as:
- different populations:
  - community
  - clinic
- measurements
- study types
Common statistical methods and terms, such as:
- descriptive and inferential statistics
- measures of association/effect sizes
- tests of significance/confidence intervals
- types of data
Common study problems and flaws, such as:
- measurement limitations
- statistical concerns:
  - power
  - sample size
- types of bias
Different types of research, such as:
- clinical/intervention
- descriptive
Funding models
Measures of deprivation and socioeconomic status
Methodologies for evaluating population health initiatives
Principles and methodologies for service evaluation
Principles of continuous quality improvement and clinical governance
Principles of epidemiology and biostatistics, including descriptive and comparative statistics
Research methodology and health needs assessments
Relevant cultural models of health

Awareness of global health and planetary health and impact on children
Burden of disease in population groups, nationally and globally
Child health indicators and priorities locally, nationally, and globally
Disease prevention
Environmental influences on child health
Global emergencies and the broad impact on children
Grant proposals and applications, and process of peer review of research for publication
Immunisation health
Impact on child health of climate change
Mechanisms for achieving change in legislation, policies, procedures and protocols
Outbreak and disease control
Principles and methods for service evaluation, such as:
- application of principles of equity to an evaluation of a program or health service
- differences between service monitoring, evaluation, and research
- evidence on factors that produce changes in clinical behaviour or managerial practice
- importance of consumer and stakeholder input into health service design, delivery, and evaluation
- principles of quality improvement, such as:
  - clinical audit processes
  - lean thinking methodology
  - quality cycle
  - systems thinking
Sources of health information and their quality, including for specific population sub-groups
Strategies for the promotion of child wellbeing and optimal developmental at a population health level
Structural competency

Environmental epidemiology

Exposure assessment:
- exposure versus dose
- group-level versus individual level
- objective
- subjective
Study designs and analytic tools:
- ecologic studies
- Poisson regression for modelling counts or rates of events
- spatial mapping, e.g. geographic information systems (GIS)
- special considerations for confounding, clustering
- time-series analyses

Infectious disease epidemiology

Basic and effective reproductive numbers
Case fatality ratio
Pathogenicity
Timeline of disease:
- constructing an epicurve
- incubation period
- symptomatic period
Timelines of infection:
- latent period
- period of infectiousness
Transmission probability:
- secondary attack rate
- transmission probability ratio
Use of whole genome sequencing

Screening

Measures of test performance:
- area under the curve
- negative predictive value
- positive predictive value
- receiver operating characteristic curve
- reliability
- sensitivity
- specificity

Surveillance

Analysis of surveillance data:
- advanced techniques to adjust for sampling designs
- descriptive statistics
Approaches to surveillance:
- active versus passive
- information systems
- laboratory-based surveillance
- notifiable disease reporting
- record linkage
- registries
- sentinel events
- surveys
Attributes of surveillance systems:
- acceptability
- accuracy and completeness of descriptive information
- flexibility
- predictive value
- representativeness
- sensitivity
- simplicity
- timelines
Descriptive epidemiology of health problems
Elements of a surveillance system:
- case definition
- confidentiality
- cycle of surveillance
- incentives to participation, e.g. for clinicians
- population under surveillance
Uses:
- detection of infectious disease outbreaks
- detection of patterns of chronic disease, e.g. geographic
- future projections
- health advocacy
- links to services, e.g. notifiable diseases
- monitoring and evaluation of interventions/public health programs
- research, e.g. generating research questions