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