Emergency response and the need for collective competence in epidemiological teams

Abstract

Objective To determine the challenges met by, and needs of, the epidemiology emergency response workforce, with the aim of informing the development of a larger survey, by conducting key informant interviews of public health experts. Methods We defined our study population as public health experts with experience of epidemiology deployment. Using purposive sampling techniques, we applied random number sampling to shortlists of potential interviewees provided by key organizations to obtain 10 study participants; we identified three additional interviewees through snowballing. The same interviewer conducted all key informant interviews during May–August 2019. We thematically analysed de-identified transcripts using a qualitative data analysis computer software package. Findings Despite our interviewees having a wide range of organizational and field experience, common themes emerged. Interviewees reported a lack of clarity in the definition of an emergency response epidemiologist; the need for a broader range of skills; and inadequate leadership and mentoring in the field. Interviewees identified the lack of interpersonal skills (e.g. communication) and a lack of career progression options as limitations to the effectiveness of emergency response. Conclusion The epidemiology emergency response workforce is currently not achieving collective competence. The lack of a clear definition of the role must be addressed, and leadership is required to develop teams in which complementary skills are harmonized and those less experienced can be mentored. Epidemiology bodies must consider individual professional accreditation to ensure that the required skills are being achieved, as well as enabling continual professional development.

Leadership, politics, and communication: challenges of the epidemiology workforce during emergency response

“…Survey questions were based on findings from key informant interviews conducted in 2019 and issues raised in the literature [ 16 , 26 ]. Questions were reviewed by the key informant interviewees and pre-tested with 11 field epidemiologists with experience in emergency response.…”

“…For questionnaire responses on roles and challenges, we performed an exploratory factor analysis to identify closely related items and distil the large data set into fewer groupings [ 16 , 17 ]. Eigenvalues and scree plots were reviewed to determine the number of groupings, orthogonal varimax rotation then supported the identification and interpretation of groupings of latent themes [ 30 ].…”

“…There is limited evidence on emergency response workforce best practice and there is a need for stronger scientific evidence and innovative research and evaluation methods [ 13 – 16 ]. The reasons for this are unclear but may relate to the lack of operational plan testing and poorly defined job roles.…”

“…The reasons for this are unclear but may relate to the lack of operational plan testing and poorly defined job roles. Epidemiology is often not included in national health workforce plans and the role may have inconsistent skill and knowledge requirements [ 16 ]. In recent years, role formalisation of other emergency response health professions has taken place, however, not for epidemiology [ 17 ].…”

“…In recent years, role formalisation of other emergency response health professions has taken place, however, not for epidemiology [ 17 ]. The lack of clarity on the role of the epidemiologist has been identified in previous research as a primary barrier to effective emergency response [ 2 , 16 , 18 ].…”