High School Epidemiology: Helping Students Practice Science Through Guided Inquiry and Authentic Learning Strategies

Abstract

A call has been made over the last decade for the expansion of epidemiology coursework into high schools in the United States. Epidemiology instruction has been shown to increase student scientific and health literacy, promote critical thinking skills, enhance students’ perception of public health as both practical and relevant, and empower students as independent, lifelong learners. Epidemiology is also a flexible science with relevance to students from diverse backgrounds, skill levels, and interests. While there has been tremendous growth in undergraduate public health education, we have yet to witness the mainstream adoption of epidemiology into high school coursework. In this article, I propose the formal integration of epidemiology into high school curricula to help students practice science as it relates to public health. I posit that epidemiology is a flexible science discipline with real-world significance to students from diverse backgrounds, skill levels, and interests. Also, teaching epidemiology through guided inquiry and authentic learning strategies can intrinsically motivate and empower students to address health-related problems in their local communities. Moreover, epidemiology instruction at the high school level can meet student learning needs, teacher instructional objectives, administrative mandates, and community interests. In essence, epidemiology instruction at the high school level can hone fundamental skills in preparation for health and science careers and promote important public health awareness and interest among adolescents.

Keywords

authentic learning epidemiology guided inquiry high school science education standards

In the last decade, a call has been made by public health professionals for the expansion of epidemiology coursework into secondary science education in the United States (Bracken, 2014; Cordell, Cordeira, Cohen, & Bensyl, 2017; D’Agostino, 2018b; Hollm-Delgado, 2014; Kaelin, Huebner, Cordell, & Szklarczuk, 2008). Epidemiology instruction has been shown at the postsecondary level to increase student scientific and health literacy, promote critical thinking skills, enhance students’ perception of public health as both practical and relevant, and empower students as independent, life-long learners (Fraser, 1987; James, Graham, Snow, & Ward, 2006; Kaelin, 2012; Kaelin & Huebner, 2003; Kaelin et al., 2008; Wallerstein & Bernstein, 1988). A growing literature further indicates that epidemiology instruction initiated in high schools can hone students’ science skills and in-depth understanding of public health practice to ultimately promote population health (Bracken, 2014; D’Agostino, 2018b; Kaelin & Huebner, 2003; Kaelin et al., 2008). Moreover, it is suggested that widespread integration of epidemiology into high school curricula would benefit the nation (Bracken, 2014).

In this article, I propose the formal integration of epidemiology into high school curricula to help students practice science as it relates to public health. I posit that epidemiology is a flexible science discipline with real-world significance to students from diverse backgrounds, skill levels, and interests. Also, teaching epidemiology through guided inquiry and authentic learning strategies can intrinsically motivate and empower students to address health-related problems in their local communities. Moreover, epidemiology instruction at the high school level can meet student learning needs, teacher instructional objectives, administrative mandates, and community interests. In this sense, epidemiology instruction at the high school level can hone fundamental skills in preparation for health and science careers, and promote important public health awareness and interest among adolescents.

Benefits of Epidemiology in High Schools

Meeting National Science Education Standards

Recent national shifts in U.S. secondary science education mandate that student instruction emphasize the integration of science and engineering design practices into classroom learning (Bybee, 2014). Specifically, in 2012, the National Research Council, the governing body of the National Academies of Sciences, Engineering and Medicine established the Next Generation Science Standards Framework (NGSS), which identifies key scientific ideas and practices for all students K-12 to achieve (National Research Council, 2012). A committee of science experts with stakeholder input designed the NGSS Framework. These benchmarks aim to mimic scientific thinking and practice in the real world and have been mapped to four disciplines: biology, chemistry, physics, and earth and space sciences (National Research Council, 2013d). The Framework also aligns with the science education literature, which posits that young individuals need to develop scientific ways of thinking in order to prosper as lifelong learners in an ever-evolving global and technological society (Jackson & Helms, 2008; Pellegrino, 2006; Riga, Winterbottom, Harris, & Newby, 2017).

In addition to identifying new science learning benchmarks oriented towards thinking and real-world practice, the NGSS have informed the development of new student assessment methods to more effectively track student progress in achieving higher order thinking skills (Bybee, 2014). To this end, students are expected to demonstrate their ability to integrate science practices with content. For example, teachers must assess students’ problem solving and scientific reasoning skills. Through providing them with opportunities to overtly share their thinking processes, teachers can support their students in honing these practices (Pellegrino & Chudowsky, 2003). As a result, teachers are encouraged to employ instructional and assessment strategies that help their students demonstrate these skills in order to best pinpoint student gaps in learning.

Epidemiology, defined by the Centers for Disease Control and Prevention, as “the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems” is the basic science of public health (Centers for Disease Control and Prevention, 2012, pp. 1-2). This discipline can be taught to high school students in ways that support new visions for science education. However, no national registry or scholarly reference that identifies which U.S. high schools currently offer epidemiology coursework is readily accessible via an online search. The literature indicates more generally that high school epidemiology-for-credit coursework is ongoing in just six states (New York, Texas, Georgia, California, Tennessee, and Washington; Cordell et al., 2017; D’Agostino, 2018b). There is potential, therefore, to expand high school epidemiology instruction on a wider scale, while helping students achieve the NGSS. For example, instructors can scaffold learning through the application of epidemiology concepts to students’ lived experiences and engagement with members of the community, including neighbors, mentors, health professionals, and those who inform policy (D’Agostino, 2018b). Teaching epidemiology to high school students can also entail assessment strategies that showcase student problem solving and scientific reasoning (D’Agostino, 2018a), therein further meeting shifts in science education standards (Yerrick & Ridgeway, 2017). Below, I describe these strategies for learning and assessment to meet the NGSS in more detail.

High School Epidemiology via Guided Inquiry and Authentic Learning

Epidemiology is fundamentally unique from other high school science disciplines because it is the foundational science of public health and consequently has both scientific and social functions (Armenian, 2008). Epidemiology is also a discipline that uses paradigms of investigating health-related problems, analyzing data, and making inferences (Armenian, 2008). Furthermore, epidemiology is a cross-disciplinary science, drawing from methods employed by a variety of scientific fields, including biology, sociology, economics, biostatistics, informatics, and the behavioral sciences (Centers for Disease Control and Prevention, 2012). These active and interdisciplinary qualities of the discipline support teachers in maintaining the relevance of classroom learning to students’ lives.

If taught with guided inquiry (i.e., student-led investigations) and authentic learning (i.e., student-relevant) strategies, epidemiology instruction can start from day one with students thinking about health and wellness as they relate to their families, friends, and extended communities. Public health problems can be readily identified by youth and their family/friends/mentors/community members in real-world contexts and experiences. Student-selected topics can pertain directly to diverse populations and a wide array of societal problems and settings, while still meeting science education standards (Kiviniemi & Mackenzie, 2017; St. George, Chukhina, & Kaelin, 2017). Students can then be provided with opportunities both during and outside of class to practice science through student-led investigations (D’Agostino, 2018b). These instructional strategies for high school epidemiology encourage students to make connections between science and global, national, and local issues as prioritized in the NGSS (National Research Council, 2013c). Moreover, these learning activities help students engage in what the NGSS Framework refers to as science and engineering practices, or,

The actual doing of science or engineering. . . . Students may then recognize that science and engineering can contribute to meeting many of the major challenges that confront society today, such as generating sufficient energy, preventing and treating disease, maintaining supplies of fresh water and food, and addressing climate change. (National Research Council, 2013b, p. 2)

Consistent with this instructional approach, my experiences teaching high school epidemiology included facilitating student-designed case-control studies based on public health issues directly pertinent to their lives and communities. Fundamental principles of epidemiology were introduced within the context of student-selected topics. Systematic literature reviews were conducted on these topics, consent documents were drafted in an ethics lesson, surveys were designed and piloted, sampling methods were discussed, data were collected, and odds ratios were calculated. Topics included insomnia, depression, diabetes, unprotected sex, unhealthy relationships, binge drinking, and marijuana use. Final presentations to classmates and community guests discussed study background and objectives, hypotheses, findings, study limitations, and steps for further research.

The instructional exercises I outline above demonstrate ways that epidemiology can meet the NGSS learning objectives by engaging students in complex problem solving that has important social and global significance (National Research Council, 2013a). For example, the NGSS outlines eight science and engineering practices: Asking questions (for science) and defining problems (for engineering); Developing and using models; Planning and carrying out investigations; Analyzing and interpreting data; Using mathematics and computational thinking; Constructing explanations (for science) and designing solutions (for engineering); Engaging in argument from evidence; and Obtaining, evaluating, and communicating information (National Research Council, 2013b). Providing youth with opportunities to ask and solve their own scientific questions in real-world contexts serves to both engage students and enhance their appreciation for the wide application of science to improving the world (National Research Council, 2013b). As the cornerstone of public health, epidemiology instruction has great potential therefore to help high school students practice science, while ultimately also serving to promote students’ interest in and connection to public health.

Culturally Responsive Pedagogy Through Epidemiology Instruction

Epidemiology instruction in high schools also benefits students in that it can meet the criteria for culturally responsive pedagogy. According to this framework, educators can be most effective and inclusive in their teaching practice when they build on students’ prior knowledge, experiences, and cultural identities (Yerrick & Ridgeway, 2017). Given that epidemiology can be taught to high school students using inquiry-based/problem-solving/action-orientated practices and drawing from topics that are intrinsically motivating and relevant to students’ lives, this discipline can be a valuable asset to science departments within schools that aim to engage students who may not identify with, or lack confidence in, the sciences. As discussed above, epidemiology in the high school classroom can provide students with an array of methods to practice real-world science and demonstrate their learning while simultaneously relating concepts to their lives and communities. Moreover, because epidemiology can be considered a low-technology science applicable to a broad range of phenomenon and everyday problem solving (Fraser, 1987), it may be more accessible to students who are not traditionally drawn to the sciences. In other words, epidemiology is particularly well suited to hone science skills in youth who were not necessarily science technology engineering and math (STEM) bound, enhancing the potential for successful science achievement for all (National Research Council, 2013a). Furthermore, because epidemiology lends itself to instruction that encourages student inquiry and authentic problem solving, it can help to draw students from diverse backgrounds into the public health profession (Armenian, 2008).

Teacher Benefits of High School Epidemiology

High school epidemiology, when taught using a guided inquiry and authentic learning approach, also primarily emphasizes the scientific process (vs. memorization of facts), which can alleviate the challenges educators may face in meeting the NGSS (Bybee, 2014). As stated in the National Research Council guidelines, the NGSS Framework is not meant to serve as an actual curriculum. Rather, the NGSS provide a set of learning goals “that reflect what a student should know and be able to do—they do not dictate the manner or methods by which the standards are taught” (National Research Council, 2013c, p. 2). High school epidemiology, as I have outlined here, can be taught in ways that emphasize a student-driven, inquiry-based approach to investigating health and wellness problems faced within local contexts. Educators can assign students with learning tasks that start with student interests (i.e., topics of personal significance), and foster a supportive teacher-mentored space in which students can design investigations that are based on student-collected data originating from those interests. In this setting, the teacher guides study design, interpretation of findings, and extending their findings to identifying areas for further research. Given that epidemiology is also a quantitative science (Centers for Disease Control and Prevention, 2012), educators with mathematics course objectives can incorporate simple calculations into students’ investigative findings, such as incidence, prevalence, and risk or odds ratios to help students learn about calculating disease burden and risk on a population level. In essence, this model of high school epidemiology instruction positions the educator as mentor/facilitator, and the student as architect and driver of their own learning. This instructional approach has been shown in the literature to promote success in teachers’ successful adoption of science reform guidelines into their practice by making learning student-centered and flexible (Ryder, Banner, & Homer, 2014). Thus, high school epidemiology can support educators in meeting the NGSS while still remaining extremely flexible and accomodating student interests and learning needs.

Administrator Needs Met by High School Epidemiology

High school epidemiology also has tremendous potential to meet administrator needs for incorporating science benchmarks into school achievement goals. For example, epidemiology instruction when taught using a guided inquiry and authentic learning approach meets education standards set not only by the NGSS, but also the American Association for the Advancement of Science, the College Board, and state education departments (American Association for the Advancement of Science, 2013; National Research Council, 2013d; Texas Education Agency, 2017), including benchmarks on science inquiry, analysis, and design. Providing students with epidemiology instruction consistent with this teaching approach also does not necessarily require extensive resources in terms of professional development training, teacher planning time, and classroom materials. Of course, most teachers are not provided with copious class preparation time, nor are they likely to already have an epidemiology background that would facilitate the development and incorporation of traditional epidemiology lessons into their respective courses and disciplines. However, epidemiology taught in high schools through a guided inquiry, authentic learning approach can maintain flexibility for schools to implement lessons that are complementary to student benchmark goals, faculty interest/expertise, and school/community factors. Depending on teacher background and training, science and mathematics teachers would likely be most qualified to teach these lessons. Also, brief (2-day) professional development trainings on basic epidemiology concepts, for example, were effective in helping high school science teachers with no prior epidemiology training incorporate epidemiology instruction into their courses (D’Agostino, 2018b). More extensive professional development programs also exist during the summer months to help train high school epidemiology instructors (Centers for Disease Control and Prevention, 2016). Educators who receive epidemiology professional development could also co-teach with or provide professional development to more junior faculty at their schools and/or partner schools to facilitate the transfer of epidemiology concepts into a variety of curriculum topics and grade levels (D’Agostino, 2018b). For example, in New York City, school consortiums such as the School Empowerment Network and New Visions Transfer Schools often provide opportunities for cross-school teacher collaboration and shared professional development (New Visions for Public Schools, 2018; School Empowerment Network, 2018). In addition, high school educators who wish to expand their knowledge of epidemiology or pursue continuing professional development can easily access multiple instructional resources online (Centers for Disease Control and Prevention, 2012, 2016).

Also important, of interest to administrators, the lessons prescribed here typically require minimal costs devoted to classroom materials, such as access to computers with Internet connections, Microsoft Excel, and a basic subscription to a survey-making software (e.g., SurveyMonkey). Compared with most science courses that require the purchase of expensive lab materials, epidemiology instruction based on this approach provides a low-cost option for high school science with great potential for high returns on student learning and teacher satisfaction. As such, high school epidemiology taught in this manner can benefit students, teachers, and administrators, regardless of whether students engage with the discipline as a stand-alone unit in a mathematics class, a comprehensive school health education curriculum, a year-long public health course, or as part of a vocational class.

Community Benefits of High School Epidemiology

Given that epidemiology is most fundamentally the study of population health, the discipline lends itself well to student learning that is driven by topics of significance to families and communities. For example, interviewing a neighbor/relative/mentor on what impairs health and wellness in the community; developing a hypothesis about risk factors for student-selected diseases/conditions pertinent to their community and based on systematic background research; visualizing local health data on topics of interest using interactive data tools; organizing symposiums with family members/community guests to discuss health topics of relevance to the community; holding a class debate on paternalism in health and protecting public versus individual rights, such as with public smoking bans or sugary beverage tax policies. These examples not only provide teachers with opportunities to hone students’ real-world problem-solving skills within their communities, but also help students and their parents/mentors connect classroom learning to society.

In fact, I often witnessed my students modeling the authentic learning strategies I used during their final presentations to community guests, such as by asking the audience about their experiences in relation to the topics at hand. Parents and mentors attending these student presentations would contribute actively to the discussions, offering their ideas as to who should be engaged in solving issues of health significance, and what information should be collected to improve the depth and usefulness of each student’s study findings for their immediate community. Furthermore, guests would praise the students for studying topics that had direct relevance to the community. Students, likewise, would describe the rewards they felt in studying something “that mattered” to their fellow students, teachers, family, mentors/employers, church groups, and so forth.

In summary, teaching epidemiology to high school students can directly benefit students, teachers, administrators, and their local communities. By initiating epidemiology instruction with adolescents in this manner, we can encourage students to practice science within the context of population health, while extending the classroom into the community. Youth can become empowered to use skills that they learn in epidemiology coursework to study health issues within their immediate context. Epidemiology instruction that draws from guided inquiry and authentic learning strategies can therefore help adolescents practice science, and also can promote awareness and interest in public health careers.

Conclusion

According to Ebert-May (2017), our goal as educators should be to foster opportunities whereby “all students can learn science by engaging in collaborative work and inquiry-based opportunities” (p. 45). I would extend Ebert-May’s argument in suggesting that epidemiology is an ideal discipline for enacting this process. Naturally, not every child will start high school STEM bound. However, by fostering an inquiry-based, authentic learning approach to epidemiology instruction in high schools we can enhance student critical thinking and problem-solving skills, while simultaneously promoting interest in the health sciences and meeting national science learning benchmarks. Here, I have encouraged the formal integration of epidemiology into high school curricula. Epidemiology in secondary schools not only can meet science education reform guidelines, but also can promote students’ value of public health as critically relevant to their daily lives.

Footnotes

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Emily M. D’Agostino

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