Academic Calendar

ECS 140A, 4 credits

The epidemiology component of this course introduces the basic principles of epidemiology, including formulation of the research question, choice of study subjects, measures of disease frequency, assessment of exposure and disease status, study design (cross-sectional studies, prospective and retrospective cohort studies, case-control studies, and clinical trials), measures of association between exposure and disease (risk ratio and risk difference measures), measurement precision and accuracy, causal inference, use of statistical testing, and interval estimation in epidemiological studies.

The biostatistical topics in this course include introduction to the use of computers for statistical analysis, exploring and organizing data, vital rates and ratios, life tables, probability concepts, discrete and continuous probability distributions, populations and samples, nonparametric analysis, sampling distributions and statistical inference, statistical estimations, hypothesis testing, sample size and power, two-sample comparisons, analysis of variance and multiple comparisons, association and correlation, simple linear regression, multiple regression, multiple analysis of variance, analysis of covariance, logistic regression, and log-linear models.

Summer term ongoing through Fall term

4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: None

ECS 130, 2 credits

This highly interactive, inter-professional elective is designed to give students an overview of health care ethics, including recognizing and responding to contemporary clinical, research, and organizational ethical conflicts in health care. The students will become familiar with the application of ethics principles to today’s health care ethics challenges faced by health care professionals. Through the discussion of case studies, students will build practical ethical reasoning skills and strategies for dealing with frequently encountered ethics issues, as well as approaches for anticipating and decreasing the presence of ethics conflicts. Students will also gain an understanding of the structure and function of a Hospital Ethics Committees and an Institutional Review Board/Committee for the Protection of Human Subjects. Emphasis throughout the elective will be on critical thinking, real-world application and decision-making in a professional environment. 

Fall term; 2 credits; (HP, P, LP, NC)

Elective short course

Prerequisites: None

ECS 154, 4 credits

This course describes the evolution of the predominant illness patterns that dominate contemporary populations. It delves into explanations for individual and population health that focus primarily social and behavioral determinants for heath promotion and disease prevention. Finally, it examines local and global responses to burgeoning factors that will significantly impact population health in the coming decades.

Summer term; 4 credits; (HP, P, LP, NC)

Required for MPH

Prerequisites: None

ECS 100 Part 1, 4 credits

In this course students engage in thinking about common health care related questions and identifying basic approaches and challenges to studying them. Part 1 of this course focuses on recognizing the purpose, structure, strengths and weaknesses of various study designs, while developing skills to critically assess the relevance and validity of their conclusions. At the same time, each student begins to develop a research question of their own and, after conducting a preliminary literature search, submits a proposal for conducting a systematic review.

Summer term; 4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: None

ECS 111, 4 credits

This course is designed to provide an opportunity for all newly-enrolled Master's students to develop a foundational understanding of critical issues in health and health care today, especially as they relate to key aspects of the research and practice of TDI. The course will use lectures and a series
of case studies, discussed from both the public health and health care delivery perspectives, to provide grounding in issues that can be explored in depth during the rest of the academic year. Students will explore how to improve the health of a population, the boundaries and financing of the US health care system, and different methods used to analyze and present solutions to problems in health and health care.

Summer term; 4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: None

ECS 140B, 4 Credits

The epidemiology component of this course introduces the basic principles of epidemiology, including formulation of the research question, choice of study subjects, measures of disease frequency, assessment of exposure and disease status, study design (cross-sectional studies, prospective and retrospective cohort studies, case-control studies, and clinical trials), measures of association between exposure and disease (risk ratio and risk difference measures), measurement precision and accuracy, causal inference, use of statistical testing, and interval estimation in epidemiological studies.

The biostatistical topics in this course include introduction to the use of computers for statistical analysis, exploring and organizing data, vital rates and ratios, life tables, probability concepts, discrete and continuous probability distributions, populations and samples, nonparametric analysis, sampling distributions and statistical inference, statistical estimations, hypothesis testing, sample size and power, two-sample comparisons, analysis of variance and multiple comparisons, association and correlation, simple linear regression, multiple regression, multiple analysis of variance, analysis of covariance, logistic regression, and log-linear models.

Summer term ongoing through Fall term; 4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: None
 

ECS 117, 4 Credits

This course offers participants the opportunity to discover and preview the knowledge, methods, and skills necessary to effect the continual improvement of the quality and value of health care. Participants will be offered an opportunity to connect that knowledge, and those methods and skills, to their personal life and work. This course includes a significant amount of weekly pre-class preparation. Small group work is encouraged during the afternoon lab period.

Fall term; 4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: None

ECS 177, 2 Credits

 The overarching goal of this course, a series of three tutorial seminars taught during the academic year, is to provide a progressive roadmap for the student’s professional development in the evaluative clinical sciences. Specific goals are to assure acquisition, demonstration, and documentation of specific competencies in the evaluative clinical sciences and guide and support the completion of an academically robust, high quality culminating research proposal or paper.

Fall term; 2 credits; (HP, P, LP, NC)

Required for MS and PhD Students

Prerequisites: None

ECS 112, 3 Credits

This course is intended to 1) illustrate the applicability of management concepts and techniques to the health care and biotechnology industries; 2) enhance the ability of managers to serve as trustees of health care organizations; and 3) demonstrate how corporate managers can exercise judgment and control over expenditures for health care benefits while protecting the health of their employees. The characteristics and components of the health care system and their interactions and determinants will be analyzed. The history of corporate and governmental intervention in health care will be reviewed. The importance of understanding the medical market dynamics and the options for data-driven strategies for market reform will be stressed. Case examples will highlight the use of new analytic techniques for understanding and managing the medical markets.

Fall term; 3 credits; (HP, P, LP, NC).

Enrollment in this course is officially in the Fall term, although the course starts during the Late Summer term. This course is cross-listed with Tuck School of Business in their MBA program. It is limited to MS students in Health Care Leadership concentration.

Prerequisites: None
 

ECS 102 Part 2, 4 Credits

Part 2 of this course is dedicated to step-by-step instruction on conducting and communicating the findings of a systematic review. Students work in pairs or trios to hone a single research question, identify and critically appraise the peer-reviewed literature on the topic, use statistical analyses to interpret and summarize their findings, and present the work in both a poster session and a final manuscript. Each team submits multiple intermediate products (a revised proposal, data collection forms, draft methods, mock tables and figures, an abstract, and a draft paper) and is given numerous opportunities for peer and instructor feedback prior to presenting their poster and submitting their final manuscript.

Fall term; 4 credits; (HP, P, LP, NC)

Core Requirement for MPH and MS

Prerequisites: ECS 100

ECS 144, 3 Credits

This four-session seminar will focus on readings from the book, Tracking Medicine, by John E. (Jack) Wennberg. Wennberg reviews his and his colleagues' work on practice variations, beginning with small area variation in Vermont, extending through efforts to evaluate the reasons behind variation in surgical procedures, and concluding with the more recent work associated with overuse of supply sensitive care as described in the Dartmouth Atlas of Health Care. The course includes a section on current health policy as it relates to practice variation. The format of each session will include an initial lecture followed by small group discussions with a report back at the end of each afternoon.

Fall term; 3 credits, (HP, P, LP, NC);

Prerequisites: None
 

ECS 141, 6 Credits

The epidemiology component of this course introduces the basic principles of epidemiology, including formulation of the research question, choice of study subjects, measures of disease frequency, assessment of exposure and disease status, study design (cross-sectional studies, prospective and retrospective cohort studies, case-control studies, and clinical trials), measures of association between exposure and disease (risk ratio and risk difference measures), measurement precision and accuracy, causal inference, use of statistical testing, and interval estimation in epidemiological studies. Taught as lectures, seminars, and assigned exercises, this course stresses the practical applications of epidemiological techniques.

The biostatistical topics in this course include introduction to the use of computers for statistical analysis, exploring and organizing data, vital rates and ratios, life tables, probability concepts, discrete and continuous probability distributions, populations and samples, nonparametric analysis, sampling distributions and statistical inference, statistical estimations, hypothesis testing, sample size and power, two-sample comparisons, analysis of variance and multiple comparisons, association and correlation, simple linear regression, multiple regression, multiple analysis of variance, analysis of covariance, logistic regression, and log-linear models.

Winter term; 6 credits; (HP, P, LP, NC)

*Core Requirement for MS Clinical/Health Services concentration
Prerequisites: None

ECS 126, 4 Credits

This course explores the history and theory of statistical process control and its application to health care. Specific topics covered include: development of measures; data collection; graphical display of data; the theory and construction of control charts for means, proportions, counts and rare events; statistical testing with control charts; risk adjusted control charts. Benchmarking and an organizational approach to measurement and improvement are discussed. The course provides case studies and small group exercises in which applicable theories and principles may be applied. Lab exercises and a personal project are included.

Winter term; 4 credits; (HP, P, LP, NC)

Prerequisites: ECS 117, ECS 140 (preferred)

ECS 122, 4 Credits

This course introduces the basic skills needed to conduct and present survey research. It will focus on two aspects of such research: designing and administering a survey (primary data collection); and accessing, analyzing and reporting on data from publicly available national survey data (secondary data analysis). Topics covered will include survey design, sampling, validity, reliability, data collection, analysis, interpretation and reporting of results. To reinforce practical skills, the course will include weekly computer labs, research in progress sessions to critique draft survey instruments, and a journal club to critically read articles reporting survey results.

Winter term; 4 credits; (HP, P, LP, NC)

Prerequisites: ECS 140

ECS 178, 2 Credits

The overarching goal of this course, a series of three tutorial seminars taught during the academic year, is to provide a progressive roadmap for the student’s professional development in the evaluative clinical sciences. Specific goals are to assure acquisition, demonstration, and documentation of specific competencies in the evaluative clinical sciences and guide and support the completion of an academically robust, high quality culminating research proposal or paper.

Winter term; 2 credits; (HP, P, LP, NC)

Required for MS and PhD Students

Prerequisites: None

ECS 151, 4 Credits

The course is open to all students who meet the course prerequisites (ECS 140 and ECS 100) and is a required course for the MPH degree and for residents in the Dartmouth-Hitchcock Leadership Preventive Medicine Residency. This course seeks to engage students in the exploration of major
environmental/occupational health issues through application of epidemiologic methods and risk assessment. Through case studies and critical analysis of the literature, the relationship between environmental and occupational exposures and human disease will be examined with emphasis on risk communication, formation of public policy, and the role of regulatory agencies. Topics include air and water quality, hazardous waste, radiation, metals, environmental pathogens, and clinical occupational medicine. This course will be taught using lectures, guest experts, assigned
readings/exercises and field/site visits.

Winter term; 4 credits; (HP, P, LP, NC)

Required for MPH

Prerequisites: ECS 140

ECS 160 Part 1, 1 Credit

Part 1 of this course is designed to provide MPH students with exposure to the organizational framework of their respective internship agencies and the related research for their capstone project. Students are to examine the following areas relevant to their internship sites: 1) populations served
(and not served) by the agency, 2) the principal public health problem being addressed by the agency, 3) how program outputs and outcomes are defined, measured, and tracked, 4) who are the stakeholders and what are their respective roles, 5) where does financial support come from and how
are funds distributed, and 6) what federal and state laws, regulations, and policies are relevant to the work of the program.

Winter term; 1 credit (C, NC)

Required for MPH; Not available for MS, PhD, Post-doc or Special students

Prerequisites: ECS 100, 102, 111, 115, 117, 140, 151, 154, 156, 157, or consent of course director.

ECS 115, 4 Credits

Strategic and Financial Management of Health Care Institutions offers students the opportunity to learn about and practice strategic and financial management as those disciplines apply to health care institutions. By the end of the course, students will be able to understand financial accounting, cost accounting, financial analysis, financial strategy, organizational structure, strategic planning, environmental analysis, and marketing. Students will be able to apply financial techniques to strategic analysis of the health care environment, cost reduction in health care and to organizational decision making. The ability to apply that knowledge will be reinforced through projects, casework and homework problems. The course integrates textbooks, cases, and projects. The first half of the course focuses on financial analysis; the second half of the course focuses on strategy.

Winter term; 4 credits; (HP, P, LP, NC)

Required for MPH

Prerequisites: ECS 100; no economics preparation assumed

ECS 125, 2 Credits

This short course is aimed at helping students develop basic skills with commonly used non-numeric data. We will cover approaches to sound collection of data, and move through an actual data analysis process, finishing with written and visual communication of findings. The basic principles of qualitative research design and analysis using grounded theory will be covered. In addition, students will gain experience with interviewing and focus group facilitation, basic data analysis (by hand and with qualitative analysis software), and other relevant qualitative research skills.

Winter term; 2 credits; (HP, P, LP, NC)

Prerequisites: ECS 100
 

ECS 131, 2 Credits

Health care decisions are complicated – really complicated – and frequently lack evidence to determine a ‘one best’ course of treatment. As such, patient‐centered health communications increasingly are recognized as a critical means to facilitate health care decisions that provide patients with “the care they need, and no less; and the care they want and no more” (Al Mulley, The Dartmouth Center for Health Care Delivery Science).
The objectives of this short course are to 1) engage you to think broadly about the impact of communication at the patient, institutional, and population level; 2) to gain skills and experience related to the design and development of decision support tools and methods; 3) to understand the challenges involved in implementing decision support into practice at both at the institution and international level.

Winter term; 2 credits; (HP, P, LP, NC)

Prerequisites: None

ECS 113, 2 Credits

This five-week two-credit short course is intended to further students understanding of health policy and financing in the United States through study of the Patient Protection and Affordable Care Act (PPACA). Specific areas of study will include accountable care organizations, health information technology, employer and individual insurance mandates, comparative effectiveness research, and insurance expansions. Learning takes place through readings of selected manuscripts, lecture and discussion, and assignments.

Winter term; 2 credits; (HP, P, LP, NC)

Prerequisites: None

ECS 147, 6 Credits

This course will develop student analytic competencies to the level necessary to conceptualize, plan, carry out, and effectively communicate small research projects in patient care, epidemiology, or health services. Lectures, demonstrations, and labs will be used to integrate and extend methods introduced in other ECS courses. The course will also cover additional new analytic methods in epidemiology and health services. The students will use research datasets from the Medical Care Epidemiology Unit at TDI in classroom lab exercises and course assignments. Course topics will include risk adjustment, sampled data, multilevel analyses, instrumental variables, and small area analysis. Practical skill areas will include programming in STATA, studying datasets for completeness and quality, designing tables, and figures, and an introduction to geographic
information systems. The instructors will tutor students as they develop their own analytic projects. Students taking the course for two credits will complete a research project, including a manuscript draft.

Spring term; 6 credits; (HP, P, LP, NC)

Prerequisites: ECS 140, 141

Required for PhD

ECS 124, 6 Credits

This course creates an opportunity for students to study and apply the principles and concepts learned in ECS 117, The Continual Improvement of Health Care: An Overview, to the work of managing the health and value of health care for a defined population of patients. Participants will work in partnership with selected managed care settings throughout the United States. Specifically, this course will offer participants an opportunity to identify the processes involved in managing a panel of patients, learn the knowledge and skills providers need to manage panels and provide optimal patient care, identify approaches for taking costs out of the care while maintaining or
improving quality and enhancing customer satisfaction, understand the difference between the efforts for improvement of care at the front line and in the front office and how they may be related, and identify some of the barriers to making the health of a population better.

Spring term; 6 credits; (HP, P, LP, NC)

Prerequisites: ECS 117

ECS 155, 4 Credits

This course provides a broad introduction to medical geography, spatial epidemiology, and the principles and methods used in the disciplines. The course is divided into three parts. The first section introduces the importance of place in understanding disease and health and covers topics in spatial epidemiology and analysis of geographic data. The second section uses case studies to explore the geography of disease, including infectious diseases and diffusion models, small area studies, workforce issues, and chronic disease. The third section of the course covers several special topics including the challenges of using aggregate data, the built environment and neighborhood planning, and parcel-level analysis in relation to chronic disease and health promotion. Students will be introduced to geographic information systems software in two lab sessions. Learning takes place through readings of selected manuscripts, the geographic information systems lab, lecture and discussion, assignments, and completion of a term project.

Spring term; 4 credits; (HP, P, LP, NC)

Prerequisites: ECS 140

ECS 119**/121, 6**/4 Credits

 (Note: Practicum Course in either ECS 119 or ECS 147 is required.) This course, which covers the fundamental principles and mechanics of decision analysis and cost-effectiveness analysis, is offered in conjunction with ECS 121. Students in ECS 119 participate in the same weekly assignments and attend the same lectures as students in ECS 121, but students in ECS 119 complete an independent practicum project and paper instead of a small group project. Approval of a practicum project by the course instructors is required before a student can pre-register for ECS 119.

Spring term; 6 credits; (HP, P, LP, NC)

Prerequisites: ECS 100 and permission from instructor prior to pre-registration.

ECS 179, 2 Credits

The overarching goal of this course, a series of three capstone seminars taught during the academic year, is to provide a progressive roadmap for the student’s professional development in the evaluative clinical sciences. Specific goals are to assure acquisition, demonstration, and documentation of specific competencies in the evaluative clinical sciences and guide and support the completion of an academically robust, high quality culminating research proposal or paper.

Spring term; 2 credits (HP, P, LP, NC)

Prerequisites: None

ECS 162 Part 2, 4 Credits

The public health capstone project provides students with an opportunity to apply principles and skills learned in the classroom and in the field – through the measurement, organization, and improvement of public health care. The capstone project will include a written component with an abstract/summary and a full paper as well as an oral presentation. The capstone product will be of sufficient quality to meet standards required for submission of a peer-reviewed manuscript, a presentation at a professional meeting and/or a grant proposal ready for submission.

Spring term; 4 credits (HP, P, LP, NC)

Required for MPH students who do not have an approved capstone pathway by the end of the Winter term. Not available for MS, PhD, Post-doc or Special students.

Prerequisites: ECS 100, 102, 111, 115, 117, 140A and B, 144, 151, 154, 159, 160 or consent of course director.

ECS 127, 2 Credits

With medical errors causing up to 98,000 deaths each year in US hospitals, Patient Safety is a topic of great importance. This course will teach students the basic concepts and principles of patient safety, and will arm them with practical tools to improve Patient Safety in healthcare settings. Students will also learn about important resources on Patient Safety that will allow them to keep up to date with new emerging knowledge in Safety.

Spring term; 2 credits; (HP, P, LP, NC)

Prerequisites: ECS 117

ECS 107, 4 Credits

This is a course concerning prescription benefits, access, and utilization in the US. The class will study current prescription access and barriers and their impact on health and health costs in the US. The course will consider the interplay between prescription drug spending and overall health costs with attention to market issues including moral hazard, adverse selection, direct to consumer advertising, public policy, and the influence of insurance and information on patient/consumer preferences. Focusing largely on Medicaid and the new Medicare Part D drug benefit, the course will examine the theory and effects of formularies, cost-sharing, prior approval requirements and optimal prescription access. The course will conclude with a brief introduction to the research opportunities and obstacles created by prescription claims data.

Spring term; 4 credits; (HP, P, LP, NC)

Prerequisites: ECS 111 or permission of the instructor.

ECS 161, 4 Credits

The public health field internship provides students with an opportunity to apply principles and skills learned in the classroom - the measurement, organization, and improvement of public health care - to real situations in the field. A minimum of 120 hours is to be spent at the placement site during the winter and spring terms. Typically, this internship occurs in the final term of the year, but other arrangements are possible, typically for part-time students, with permission of the course director. Students who have completed their internships prepare and present an overview of their experience at the conclusion of the spring term and complete an exit appraisal of their experience and achievements.

Spring term; 4 credits (C, NC)

Required for MPH; Not available for MS, PhD, Post-doc or Special students.

Prerequisites: ECS 100, 102, 111, 115, 117, 140A and B, 144, 151, 154, 159, 160 or consent of course director.

ECS 130, 2 Credits

This highly interactive, short course is designed to give students an overview of health care ethics, including recognizing and responding to contemporary clinical, research, and organizational ethical conflicts in health care. The students will become familiar with the application of ethics principles to today’s health care ethics challenges faced by health care professionals. Through the discussion of case studies, students will build practical ethical reasoning skills and strategies for dealing with frequently encountered ethics issues, as well as approaches for anticipating and decreasing the presence of ethics conflicts. Students will also gain an understanding of the structure and function of a Hospital Ethics Committees and an Institutional Review Board/Committee for the Protection of Human Subjects. Emphasis throughout the short course will be on critical thinking, real-world application and ethical decision-making in a professional environment.  Two guest faculty, including Howard Brody, MD, PhD (Director, Institute for the Medical Humanities, Professor, Family Medicine, University of Texas, Galveston) will augment the primary faculty.

Late Summer term; 2 credits; (HP, P, LP, NC)

Prerequisites: None