The main focus of this course is to help participants acquire the necessary skills to teach quality improvement and patient safety to peers and trainees in their own practice setting. Participants will develop the ability to utilize a variety of different pedagogical approaches to teach quality improvement and patient safety, including large group interactive lecturing, facilitating small group discussions, case-based learning (including re-vamped patient safety M&M rounds), use of role play/video debrief, and experiential quality improvement projects.

Objectives: 1) Define key educational terms used in health professions education. 2) List the core patient safety and quality improvement competencies for all health professionals. 3) Apply 5 different teaching methods to teach patient safety and quality improvement. 4) Describe effective strategies to supervise others in their quality improvement work. 5) Create an educational plan that outlines the key components of a patient safety or quality improvement curriculum.

Efforts to improve patient safety have thus far fallen into two different but, not mutually exclusive categories: 1) a "safety science approach," drawing on lessons from other high risk industries to develop systems for reporting and learning from safety problems, recognizing the degree to which human errors are often facilitated by latent system problems, attention to human factors design principles affecting everything from equipment use to shift schedules and clinical environments, as well as the importance of teamwork, communication strategies, and organizational culture. 2) "evidence-based medicine approach": as with much clinical research, this approach targets common problems (in this case, harms caused by medical care as opposed to diseases), looks for interventions to prevent such complications (e.g., prophylaxis for venous thromboembolism, bundles for preventing central-line associated infections, bar-coding to prevent medication administration errors), assesses the evidence supporting these interventions and the degree to which effective implementation strategies also exist.

Beginning with a brief history of patient safety in health care, including high-profile cases and seminal studies that launched the widespread interest in patient safety, the course will cover key concepts and examples from both of the approaches to studying and reducing patient safety problems. The course will use examples of commonly discussed patient safety practices to convey the state of the evidence supporting the practices as well as key underlying concepts. For instance, the discussion of order sets and computerized decision support will include a review of what is known about their current effectiveness, but also include human factors concepts related to optimal order set design. Similarly, the discussion of checklists will include not just the evidence supporting their benefit (e.g., in peri-operative settings) but also the importance of attending to teamwork and communication issues that support successful implementation.

Objectives: 1) To describe the impetus for improving safety in health care. 2) To describe fundamental issues in human error and systems thinking related to improving patient safety. 3) To describe lessons from other high reliability organizations, including the importance teamwork and culture. 4) To analyze an evidence based approach to common health care safety problems. 5) To describe key elements of organizations that support safer care. 6) To analyze quantitative and qualitative measurement strategies in patient safety. 7) To identify strategies to gather patient perspectives to expand their role in supporting effective outcomes of care. 8) To describe and choose strategies to identify, analyze, and address patient safety issues.

This course will utilize some of the principles learned in Quality Improvements Methods course to illustrate patient safety issues (e.g., Analysis of Statistical Process Control charts).

This course will provide the learner with comprehensive working knowledge of Human Factors (HF) and how it relates to and affects health-care quality and safety. It focuses on key concepts and frameworks in HF research and practice and identifies how these can be applied to and tailored depending on the health-care issue. This knowledge is relevant to policy makers, practicing clinicians, health-care managers, and health services researchers.

The broad learning goal for the project course is to effectively apply principles, theories, and methods of improvement science to a workplace issue. More specifically, students will learn to exercise creative and critical thinking, analyze a process, model, or situation to determine where specific interventions should be targeted, determine if an intervention is even necessary, and determine whether desired outcomes have been achieved and to assess the impact and sustainability of the interventions The project course includes the fundamentals of project management, practical skills and tools for rigorous design and implementation of a QI project, statistical methods for QI, methods for critiquing the literature related to the interventions identified and skills for writing for publication, and what QI journals typically look for when reviewing articles. Students will learn to evaluate their projects from a broader perspective, assessing how an intervention fits within a broader health care context and how to design quality improvement projects to answer more complex questions. Instructional time will be embedded into each required course to cover the learning objectives that relate specifically to the project practicum and a session in each module will be dedicated to project development and discussion. For example, the Fall term courses will include instruction on literature reviews, research methods that are appropriate for quality improvement projects, discussion about research ethics, and project charters, reporting project progress to executive sponsors, development of indicators and measures. Students will meet regularly with their project mentors for guidance on their projects.

Objectives: 1) Identify theoretical concepts of improvement science relevant to their workplace projects. 2) Appraise and apply research methods that are appropriate for assessing the impact or implementation of their workplace projects. 3) Demonstrate effective communication skills in the presentation of the projects. 4) Identify the elements of an effective plan for communicating the project to the sponsoring organization. 5) Select and apply methods for assessing the literature related the workplace project that assesses the strength and weaknesses of the interventions proposed. 6) Develop the skills needed to write an article suitable for publication that describes the project.

The required project development course "thesis-based" option is a research project that students will focus on for the duration of their program to which they will apply principles and theories from the core curriculum. A key knowledge component of the curriculum is the bridge between theoretical knowledge and the application of theory to practice. In the "thesis-based" option students will be required to exercise essential creative and critical thinking, break down and apply theory rigorously study the impact and sustainability of a change concept, critique research methods appropriate for quality improvement, lead and communicate a quality improvement project, and learn the skills required to design studies to evaluate cause-effect relationships and test the changes. In this course, students will also learn the fundamentals of project management and skills for writing for publication. The thesis must be presented and defended at a departmental oral examination before a committee of at least two graduate faculty members (one from IHPME) in addition to the thesis supervisor(s).

Objectives: 1) Evaluate whether or not research ethics board (REB) approval is required for a project. 2) Explain what to include in the REB application. 3) Apply effective library search strategies and demonstrate an ability to search databases and cite sources. 4) Evaluate and critique the quality and safety literature related to a specific improvement issue in a specific environment. 5) Measure early on in a project, the relevant sample size considerations, and how measurement can help decide readiness for a more formal evaluation of improvement. 6) Select appropriate qualitative method to address specific quality improvement question. 7) Select appropriate interventional (experimental) or observational (qualitative, quantitative, or mixed methods) study designs to address specific research questions. 8) Use sound quantitative and/or qualitative evidence to defend or evaluate a health care quality improvement or safety projects. 9) Explain the theory behind qualitative analytic methods. 10) Choose appropriate strategies for analyzing and presenting qualitative and quantitative data. 11) Describe the considerations involved in rigorous qualitative and quantitative analysis. 12) Use appropriate analytical methods to clarify associations between variables and to delineate causal inferences. 13) Distinguish improvement science and planned experimentation objectives. 14) Distinguish parametric and nonparametric procedures. 15) Demonstrate skills in effective written communication. 16) Understand how to advance the QI/PS research agenda through a program that interconnects controlled and representative methodologies to contribute to theoretically sound evidence and practical applications.

The course will cover the knowledge domains of systems thinking and theories derived from social science, organizational theories, and psychology related to influencing transformational change and overcoming resistance to change at the clinical micro-system level and will cover a number of topic areas including: 1) A self-assessment of personal leadership skills. 2) Change management theories and application; overcoming resistance to change and modeling the environment for change. 3) Leadership strategies using cases and role playing exercises. 4) Distributive leadership for embedding and sustaining improvement and safety into practice at all levels. 5) Negotiation, coaching and conflict management. 6) Physician and other stakeholder engagement. 7) Strategic alignment of quality from the top and from the bottom. 8) Definition of knowledge translation and its application to quality improvement and safety.

Objectives: the overall course objective is to enhance individual leadership capacities and provide leadership tools for influencing organizational effectiveness around quality improvement and patient safety at the clinical microsystem level. Upon completion of this course it is expected that students will: 1) Demonstrate the integration of knowledge and application of different conceptual frameworks for basic leadership, change management, systems theories, and knowledge translation theories and competencies required to improve quality and enhance patient safety at the clinical microsystem level linked to organizational (meso) and system (macro) levels. 2) Describe their personal leadership style and explain how it relates to leading and managing change in health care at the clinical microsystem/team level. 3) Identify key leadership, change management (negotiation, coaching, and conflict management skills) and knowledge translation strategies for creating and sustaining practice/process change and innovation, including the senior leadership practices required to support and enable microsystem level improvement. 4) Understand strategic alignment of the quality and safety agenda with other key organizational priorities and initiatives. 5) Describe various strategies for engaging physicians and other stakeholders to improve quality improvement and patient safety. 6) Identify the characteristics of high-performing health care systems and judge the effectiveness of current systems in adopting and implementing these strategies.

This course focuses on understanding how health care organizations and broader health systems create and implement strategies to improve care. The course builds upon the quality knowledge, skills, and methods provided in the Leadership and Managing Change course, the Concepts and Strategies in Patient Safety course and Fundamentals course. In this course we shift focus from an emphasis on quality improvement and patient safety at a team or microsystem level to emphasize the key elements of organizations and broader health care systems needed to implement, spread, and sustain improvements in turbulent health care environments. What knowledge do leaders need to support improvement? What is the role of governing boards? What benefit and how can we include patients in the design of care processes and systems? How do electronic health records help to promote quality improvement and patient safety? Case studies, guest lectures, readings, discussions, and exercises will be use to identify key issues facing health care systems, strategies for addressing these issues and the factors that influence successful implantation of organizational and system-wide improvement efforts.

Objectives: 1) Analyze the critical skills and knowledge that leaders need to lead change in health care organizations. 2) Assess the strategies leaders use to create effective quality and patient safety strategies in organizations and broader systems. 3) Understand how organizations need to assess risk and deal with organizational failures. 4) Identify the strategies needed for effective governance of quality and patient safety and appraise their implementation in various settings. 5) Explain the impact that engaging patients can have on improvement strategies and assess the approaches used to engage patients in these efforts. 6) Appraise the role of electronic health records in large scale improvement. 7) Assess the role of quality councils, Ministries of Health and other support groups in monitoring and guiding system change. 8) Identify the characteristics of high performing health care systems and judge the effectiveness of current systems in adopting and implementing these strategies.

This course will cover a number of topic areas including: The risk management process (i.e., identification, assessment, mitigation), methods for identifying and ranking top clinical and other risks using data from a range of patient safety and risk management sources; Strategies for integrating organizational risk management, quality improvement and patient safety activities; Methods for identifying, managing, and investigating critical incidents, and for implementing and sustaining effective commendations for improvement; Principles and practices for disclosure of adverse events; Relevant legislation and regulations (e.g., the public hospital act, disclosure, apology, consent and capacity, etc.); The rationale and legal protection for quality assurance activities; The medical-legal claims process and the effect of claims on patient safety and quality; The role of professional colleges in ensuring quality care, and potential issue related to the systems approach to patient safety and implementation of a just culture; The role of the coroner in patient safety; The role of accreditation in ensuring quality and in influencing organizational priority setting in patient safety and quality. The course will include didactic pre-reading, lectures from leading experts, group discussion, and in-class simulations.

Objectives: 1) Identify and assess the range of clinical and non-clinical risks within a health care organization and apply a structured methodology to identify high priority risks requiring leadership and governance attention; 2) Recognize the linkage between risk management, quality improvement and patient safety functions and understand how they can be effectively integrated within an organization; 3) Categorize the multiple sources of risk management data (including incident reports, critical incident investigations, patient complaints, medical legal claims, M&M reviews, alerts, audits, etc.), and outline strategies to obtain actionable information from data mining efforts; 4) Recognize the significant laws and regulations which govern health care quality and safety; 5) Understand the unique relationship between physicians and hospitals and describe the important role of credentialing of health care professionals in ensuring quality care; 6) Formulate arguments both for and against the protection of quality assurance information in health care; 7) Understand the civil litigation process and factors which may contribute to an adverse event proceeding to a medical malpractice claim; 8) Describe the challenges associated with identifying and managing critical incidents and outline the elements of successful investigation and follow up; 9) Outline the rationale for disclosure of adverse events to patients, debate the evidence regarding the effect of disclosure on medical malpractice claims, and analyze and critique disclosure skills; 10) Understand the mandate and activities of the coroner's office, professional colleges, and accreditation, and debate their role in advancing health care quality and safety.

This is a 0.5 FCE course that comprises 120 hours in a work environment that is external to a student's usual work environment and takes place after the student successfully completes the required courses in the MSc QIPS concentration. The external practicum is intended to be a focused work experience with measurable student-initiated learning goals that are not only tailored to each student's learning needs, but also agreed to formally by a sponsoring organization and the IHPME MSc QIPS Program Director. Specifically, the external practicum provides students with unique opportunities to further develop their knowledge and leadership skills applied to quality improvement and patient safety. The practicum is structured so that students will receive supervision and support from experienced senior health services professionals and academic faculty.

Objectives: the overall objective of the external practicum is to broaden and consolidate the student's skills and knowledge in leading and supporting quality improvement and patient safety by allowing students to evaluate, test, and further develop their quality improvement and patient safety competencies in a practical setting. The focus of the practicum is on the student's individual learning goals. The student is thus required to reflect on their quality improvement and patient safety knowledge and leadership skills and identify areas for further development.

Health care remains a top policy priority in Canada and a key defining characteristic of Canadian identity. Under Canada's universal, publicly funded health insurance plan (Medicare), all Canadians have access to medically necessary hospital and doctor care regardless of the ability to pay. Yet, like health systems across the industrialized world, Canada's faces growing challenges. An aging and increasingly diverse population, global pandemics, emerging and more costly medical technologies and drugs, and rising public expectations about timely access to care, put additional demands on already stretched health care resources. The site of care is shifting as more care moves out of hospitals and into home and community. Individuals and communities are demanding a greater role in decision-making. There are increasing pressures to harmonize domestic health care policies with global "benchmarks." In spite of billions of new health care dollars, public concerns about wait times for non‐emergency care continue to fuel debate about health system sustainability and the need for private pay care options.

This course (and HAD5011H, its counterpart for students in the MSc and PhD research stream) is the first of two courses which develop and apply a policy analysis "tool kit" to critically analyze key issues and trends in Canada's health care system and health policy. Course sections examine the current state of health care in Canada, the public-private mix, the influence of powerful interest groups, and the determinants of health, paying particular attention to the ideas, interests, and institutions which have shaped the Canadian health care system in the past and which now shape its future. This graduate course is designed for health professionals and students of health policy who need to "make sense" of a rapidly changing and increasingly politicized health care environment in which "evidence" is often only one factor driving the pace and direction of change.

Objectives: upon successful completion of this course, students will be able to: 1) Identify major elements of Canada's health care system. 2) Explain current health policy issues and trends in Canada and internationally. 3) Apply a conceptual policy analysis tool kit to "make sense" of a volatile health policy environment. 4) Write short, concise briefing notes which synthesize academic articles, policy papers, and reports. as the basis for evaluating and recommending policy options. 5) Value the need for a policy analytic approach.

Learner competencies (competencies refer to the National Center for Healthcare Leadership Competency Model): analytical thinking; communication skills; information seeking; initiative; innovative thinking; self-confidence.

The Canadian health care system (Medicare) remains a top policy issue and a key-defining characteristic of Canadian identity. There continues to be strong public and political support for Medicare's guiding principles: universality, comprehensiveness, accessibility, public administration, and portability. Yet, as recent federal and provincial reports on health care have emphasized, Medicare faces tremendous challenges. An aging and increasingly diverse population, new diseases, new and more costly medical technologies, as well as changing values and expectations have generated rising and more complex demands. There is an increasing emphasis on community-based health promotion and social support in contrast to more traditional care in hospitals and institutional settings. Individuals and communities are demanding a greater role in decisions about their health and the use of scarce health resources at the same time as the pressures of globalization begin to constrain the capacity of governments to implement domestic policy solutions. In spite of billions of new health care dollars, public concerns about long waits for care in Canada continue to fuel debate about the "sustainability" of publicly funded health care and the need for commercial health care options. This course (and HAD5010H, its counterpart for students in the professional stream) is the first of two courses which develop and apply a policy analysis "tool kit" to critically analyze key issues and trends in Canada's health care system and health policy. Course sections examine the current state of health care in Canada, the public-private mix, the influence of powerful interest groups, and the shift toward home and community care, paying particular attention to the ideas, interests, and institutions which have shaped the Canadian health care system in the past and continue to shape its future. HAD 5010H/5011H is designed for health professionals and students of health policy who need to "make sense" of a rapidly changing and increasingly politicized health care environment in which "evidence" is often only one, but rarely the most important factor driving change. This course is directed towards students in research streams (MSc/PhD) who must demonstrate strong analytical skills and a more developed mastery of the research literature.

Objectives: this course has two purposes: 1) introduce students to some key content about current trends and issues in Canada's health care system and health policy; and 2) develop analytic tools for critically analyzing them. By bringing together students, tutors, and faculty from a range of different disciplines and backgrounds, the course also aims to increase understanding and awareness of the range of interests, ideas, and approaches, which shape ongoing health policy debates. This course develops analytic tools for critically analyzing current trends and issues in Canada's health care system and health policy. Upon successful completion of this course, you should be able to: 1) Identify and discuss major elements of Canada’s health care system. 2) Describe key issues and trends in health care delivery and health policy. 3) Demonstrate a developed understanding of basic tools for policy analysis. 4) Apply these tools to analyze critically current issues and trends in Canada's health care system.

The study and practice of patient and caregiver engagement in research are growing across the globe. Engagement of patients and caregivers (i.e., including family), in research is encouraged broadly by patient groups and advocates, government and other funding programs, and researchers keen to enhance relevance and application/uptake over the course of their work. There are many approaches and methods relevant to the different stages of the research cycle. These methods have been used in various domains of research and quality improvement initiatives to address challenges in clinical care, the organization and delivery of health care, as well as at the population health level, and in health policy. Evaluation in patient and caregiver engagement is also growing and there are multiple tools available to assess perceptions and experiences of engagement from the perspectives of researchers, patients, and caregivers.

In this course the student(s) will learn and critique: underlying theories and frameworks that have influenced this phenomenon; emerging definitions of partnership and engagement; the predominant methods for engagement; their application in different settings and types of problems; and efforts in evaluation. The aim of this course is to provide exposure to the breadth of the current knowledge and approaches in researcher-patient partnerships, as well as an understanding of strategies to overcoming the challenges and pitfalls associated with this work so that its true value and impact can be realized. As a growing body of evidence suggests, patient and caregiver engagement in research is an important skill set and contributes toward a higher quality and better functioning health care system.

Objectives: upon completion of this course you will be able to: 1) Analyze and evaluate the underlying theories, trends and frameworks that contributed to the emergence of patient and caregiver engagement in research as a valued approach, area of study and area of expertise. 2) Understand current definitions and meanings of key terms (e.g., patient and caregiver engagement, patient-oriented research, etc.). 3) Examine selected methods adopted by research teams and patient and caregiver groups to engage patients and caregivers across the research cycle, and the types of settings and/or problems within health care where these approaches are applied. 4) Evaluate the benefits and challenges of engagement from different perspectives and strategies to address these challenges. 5) Identify available tools and resources to support the evaluation of actual/perceived value, impact and implications of engagement — from different perspectives (e.g., researcher, patient or caregiver, policy maker, or research funder). 6) Apply patient and caregiver engagement concepts to a research topic of choice.

The purpose of this seminar is to provide doctoral students with an understanding of the fundamental constructs of emotions and ethics within the organizational context. Drawing on literature in psychology, social psychology and organizational behaviour, this course will focus on the functioning of human affect and behavioural ethics, how these two domains can mutually influence each other and how they can be harnessed to inform our understanding of individual and group behaviour within the workplace. The course is designed to provide an overview and introduction to these literatures and an understanding of their central concepts. The intention for this course is to provide students with the knowledge to integrate approaches and insights from the emotions and ethics literatures to their own research agendas.

Objectives: 1) To gain knowledge of the dominant theories of affect and (un)ethical behavior as they pertain to both individual and organizational functioning. 2) To understand the cognitive and affective processes through which unethical attitudes, behaviours, and decisions permeate an organization. 3) To utilize concepts and theories of affect and ethics to create viable research questions that provide insight into questions faced by individuals and organizations working in the health services sector.

In this course, students will have an opportunity to apply their foundational understanding of Canadian health policy in two ways: to analyze complex policy issues and to have direct impact on policy-making process.

Health technologies (drugs, devices, diagnostics, information and communication systems, surgical interventions, etc.) have complex roles in health systems with the potential to improve health outcomes and quality of life and to support change in service delivery for more effective, sustainable and person-centred care. But though real, this potential is often not realized due to the partial alignment between R&D interests and public health needs, as well as cost or access issues, evidence limitations, the risk that technologies will prove ineffective or harmful and challenges of misuse, overuse or underuse. Adding to these challenges for health policy and health systems are the broader roles of technologies within political economies and public policy. Governments play significant roles in the development of health technologies, sometimes advancing policies that are in conflict with the aims of population health or health equity, but which may be seen to align with the aims of science, industry or trade policy. As well, there is increased policy attention to the role of health systems as generators of both "health" and "wealth" with the latter aim served by health system support for research and development as well as the adoption and use of novel products and services. Whether and how this "double promise" can be realized, and whose health and wealth will be enhanced, remains politically contentious.

The aim of this course is to explore these complex contexts. Specifically, we look at the developmental and regulatory institutions through which public policy seeks to shape health technology development, adoption and dissemination and we consider the health and innovation systems within which these institutions operate. As well, we consider the underlying interests and ideas that shape the operation and effect of these institutions and systems. Throughout, we consider the implications of these policies, systems, institutions, interests, and ideas for the meaning of population health and its equitable distribution (i.e., health equity).

Objectives: 1) To understand the role of health technologies within health systems and political economies. 2) To learn about institutions in Canada and internationally that have particular relevance to the development and dissemination of health technologies. 3) To support critical and reflective thinking and writing about key course concepts: health technologies, policies, systems, institutions, ideas, interests, population health, and health equity.

To introduce principles of epidemiology as applied to clinical research, emphasizing diagnosis, prognosis, treatment, the measurement of signs and symptoms of health and disease, and the evaluation of diagnostic, treatment and compliance-improving maneuvers.

Objectives: 1) To introduce the clinical epidemiology program and the courses offered; 2) To develop an approach for addressing health research questions using appropriate research methods; 3) To introduce the types of research designs used in clinical and epidemiologic research, including those using primary and secondary sources of data; 4) To understand the threats to the validity of different study designs, and to become familiar with the methods used to enhance the validity of clinical research; 5) To be able to critically appraise a biomedical research article; 6) To be able to write a clinical research protocol.

The ultimate goal of good measurement is to generate a numeric score that has meaning so that we can use it to represent a given concept (depression, health, disease activity) in our statistical analyses in a given population. Measurement is like the "basic science" of clinical epidemiology and impact on our measurement of causal, prognostic and outcome variables. The purpose of this course is to learn principles of measurement (good scale development, clinical usefulness, validity, and reliability) so that they can be applied to the critical appraisal of a given instrument when a measurement need is defined.

In this course we will help you define a particular measurement need — what do you need to measure, in whom, and why? — and from that move to the appraisal of a scale of your choice to see if it would be appropriate for that application. Students taking this course will focus on measures that are based on expertise, clinical judgment, experience, or the subjective perceptions of either the providers or consumers of health care. These might include clinimetric indices which are aggregated scores across various domains — such as disease activity indices, or prognostic indices; or more psychometric scales where there are multiple items to tap a single concept like depression, health, performance, or function. Measures that are single items, or which are uncontested or irrefutable gold standards of truth would not be good selections for work in this course. The classes are split into two: lecture (instructors or guest lecturer) and student-led presentations/seminars. Tutorials are offered in the hour preceding the course on certain topics.

Objectives: The students will work through the principles of measurement, and at each stage reflect on this for their chosen measurement instrument and need. The assignment is best done as the course progresses. By the end of the course, students are to apply measurement principles and methods in the critical assessment and development of measures employed in clinical and epidemiological research. Many of our students have published their final assignments.

Students are provided with weekly readings from textbooks and from the original literature. Each session consists of a one-hour didactic lecture providing an overview of the subject matter of the particular week's topic followed by a small group tutorial during which time students will develop their protocols with the assistance of tutors. Students are expected to develop their own controlled clinical trial proposal throughout the term. These proposals will serve as the focal points for the discussions during the tutorial sessions. At the completion of the course students will have completed a fully developed proposal which will be presented at an oral presentation and submitted as a final protocol.

Objectives: this introductory course is designed to provide the student with necessary background and tools for the design and conduct of a 2-arm parallel group controlled clinical trials. It is geared for the individual who wishes to pursue a career as an independent investigator and clinical trialist but will be of interest in others who wish to be involved in clinical trial in other capacities. Students should prepare for the course by developing a research question that can be addressed using randomized controlled trial design and starting their literature review. Students are encouraged to design a 2-arm parallel group superiority trial; students should contact the course instructors if considering a different design. As this is an introductory course, students seeking advanced design may consider HAD5313H Advanced Design and Analysis Issues in Clinical Trials after its completion. In order to assist the coordinators in assigning small group tutorials, please inform the Tutorial Assistant of your clinical specialty.

This course will provide an introduction to the principles and applications of decision sciences as they relate to clinical decision-making. The major themes will be a method of evaluating diagnostic and therapeutic strategies in order to optimize individualized patient care and inform policy decision, including those in which a fixed amount of resources are an important consideration. The basic building blocks of decision analysis (Bayes theorem, test and test-treatment thresholds, tree building, utility measurement, Markov processes and cost-effectiveness) will be reviewed and synthesised. Students will use decision analysis software to build and test their own decision analyses.

Objectives: 1) To learn the principles of decision analysis. 2) To learn how to use decision analysis software. 3) To perform a decision analysis by developing a model, gathering the relevant data, and performing complete sensitivity analyses. 4) To learn how to present a decision analysis orally and in writing.

Each student will select a guideline topic applicable to their field and apply principles learned during seminars to the development of the guideline. During the latter part of the course, participants will present their guideline to classmates to experience the consensus development phase of the course.

Objectives: 1) To understand the characteristics of high-quality guidelines. 2) To be able to develop an analytic framework to guide evidence extraction and synthesis. 3) To discuss criteria for grading quality of evidence with respect to diagnostic tests and interventions. 4) To understand strength of recommendations. 5)To develop skills in forming recommendations based on strength of evidence.

An introduction to research methods for evaluating the outcomes and effectiveness of health care services using secondary data (with an emphasis on administrative databases). These methodologies are used to answer questions about which treatments, services, and policies are effective when applied to whole populations in real practice and policy settings. In this course students will learn not only about the use of secondary data for research purposes, but also how to apply and think about these research findings in the context of the current health care system. This will include the strengths and weaknesses of secondary databases, data accuracy, bias and risk adjustment, study design, and a variety of analytical tools. The course will have a strong focus on sources of secondary data available in Ontario.

This course is intended for students using health administrative data (or other secondary data source) as a component of their thesis as the course evaluations focus on methodological components of developing part of each student’s thesis protocol. Auditing the course may be preferred for students who are not using health administrative data (or other secondary data sources) for their research project. Auditing students have access to all course content and lectures but do not participate in weekly tutorial sessions. Tutorial sessions are restricted to students enrolled in the course and provide students with one-on-one assistance from tutorial leaders that focus on students individually developing their research protocol using health administrative data.

Objectives: 1) To recognize the diversity of research questions, data sources and methodologies that are applied in health services research using secondary data. 2) To identify key study design and analysis considerations when using secondary data sources for health services research. 3) To understand the importance of a critical appraisal approach in reviewing and interpreting health services research. 4) To develop basic skills and knowledge for carrying out health services research with secondary data: a. develop a research question for a health care issue, b. assess data validity, c. select an appropriate study design, and d. plan appropriate statistical analyses. 5) To further develop written and oral communication skills for use in planning, reviewing and disseminating health services research.

This course is designed to give clinical epidemiology students' knowledge and skills in statistical methods that apply to clinical epidemiology. Students will acquire working experience in applying these methods to datasets, analysing epidemiological data, and interpreting findings. As well, students will develop statistical writing skills and learn how to present results to assist them with future research publications.

For each statistical method, this course will be focused in teaching: "what is it" and "how to do it." Topics covered in this course include: data types, measures of central tendency, measures of variability, testing for the difference between two groups (analysis of means, rates, and proportions), constructing 95% confidence intervals, nonparametric analyses sample size and study power estimation, testing for trend, analysis of variance, analysis of covariance, simple and multiple linear regression, logistic regression, survival analysis-life table and Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models. The final part of the course focuses on how to build a good multivariable model by assessing details such as the number of variables allowed and statistical fit. Computing is also part of this course. Knowledge in SAS or other equivalent statistical packages (such as SPSS, STATA, MINITAB etc.) is a prerequisite of the course. Students are recommended to get training in a statistical packages (SAS) prior to taking this course.

Objectives: 1) To learn about data types, measures of central tendency, 95% confidence intervals, measures of variability, and both parametric and nonparametric tests of differences between two groups. 2) To learn how to compare three or more groups using tests such as analysis of variance and analysis of co-variance. 3) To learn how to calculate sample size and statistical power for a study. 4) To carry out multiple linear regression, logistic regression, and survival analysis. 5) How to build a good multivariable model by assessing details such as the number of variables allowed and statistical fit. 6) To use SAS statistical package for data analysis.

This course is designed to teach health care professionals, who have some background in critical appraisal of the literature and study design, how to systematically review evidence related to interventions, diagnostic tests, prognosis, or prevalence. The course will also cover statistical techniques for meta-analysis.

Students will select a research question for their systematic review. They will be evaluated on submission of a review protocol and final paper describing their completed systematic review and meta-analysis, in addition to presentations and class participation. It is expected that students will eventually publish their reviews in a peer-reviewed journal or the Cochrane Library.

Before the first session, it is highly recommended that students develop a systematic review title and question (using the PICO format, or other format as appropriate for the question). In addition, it is recommended to conduct a preliminary literature search (MEDLINE, EMBASE, Cochrane Library, PROSPERO) to identify any protocols or reviews that might overlap with your topic, and to verify that sufficient primary literature exists to make your proposed review feasible.

Objectives: The primary objective is for the student to conduct a systematic review and meta-analysis that will be acceptable for publication in a peer-reviewed journal or as a Cochrane review. A secondary objective is to develop scientific writing skills.

This course covers conceptual, design, and methodological issues related to research using observational methods. Prerequisites include an understanding of basic research design and statistics including regression techniques. Knowledge and experience with clinical patient care as well as familiarity with existing data sources are an asset but are not prerequisites for the course. The format of the course includes lectures, group discussions, and class presentations along with individual feedback and mentoring sessions with the instructors. The 12-session course is divided into three different blocks. The first four sessions will deal with conceptual and theoretical issues related to causality and bias in observational research. The next three sessions will deal with design issues in observational research. The final five sessions will address specific methodological topics in observational research.

Objectives: 1) To provide the students with an overview of current conceptual and theoretical issues related to causality and bias in observational research. Performance expectation: at the end of the course the students should understand theories of causality and be able to apply those theories and ideas to their research. 2) To provide the students with an overview of the design options for observational research. Performance expectation: at the end of the course the students will understand the available design options and be able to assess observational study designs and to conduct research using different designs. 3) To provide students with an overview of current topics in key methods used in observational research. Performance expectation: at the end of the course the students will understand different methods that can be used in observational research and will be able to assess the methods used in observational research and conduct research using different methods.

Each session will be devoted to common issues or concerns that arise during the conduct of an RCT. You will be expected to consider each issue in the context of your own clinical trial and to develop a written strategy to address the issue. You should be prepared to discuss the strategies you developed at each session. Individual strategies can be developed by review of the pertinent published literature (a list of suggested references accompanies the assignments for each session), as well as relying on your own RCT experiences. Each session related strategy should be no more than one page in length. Course coordinators will collect the assignments on two occasions: mid term and at the end of the course. These assignments will be used, in combination with your class participation, for your evaluation. Sessions will be moderated by one of the two course coordinators and a content expert. In addition, one student will be responsible for moderating each session. The responsibility of the moderator is to encourage discussion among your colleagues.

Comprehensives component: A methodologic topic will be chosen by the PhD student together with her/his supervisor and committee members. An appropriate reading list will be developed by the student, and approved by the supervisor/committee. The student will be expected to conduct a thorough review of the literature on the chosen topic, and prepare a summary of the material (10 pages, written, single spaced — ideally appropriate for publication in a peer-review journal). The summary will be presented orally by the student to her/his supervisor/committee (20-minute presentation, similar to a thesis defense) followed by a 30- to 40-minute question-and-answer period during which the supervisor/committee will determine whether the student has a clear understanding of the material presented, and has developed a degree of expertise in the area.

Synthesis component: PhD students will attend four 1/2 day seminars, for a total of 16 hours. Each seminar will be led by a recognized leader in the field of clinical epidemiology, who will focus the discussion on the history and philosophy of the area of research of focus within clinical epidemiology, and/or perform informal "mentoring" of the students about developing a successful clinical research career.

Objectives: our expectation of a successful PhD in clinical epidemiology is that she/he will have sufficient breadth and depth of knowledge in their chosen field of clinical research — sufficient to be considered an expert in this field. This implies a thorough understanding not only of the research methods (which is the focus of the majority of the PhD coursework), but also of the theoretical underpinnings of these methods. The intent is for the Comprehensives/Synthesis course outlined here to ensure the latter. In addition, through the Synthesis component, we hope the students will have a good understanding of the history/evolution, and philosophical principles underlying, the field of clinical epidemiology.

This course will overview the principles and applications of decision analytic modeling for the purposes of developing clinical policy (e.g., what's the optimal screening method and interval for cervical cancer screening) and evaluating the efficiency (cost effectiveness/cost utility) of health interventions. The course will involve both theoretical and practical aspects. Students will have an opportunity to read more deeply in the history and theoretical underpinnings of decision analysis. However, students will also be expected to learn practical skills in advanced modeling by constructing, debugging, and presenting their own complex decision model. Themes covered in the course will include: a brief history of decision analysis, descriptive and normative theories of decision making, measuring health outcomes with patient-derived and community weighted utility measures, using the QALY and its competitors, Markov modeling, Monte Carlo simulation, using mathematical functions in models, modeling for cost effectiveness analysis, and an introduction to Bayesian approaches in modeling.

Objectives: Understand the theoretical assumptions used in decision modeling. Develop advanced practical modeling skills.

This course will overview issues identified by students conducting clinical trials. It is expected that this course will meet the individual needs of enrolled students.

Objectives: 1) To identify individual needs of students conducting clinical trials. 2) To discuss certain topics such as: cluster randomization designs, cross-over designs, n-of-1 designs, group sequential and other adaptive designs, cost-effectiveness clinical trials, issues in sample size development, Bayesian trials, safety monitoring and interim analysis, composite endpoints, subgroup analysis. 3) To identify readings related to this topic. 4) To present the readings in a seminar format.