Strengthening field epidemiology capacity in Canada: a mixed-methods evaluation of the Canadian field epidemiology...

Field epidemiology training programs (FETPs) play a critical role in strengthening public health capacity for surveillance, outbreak investigation, and evidence-based decision making. The Canadian Field Epidemiology Program (CFEP), established in 1975, was the first program outside of the United States. This study presents findings from a mixed-methods evaluation examining program outputs, outcomes, and impacts.

Canadian field epidemiology program was evaluated using a theory-based mixed-methods study design. An online survey was administered to all CFEP graduates completing the program from 2018 to 2023. Semi-structured interviews were conducted with graduates, placement site supervisors, and current managers. Quantitative and qualitative data were analyzed and integrated through triangulation.

The online survey was completed by 24 (69%) CFEP graduates and interviews were conducted with 22 graduates, 15 placement site supervisors, and 13 current managers. Graduates developed and applied technical and non-technical skills across all six CFEP competency domains. Most trainees (91%, n = 20) evaluated, enhanced, or implemented a surveillance system; after graduation, 84% (n = 16) continued to be involved in surveillance activities. Trainees investigated 145 outbreak investigations, while graduates investigated 48 outbreaks. Trainees and graduates introduced innovations in data management and analysis to support evidence-based decision making. Most graduates (75%, n = 18) were employed as epidemiologists after CFEP, primarily at the federal level, with a majority (54%, n = 13) progressing to supervisory or management roles. Placement site supervisors and current managers emphasized the contributions of CFEP graduates to strengthening disease surveillance and outbreak response systems, improving data analysis processes, and sharing field epidemiology skills with the broader workforce. Trainees were noted for introducing new analytical tools and approaches, including the use of R and advanced data visualization.

CFEP made a substantial contribution to Canada's public health workforce by developing skilled field epidemiologists who applied their skills to strengthen disease surveillance, outbreak response and evidence-based decision making. Expanding mobilization opportunities, formalizing alumni networks, and providing ongoing professional development opportunities would further strengthen field epidemiology competencies and amplify program impact.