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No. 3, 2011

COMMUNICATIONS, EDUCATION, AND BEHAVIORAL STUDIES BRANCH UPDATE

Revised and Updated Core Curriculum on Tuberculosis: What the Clinician Should Know

Background
For the U.S. to reach the goal of TB elimination, clinicians and other public health professionals must have access to current TB control and prevention information. To help address this need, the Core Curriculum on Tuberculosis: What the Clinician Should Know (Core Curriculum) was originally developed in 1989. Last updated in 2000, the Core Curriculum required updating to reflect new guidelines for TB prevention, treatment, testing, diagnosis, and patient management and public health practice. A multiphased, systematic process was utilized for this update.

Beginning in 2007, a needs assessment was conducted with TB experts from several state and local TB agencies who provided guidance on how to improve the Core Curriculum. This was followed by an extensive update of the Core Curriculum content using the latest CDC guidelines for TB prevention, treatment, testing, diagnosis, patient management, and public health practice.  The topic layout, formatting, and study question design were revised by an instructional design expert. TB subject matter experts from CDC and state and local TB agencies reviewed the updated materials for scientific accuracy.

Two-Phase Pilot Test with Target Audience
A two-phase pilot test was conducted with the target audience to evaluate the accuracy and clarity of the content and the effectiveness of the instructional design. The target audience included a small (5-person) focus group facilitated by CDC and a larger (64-person) national group who completed the pilot test on their own.

Pilot Test Phase 1 – Focus Group
We recruited five health professionals with varied TB training and experience from Atlanta, Georgia. The pilot test was conducted over 2.5 days in a controlled classroom setting. The participants worked continuously through the pilot test materials at their own pace and participated in group discussions. Evaluators observed participants working through materials, facilitated discussions, and administered pretests and posttests.

Participants from Phase I pilot test discussing materials.

Participants from Phase I pilot test discussing materials.

Pilot Test Phase 2 – Nationwide Group
We then recruited 64 clinicians and other public health professionals with varied TB training and experience from several state, local, and island jurisdictions. The pilot test materials were sent to each participant, and the pilot test was conducted over a 1-month period in realistic conditions at each participant’s work or home.  Participants worked through the materials at their own pace and returned the completed materials to CDC.

Results
Clinicians and other public health professionals participating in the pilot test gained an increase in TB knowledge as demonstrated by pretest and posttest scores. Additional results are indicated below.

Increase in Pretest and Posttest Knowledge Scores

Pilot Test Group % Increase

Phase 1 – Focus Group

11.5% increase in score

Phase 2 – Nationwide Group

13.4% increase in score

Selected Pilot Test Objective Evaluation Results

Evaluation Questions

% Answer

Does the Core Curriculum meet the stated objectives?

100%: Yes

How do you rate the level of the content for the target audience (doctors, nurses, and other health care staff)?

90.5%: Just right

Overall, how confident are you that the target audience can learn about TB after having worked through the Core Curriculum?

95.3%: Confident

Summary of Comments from Reviewers and Pilot Test Participants: The content was clear, easy to understand, in-depth, and relevant to public health; the writing was clear, easy to follow, concise, and to the point; the study questions reinforce material, are challenging, create interactivity; the tables clarify content. Comments on the educational aspect: Fantastic resource, comprehensive. General comment: Excellent work.

Target Audience
The Core Curriculum is intended for clinicians and other public health professionals who care for persons with or at high risk for TB disease or infection.

Sections of the 2011 Core Curriculum
The Core Curriculum can be used as a self-study guide or reference manual and includes the following sections:

Introduction to the Core Curriculum 
Chapter 1:  Overview of TB Epidemiology in the United States
Chapter 2:  Transmission and Pathogenesis of TB
Chapter 3:  Testing for TB Infection and Disease
Chapter 4:  Diagnosis of TB Disease
Chapter 5:  Treatment for Latent TB Infection
Chapter 6:  Treatment of TB Disease
Chapter 7:  TB Infection Control
Chapter 8:  Community TB Control

The manual also includes a glossary, answers to the study questions, and copies of the PowerPoint slide set that accompanies the Core Curriculum.

To view the Core Curriculum, please visit the CDC website.

To view or download the Core Curriculum slide set, please visit the CDC website.

Continuing education (CE) credits are offered free of charge for various professions.

Print copies of the Core Curriculum will be available for ordering by the end of October.

—Reported by Cheryl Tryon and Peri Hopkins
Div of TB Elimination

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