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Tuberculosis Education for School Nurses

Group Training

If a school district is in a location of high TB prevalence, it may be useful to do a group training program on TB. This can be valuable, since the school district most likely has a TB skin testing policy. School nurses in the district may also be asked to provide DOT in school. Again, the Tuberculosis School Nurse Handbook is a good resource for nurses to have for reference. In addition, discussed in this section are areas essential for a group training program, namely, the needs assessment, agenda setting, and evaluation.

The school nurse learning objectives for group training based on the materials provided for you in this manual are to:

  • Describe the transmission of TB
  • State the differences between latent TB infection and TB disease and the ways in which they are treated
  • Describe the process of administering a Mantoux tuberculin skin test and reading and interpreting its result
  • Define DOT
  • Resolve challenges in school-based directly observed therapy

All of the above topics are covered in the slides that you may download in Power Point® format as presentation materials or modify for you own specific needs.

Needs Assessment

Prior to conducting any type of training, it is important to assess the level of understanding of your audience. Training is most efficacious when it addresses topics at the learners’ existing level of knowledge. One way of doing this is by pre-testing the group on topics that will be addressed in the presentation. Based upon the average scores on the test you can judge how much time needs to be spent on certain topics. The sample pre-test, at the end of this resource, is based on the materials provided for presentation purposes. The test can be modified if you wish. For example, if you want to have a presentation on the local school district’s medication administration policies or tuberculin skin testing, you may want to include specific details on these topics in the test. To assist in your planning, you will find the sample pre-program needs assessment that can be used prior to a training program. Depending upon your time constraints, you will require at least one month to administer the test and assessment, receive responses back, and analyze them for preparation of your program.


Based on the results of your needs assessment via the pre-test and pre-program needs assessment, you can design an agenda for the training program. The topics covered and time devoted to each should depend on the results of your testing and questions. If for example, many nurses were unable to accurately answer the questions on skin testing, this topic should be heavily emphasized in the program.

The agenda should be discussed ahead of time and specific responsibilities assigned to the local health department representative and the school nurse supervisor. Depending upon how much time you have, you may adjust your training schedule accordingly. For an hour-long training, your agenda may follow this course for example:

Examples of an hour-long training:

30 minutes Fundamentals of TB for School Nurses presentation

20 minutes Role of the Health Department

  • Referrals from schools and follow-up treatment for TB infection & disease
  • Use of School Nurses to Provide DOT in Schools

10 minutes Questions and Answers

Should the local health department representative require some additional material for this presentation, (s)he may refer to the NJMS National Tuberculosis Center’s manual "Guidelines for Initiating a School-Based Directly Observed Therapy Program." You or your co-presenter may also consult the Centers for Disease Control and Prevention’s (CDC) "Self-Study Modules on Tuberculosis: Modules 1-5." The Modules contain comprehensive and concise information on TB. You may also refer to the Handbook’s "Frequently Asked Questions" on page 23 for further preparation for your group training.


After you have completed your group training, it is always important to obtain feedback on the training process. This may be accomplished in two ways — by post-testing and by written evaluation summary.

Post-Testing —Testing on material that is provided in the training can indicate whether or not the information that was to be conveyed was done appropriately. Since you have already administered a test prior to training, you may administer the same brief test after the training to see if the average scores on the tests increased or decreased, specifically looking at with which questions the nursing audience may have had ease or difficulty.

Written evaluation — Another method for judging the quality of a training program is the written evaluation, which is a subjective measure of how the participants viewed the training. The sample evaluation form that is found at the end of this resource can be used in its current form or modified. It covers how well the objectives of the program were addressed, the relevance of the program content, and the quality of the speaker(s).

The evaluation forms should be filled out by the training participants and then collected at the end of the program. You can summarize the forms by taking an average score of the answers given. The summary of these average scores will be useful to you for future training or educational development of the nurses with whom you work.

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