Curry International Tuberculosis Center
Tailored TB Training Program
2017 Application
The Tailored TB Training (TTT) program is Curry Center’s effort to bring customized tuberculosis training to nurses, physicians, and allied healthcare workers working in the field throughout the western region of the United State. These trainings can be 4-8 hours in length, and the topic areas will be jointly determined by the hosting jurisdiction and CITC staff. Partnership with local faculty is encouraged, particularly for full-day trainings. We are now accepting applications from jurisdictions within our Western Region service area for a limited number of Tailored TB Trainings to be scheduled in 2017.
Role of the hosting jurisdiction:
· Assist in determining training topics/agenda, based on local needs determined by needs
assessment activities
· Identify local staff to assist in the planning
· Assist in recruitment of local TB program staff and/or content experts to serve as faculty
· Identify and secure site where training will take place
· Market and publicize training to target audience
· Provide A/V and other technical support
· If possible, provide coffee and/or refreshments on day of training
Role of Curry International Tuberculosis Center:
· Coordinate and facilitate planning the training
· Assist in development of training agenda
· Assist in needs assessment activities to help determine agenda
· Create brochure (electronic and/or hard copy) to market training to appropriate learners
· Manage registration of participants
· Provide access to the materials developed for the training
· Provide a CITC faculty/trainer and assist in securing local faculty, as needed
· Provide continuing nursing education contact hours (and certificates) and/or continuing medical education contact hours (and certificates) for all eligible participants
· Evaluate training and provide summary of feedback to hosting jurisdiction
To apply:
1. Use the application form to provide a written statement indicating why you are interested in hosting a Tailored TB Training in your jurisdiction.
2. Include background information/data on TB training needs of the target audience in your locale.
3. Identify specific topic(s) of interest (e.g., case management, identification and treatment of latent TB infection, TB outbreak management, etc.) and local faculty/trainers who may be willing to serve as faculty for the training.
4. Provide several possible training dates (month/year) that would work for you.
5. All applications will be reviewed by CITC’s Health Education Committee. Applicants will be informed of their application status within 1 month of submitting their application.
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Name: ______Credentials: ______
Position/Title: ______
Institution: ______
Street Address: ______
City: ______State: ______Zip Code: ______
E-Mail: ______
Work phone: ______Cell (optional): ______
The best way to contact me is by:
o E-Mail o Work Phone o Cell Phone
Please indicate why you are interested in hosting a Tailored TB Training in your jurisdiction. ______
What are the specific TB training needs in your locale? How were they assessed?
______
Who is the target audience for this training?
______
Please provide any comments or questions you have for us regarding the Tailored TB Training.
______
______
What are your preferred date(s) to host a Tailored TB Training?
1st choice: ______
2nd choice: ______
3rd choice: ______
Length of training (minimum of 4 hours to maximum 1 day): ______
Select from the following TB topic areas, the three topics areas of greatest interest to your target audience (with 1 being area of most interest).
______Case management
______Contact investigation/interviewing
______Radiology
______Program management
______Program evaluation
______Infection control; preventing TB transmission
______Identification and management of latent TB infection (LTBI)
______Medical management of tuberculosis
______Management of drug-resistant tuberculosis
______Quality assurance methods for TB control/Cohort review
______Patient education and counseling
______Tuberculin skin testing/IGRAs
______Cultural sensitivity
______Other topic (please specify) ______
Please list any local colleagues that may be available and willing to assist with planning and/or delivering the TTT:
______
Please add any other comments that may be helpful for us as we plan these trainings:
______
______
Applicant’s signature: ______Date: ______
Please return the completed form to:
Tailored TB Training
Curry International Tuberculosis Center, UCSF
300 Frank H. Ogawa Plaza, Suite 520
Oakland, CA 94612-2037
E-Mail:
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