The goal of this proposal is to develop and implement comprehensive, interdisciplinary curricula on tuberculosis for health care providers in academic and community settings. We will first establish interdisciplinary curricula at a Health Sciences campus, train faculty to disseminate these curricula, and adapt the curricula for use in the community.
Our specific aims are: 1) Establishment of comprehensive, interdisciplinary tuberculosis curricula at a Health Sciences campus. The target audience will include physicians, physician assistants and nurses who care for most tuberculosis cases in urban areas, and primary care providers who evaluate most patients for tuberculosis infection. As part of this aim, we will use a Telemedicine system that allows transmission of high-quality images and interactive videoconferencing between faculty at a central location and trainees at geographically separate sites. The effectiveness of the tuberculosis curricula will be measured by: (1) objective tests of factual knowledge and clinical decision-making skills, using written tests and structured clinical examinations; (2) evaluation of changes in clinical practice patterns, using focused chart reviews. 2)Training Health Sciences faculty to provide instruction in tuberculosis. Faculty will be trained to disseminate the curricula developed in aim 1. Regularly scheduled forums will be established to provide ongoing education and discussion among trainees and faculty, and the quality of faculty teaching will be assessed and improved through evaluations by trainees, peers and experts. 3) Expansion of educational efforts to the community. Using the educational infrastructure of Tuberculosis Control of Los Angeles county, we will adapt the tuberculosis curricula developed in aim 1 for delivery to community health care providers, including those who work with populations in which special problems are encountered, including the homeless, immigrants, HIV-infected persons and inmates of correctional institutions. Computer-based interactive programs using CD-ROM technology and/or the Internet will be used for some target audiences. Supervisory physicians and nurses at Tuberculosis Control will be trained to disseminate these curricula. The efficacy of these curricula will be assessed by objective measures of clinical decision- making skills and clinical practice patterns.
