TST Training Curriculum

Curriculum for Training and Certifying Unlicensed Staff as TST Technicians

Table of Contents

Trainer's Guide

Download entire guide here (.zip)

Participant Workbook

Download entire guide here (.zip)

PowerPoint Presentations to Accompany the Curriculum

Download all presentation here (.zip)
(Session 5 is a practicum, so is not accompanied by a PowerPoint presentation.)

Download TST Training Curriculum (.zip file)

About This Curriculum

The Curriculum for Training and Certifying Unlicensed Staff as TST Technicians was developed by the Tuberculosis Control Branch of the California Department of Public Health (CDPH) in collaboration with the Francis J. Curry National Tuberculosis Center (CNTC). The curriculum has been approved by the California Tuberculosis Controllers Association (CTCA) for training and certifying unlicensed public health department staff as TST technicians.

The curriculum content conforms to the requirements of State of California Health and Safety Code .

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Curriculum Content

The Curriculum for Training and Certifying Unlicensed Staff as TST Technicians is divided into six sessions, each approximately four hours in length. The six sessions should be delivered sequentially. The sessions are:

Introduction to TB and TB Control - Part 1
Introduction to TB and TB Control - Part 2
Principles of TST - Part 1
Principles of TST - Part 2
Practicum: Placing and Measuring TST
Confidentiality, Professional Behavior, Using Interpreters, Final Review, and Next Steps

The curriculum features a Trainer's Guide and a Participant's Workbook for each session. Each Trainer's Guide contains instructions for trainers, timing guidelines, masters for overhead transparencies, and PowerPoint slides on a CD-ROM. EachParticipant's Workbook is a reproducible master that you can photocopy and distribute to the course participants.

Each session's content can be modified or supplemented as needed to incorporate a local program's specific data, policies, and procedures.

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How To Use This Curriculum

General overview

This curriculum was designed as a highly interactive educational process that allows participants to gain new knowledge and skills to help them become effective TST technicians. As the trainer, it is important for you to do everything you can to invite all individuals to participate as fully as possible. There are numerous small- and large-group activities interspersed among presentations by the trainers. Our hope is that this medley of training methods will meet the needs of all participants.

Each module is numbered, has a specific title, and accommodates different learning styles. Each begins with a brief overview of the session and lists the materials that are provided in the module, as well as those that the trainer needs to provide. It also provides reference information so that you can easily access it, if interested.

A list of learning objectives is the next component of each session introduction. It is important to review the objectives with the participants at the beginning of each session, as these provide the framework for the session. If time allows, also review the objectives at the end of the session and ask the participants whether they think the objectives were met.

Within each session, the curriculum developers have suggested an approximate amount of time that each section requires. This allows you to plan accordingly and to make decisions about when each session can be conducted.

All sessions include informal presentations to be conducted by the trainer(s). The Trainer's Guide provides an outline of the presentation and is also included in the Participant's Workbook. Included with the trainer's instructions for each session are references to overhead transparency masters and PowerPoint slides (available to users of this curriculum in December of 2004.) The overhead transparency masters can be photocopied onto acetate and used with an overhead projector. The PowerPoint slides can be used with an LCD projector and laptop computer. The use of visuals is recommended when conducting the sessions; not only does it help you, the trainer, stay on track, but visual aids also help the participants absorb the material.

If it is at all possible to divide the curriculum sessions among two or more trainers, we recommend that you consider the advantages of using a team approach to training. Participants benefit from the diverse skills and approaches that a team of trainers can bring to the learning experience. Trainers can learn from one another by watching how their colleagues present the material, and the burden of training responsibilities does not rest exclusively on one individual.

Preparing for the training session(s)

The Trainer's Guide for each session includes two lists of items needed to conduct the session: one list of items included in the guide and another that you, the trainer, will need to provide. It is recommended you also use a checklist to track logistical issues well in advance of training sessions. A sample checklist follows:


Person(s) responsible

Due date

Identify co-trainer(s) and guest speaker(s) (if any)


Recruit/select participants


Notify participants of training date/location


Send reminder to participants (1 week prior)


Discuss expectations with guest speaker(s); roles and responsibilities with co-trainer(s)


Arrange for continuing education credits (if appropriate)


Arrange for refreshments (if allowed)


Reserve training space


Check light and temperature controls


Check how space will accommodate A/V equipment


Collect any special materials needed (such as for Session 5: Practicum)


Check seating: enough seats? Movable?


Check parking logistics for participants


Check restroom location


Plan and prepare signs to direct participants


Duplicate copies ofParticipant's Workbook


Prepare any other participant hand-outs


Prepare flipcharts, overheads, slides



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Training Room Layout

Seating arrangements for training participants can greatly influence group dynamics and participants' ability to communicate and cooperate with the trainer and with one another. The Curriculum for Training and Certifying Unlicensed Staff as TST Technicians includes activities that involve traditional lecture formats, large group discussion, small group discussion, video viewing, and TST practicum. No single seating configuration can ideally accommodate each kind of activity; however, a circular, modified circular, or U-shaped seating formation will work well for most sessions of this curriculum. (The Session #5 Practicum requires a special arrangement. See the Session 5 Trainer's Guide for details.)




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Trainer Participant

The Art of Training: Skills and Guidelines for Effective Trainers

Qualities of Effective Trainers/Facilitators*

Effective communication skills, including good delivery skills
Group facilitation, including the ability to let the group work on its own
Self-awareness, including a sense of the impact of your own behavior
Ability to plan, organize, and make clear presentations
Ability to plan objectives and to move a group toward them
Patience, flexibility, and adaptability in regard to the group's needs
Respect for the needs of adult learners and the ability to put adult learning theory into practice
Ability to deal with ones own feelings and the feelings of others
Ability to make appropriate interventions
Ability to encourage the taking of risks without embarrassing participants
Ability to give and receive feedback and criticism
Ability to evaluate the training event

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Ground Rules for Participants*

We advise you to start each training session with a brief review of "ground rules." Ground rules are guidelines that help you to create and maintain an effective, respectful, and non-threatening learning environment. Ground rules can be designed in advance and then presented to the group; ideally, you will invite the group to contribute additional ideas about how to create an optimal learning environment. Ground rules often cover the following issues:

Punctuality and attendance: The trainer will begin and end each session on time; participants will arrive on time and stay for the entire session.

* This material was adapted from "AIDS outreach in the community: training design and delivery," a trainer's manual developed by R.O.W. Sciences, Inc., Maryland. Sponsored by the U.S. Department of Health and Human Services; 1990.

Respectful interaction: Trainer and participants will not interrupt one another; participants will actively contribute during group activities.

Confidentiality: Personal disclosures and other sensitive information that are communicated during training sessions will not be shared outside of the training group.

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Guidelines for Giving and Receiving Feedback*

Participants will benefit from receiving your constructive feedback, especially during exercises in which they are practicing new skills. The following guidelines will help you to provide feedback that is more likely to have a positive impact on participants and not raise their defenses. A shortened, modified version of these suggestions can be shared with participants to assist them in giving and receiving feedback to/from one another.

Giving feedback

Frame your feedback in positive, rather than negative, terms. Help and feedback need to be given and heard as an offer, not an imposition.

Focus your feedback on behaviors. Comment on what a person does rather than what you think of the person. Describe actions instead of personal qualities.

Direct your feedback toward behavior that the receiver has control to change. Frustration is only increased when a person is reminded of a characteristic over which he or she has little or no control. ("You're much taller than most of our patients.")

Be specific in your feedback to what you see and hear; avoid being general or judgmental. To be told, "You are shy," is not as useful as being told, "When you did the role play I noticed that you looked away from the patient and I had trouble hearing you."

Feedback is most useful when it is solicited rather than imposed.

* This material was adapted from "AIDS outreach in the community: training design and delivery," a trainer's manual developed by R.O.W. Sciences, Inc., Maryland. Sponsored by the U.S. Department of Health and Human Services; 1990.

Accompany your feedback with suggestions for improvement. Focus on an exploration of alternatives, rather than answers, solutions, or advice.

Respectful interaction: Trainer and participants will not interrupt one another; feedback will be given in constructive, nonjudgmental ways. Participants need freedom to determine the most appropriate course of action.

Offer your feedback as immediately as possible in order to be concrete and free of the distortions that come with the lapse of time.

Check with the receiver of your feedback to ensure clear communication. Ask the participant to rephrase the feedback to see whether it matches what you had in mind.

Give your feedback in a measured amount. Overloading a participant with feedback reduces the possibility that he/she will use it effectively.

Receiving feedback

Accept feedback without comment or defensiveness.

Listen to what is being said. Do not say, "Yes, but?"

Accept feedback with appreciation. Thank the person who is giving you feedback whether or not you agree with all of what he/she says.

If you are not sure that you understand the feedback, restate what you heard. Ask the person giving feedback, or others in the group, for further clarification or amplification.

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Evaluation of This Curriculum

Evaluation instruments for participants to complete immediately after each training session are included in the Participant's Workbook. We strongly recommend that you require all participants to complete an evaluation form at the end of each session. Review the feedback as soon as possible after each session, in order to learn what you can do to be more effective as a trainer.

CDHS is very interested in receiving feedback from trainers about their experiences using this curriculum. Please see the trainer's evaluation form included with the curriculum materials.

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CDHS gratefully acknowledges the following individuals and organizations for their contributions to this curriculum:

CTCA Workgroup and Executive Committee Reviewers

Shukri Adam, PHN

San Diego County Health and Human Services

Kathy Ahoy, PHN, MSN

Alameda County Public Health Department

Charles Crane, MD, MPH

Contra Costa County Health Services

Debbie McIntosh, RN, BSN, PHN

(formerly) San Diego County Health and Human Services

Devery Mandagie, PHN

San Diego County Health and Human Services

Tony Paz, MD

San Francisco County Department of Public Health

Karen Smith, MD, MPH

(formerly) Santa Clara County Health Department

Allyson Tabor, PHN

El Dorado County Public Health Department

Lynda Zimmer, RN, PHN

Santa Clara County Health Department

Organizations/Agencies and Individuals Whose Materials Appear in This Curriculum

Community and Professional Education Branch, National I

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