The Union Courses Online

Welcome to Online course for interpretation of CXRs in children with presumptive TB

The course is based on the Union’s Diagnostic CXR Atlas for Tuberculosis in Children: a Guide to chest X-ray Interpretation (2nd edition, 2022) that provides pragmatic guidance to healthcare professionals working in child tuberculosis.  We aim to narrow the detection-treatment gap in child tuberculosis and fill a training gap among health care workers on the topic of interpretation of chest X-rays in the context of high tuberculosis burden settings. 

The course is available free-of-charge to all audiences, particularly those health care workers who are diagnosing and treating TB in children in high TB burden settings. It is as an asynchronous online learning, comprising of nine video presentations that last approximately 20 minutes each. Each video presents several chest X-ray images that are discussed.   At the end of each presentation there is a quiz to reinforce the learning point.

Once you complete all the modules, you will be allowed to take the post-course test to assess your knowledge gain. The pass mark is 80% and you can take the test as many times as you wish. After the post-course test, there is a course evaluation for you to provide feedback on the course.

Estimated time to complete the course is approximately 5 hours. You can start the course at any time, pause and come back to it at a later stage, and continue at the same point where you had left it. You will receive a course completion certificate at the end of the course. 

After completing this course, you may wish to have a look at more chest X-ray images of children with presumptive tuberculosis; you are welcome to visit:  https://theunion.org/technical-publications/diagnostic-cxr-atlas-for-tuberculosis-in-children

This online course was supported by Cooperative Agreement Number NU2GGH002222 from the U.S. Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the U.S Centers for Disease Control and Prevention, the U.S Department of Health and Human Services, or the U.S government.

Module 1. Introduction to the course

     1. Topics:

          1. Course learning objectives
          2. Why is this course important
          3. Course faculty
          4. How to progress through the course
          5. Overview of the role of CXR in the context of childhood TB

Module 2. The role of the CXR in childhood TB

     1. Learning objectives: To understand the different roles of CXR in child TB. To understand how CXR can be used in treatment decision algorithms. To appreciate that decisions in child TB can be made without CXR

     2. Topics:

          1. Overview of the role of CXR in childhood TB
          2. The role of CXR in child TB
          3. Focus of this CXR interpretation course
          4. The place of CXR in treatment decision algorithms for TB-exposed well children
          5. Treatment decision algorithm without CXR
          6. Quiz
          7. Conclusion

Module 3. An approach to CXR interpretation and classifying technical quality

     1. Learning objectives: Understand that a CXR is only part of the diagnostic process for TB in children Understand that a CXR is only part of the diagnostic process for TB in children, Identification of CXR, be able to assess the quality of a CXR
     2. Topics:

          1. Understand that a CXR is only part of the diagnostic process for TB in children
          2. Identification of CXR
          3. Technical quality of the CXR
          4. Using a systematic approach
          5. Exercise
          6. Quiz
          7. Conclusion

Module 4 Part 1. The algorithmic approach to CXR classification

     1. Learning objectives: By the end of this lecture you should be able to understand: The concepts of sensitivity and specificity, which CXR features are very specific to TB
     2. Topics:

          1. Introducing the algorithmic approach to CXR classification
          2. Understanding sensitivity and specificity
          3. The CXR features that are very specific to TB
          4. Quiz
          7. Conclusion

Module 4 - Part 2. The algorithmic approach to CXR classification

     1. Learning objectives: recap of Part 1 of this module. By the end of this module you should be able to: be able to identify and classify the CXR features that are abnormal but NOT very specific to TB, including the normal CXR
      2. Topics:

          1. Recap
          2. The CXR features that are less specific to TB
          3. Quiz
          4. Conclusion

Module 5. Classifying radiological disease severity on CXR

     1. Learning objectives: At the end of this lecture, you should be able: to recap of the algorithmic approach to CXR classification – where does disease severity fit in? To develop confidence in classifying disease severity on CXR. To facilitate access to shorter treatment regimens for children.
     2. Topics:

          1. Recap of the algorithmic approach to CXR
          2. Examples
          3. Quiz
          4. Conclusion

*Optional Module:

Module 6. The use of advance imaging in the diagnosis of PTB

     1. Learning Objectives: By the end of this presentation you should be able: To determine when advanced imaging is needed. To understand the value of advanced imaging in the diagnosis and management of childhood TB
     2. Topics:

          1. Chest CT scan
          2. CT scan reconstructions
          3. MRI
          4. Ultrasound
          5. Bronchoscopy including TBNA
          6. Ultrasound-bronchoscopy (EBUS)
          7. 3D visualizations
          8. Virtual bronchoscopy
          9. FDG/PET scan
          10. Virtual bronchoscopy
          11. Combination of imaging
          12. Conclusion

Module 7. CXR as part of diagnostic decision making: practical cases

     1. Learning Objective: by the end of this presentation, you should have been able to review the concepts presented in the previous modules.

     2. Topics: six scenarios.

Module 8. Post-test and certificate

     Pass rate of 80%

     Certificate upon completion

Post-course test

When you complete all the modules, you will need to take a test with 20 questions. The passing mark is 80%. You can repeat the test as many times as you wish until you reach the passing mark.

Course evaluation

Once you pass the post-course test, you will be asked to complete a standard questionnaire to leave feedback about the platform and quality of the course.

Certificate of completion

Once you complete the course evaluation, you will be able to download a certificate of completion with your name, the title of the course, the date of completion. The certificate also includes the equivalent number of hours of the educational content (pre-recorded lectures only).