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TB Notes Newsletter

No. 2, 2008

Communications, Education, and Behavioral Studies Branch Update

Teachback Methodology: An award-winning curriculum for training trainers


Owing to increasing global demand for training assistance in critical health disciplines such as TB and HIV, trainers at CDC recognized the value of building training capacity for health programs requesting assistance. In order to effectively help build training capacity, there was a need for developing and providing both

  • A systematic method for planning and conducting trainings and
  • Training-of-trainers (TOT) courses

To meet these needs, the CDC Global AIDS Program Training Team and DTBE’s Communications, Education, and Behavioral Studies Branch, in partnership with the International Training and Education Center on HIV (I-TECH), developed the CDC Teachback Training Curriculum. (I-TECH is a global AIDS training program working at the invitation of ministries of health and the U.S. government.) CDC has used this curriculum to develop and implement TOT courses around the world. The Teachback Training Curriculum can be used in two ways:

  • As a stand-alone curriculum to train others on how to develop and facilitate trainings, or
  • Integrated into any existing curriculum ( e.g., TB Contact Investigations) to develop a TOT course

Teachback Methodology Description

The CDC Teachback Training Curriculum is based on the Teachback Methodology, developed in 1975 by Dr. Gordon Pask. The Teachback Methodology was first used at CDC by trainers in the Division of HIV/AIDS Prevention and the Global AIDS Program to teach HIV counseling and testing TOT courses.

The rationale for using this methodology is its unique approach that blends the learning of training skills with the teaching of course content. Many people who facilitate trainings do so because they have expertise in a particular content or technical area. However, they often do not have formal education in training. The goal of the Teachback TOT courses is to enhance the participants’ training skills so that they are better prepared to train others.

The Teachback Methodology provides participants with an exciting opportunity to improve their existing training skills. This methodology is based on the technique considered the most effective for training adults, which is participatory training. The curriculum was designed to provide

  • Sustainable skills that will build the training capacity of course participants,
  • An easy method for adapting an existing course into a TOT, and
  • Materials that are flexible and easy to use.

The distinctive features of the methodology are that course participants gain skills in training adults, practice teaching a particular course content, and receive feedback on their performance. There are three steps to the process:

  1. A trainer teaches a set of training skills to the participant
  2. The participants use the training skills to teach a portion of the course curriculum (this is when they “teach back” the skills and course content to the other participants)
  3. The participant receives feedback on his or her performance from a master trainer and other participants (feedback is presented orally, in front of other participants and in writing using feedback forms)

For participants, Teachback can be empowering because they can integrate training theory with the teaching of course content, practice training in a safe environment, and receive feedback on their performance of training skills. For trainers, Teachback can be very gratifying because they can directly observe the participants’ performance and see immediately how participants apply the knowledge and skills that they have learned.

Objectives of a Teachback TOT

The Teachback TOTs are skills-based trainings. After attending a Teachback TOT, participants demonstrate the knowledge and skill they have gained by

  • Applying training basics when they facilitate a training (e.g., knowing your audience, being prepared, using adult learning principles, managing the training, communicating effectively, and engaging the participants)
  • Facilitating any of the following (this depends on which skills are needed to teach a particular course):
    • Interactive lecture
    • Exercise and group discussions
    • Role play
    • Lab skills
    • Computer skills
  • Conducting a Teachback TOT course (if appropriate)

Curriculum Description

Because each training course is unique, the materials were designed to be used with a wide variety of courses to create a training-of-trainers course. Trainers can use any sections of the curriculum that are appropriate for their setting. Materials include--

  • A 35-minute video that explains the Teachback Methodology and how it can be adapted for existing courses. It also provides a demonstration of the feedback.
  • PowerPoint slides
  • Facilitator guides that provide detailed suggestions on how to train others in each of the topics
  • Handouts that provide detailed content
  • Exercise materials
  • Forms that provide a systematic method for providing feedback
  • Job aids for assistance during the training


To date, many of the materials have been translated into the following languages:

  • Russian
  • Latvian
  • Vietnamese
  • Spanish
  • Georgian


The CDC Teachback Methodology Curriculum received the CDC/Public Health Education and Health Promotion Network Award of Excellence for Public Health Training in 2007. In addition, the Train-Up with Teachback Video received the CDC/ATSDR Communicators Roundtable Award in 2005.

Teachback Methodology Trainings Since 2003,

  • 757 total participants from 28 different courses and over 50 countries have participated in a Teachback TOT, and
  • 139 total trainers (CDC and external partners) have been trained to conduct Teachback TOT courses.

Following are some selected CDC sponsored courses that have used Teachback Methodology to train trainers:

  • Managing TB at the Raion Level (Russia)
  • MDR TB (Latvia)
  • TB/HIV Surveillance (Botswana and South Africa)
  • TB/HIV Diagnostic Testing and Counseling (Tanzania & Kenya)
  • Contact Investigation Course, with Francis J. Curry Center (Los Angeles)
  • TB/HIV Collaborative Activities (Uganda)
  • TB Operational Research (Argentina)
  • HIV Rapid Test, CD4, Hematology, and Chemistry (Africa)
  • Epi-Info (Vietnam)

For more information

Photo of teachback trainingIf you are interested in learning more about the Teachback Methodology and how to integrate it into an existing curriculum to create a training-of-trainers course, please contact: Cheryl Tryon, MS,, (404) 639-5320, Amera Khan, MPH,, (404) 639-6428, or Peri Hopkins, MPH,

During the MDR TB Teachback Training-of-Trainers in Latvia, a course participant teaches how to fit test a particulate respirator.

—Reported by Cheryl Tryon and Amera Khan
Div of TB Elimination


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

Please send comments/suggestions/requests to:, or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333