An operational study to understand the influence of training of Peripheral Health Institution (PHI) Medical Officers (MOs) at District Tuberculosis Centre (DTC) in comparison to on the job training in their own PHIs in carrying out case-finding activity, was carried out in districts of Mysore, Mandya, Bellary and Hassan of Karnataka State in 1980 81. These districts are now being referred as I, II, III and IV respectively. From each district, 20 Microscopy Centres (MCs) were selected. All the selected MCs of the above four districts after stratified random allocation were divided into two groups, i.e., A & B. The MOs of Group A of each district were trained for 2 days in Case-finding activity at the respective DTCs by District Tuberculosis Officer and District Health Officer, while the MOs of Group B were given on the job training as per manual. In all, 108 MOs: 52 in Group A and 56 in Group B were under study. The performance of each PHI was monitored in terms of number of new Out patient Attendance, selection of chest symptomatics for sputum examination and number of smear positive cases detected, for a period of 12 months after the training.

At the end of one year it was observed that there was a boosting in case detection in districts I and III, no effect in district II and negative effect in district IV. The efficiency in districts I and III was higher by methodology A. It was enhanced from 7.6% pre-training efficiency to 16.7% after training and in district III, 18% to 65.8%. The enhancement with methodology B was from 5.5% to 8.1% in district I and from 19.1% to 43.2% in district III. The average increase by amalgamating all the four districts was from 8.5% to 17.8% with methodology A and from 9.7% to 12.3% with methodology B. There was a suggestion of better improvement through methodology A, which, however, did not attain statistical significance.

In the districts under study, Case-finding was at a very low ebb. Systematic training by either of the two methodologies, did improve the activity in I and II i.e., in two of the four districts. In districts II and IV other variables might also have been at work e.g., training variables of knowledge, skill and communication abilities of DTOs who were trainers could have influenced the outcome.