Needs Assessment in Postgraduate Medical Education--论文代写范文精选

资格考试是基于明确的教育目标，由专业机构进行考试。这些考试试图确保新合格的医生获得必要的知识和技能。下面的essay代写范文进行讲述。

Abstract
Although the concept of needs assessment in continuing medical education is well accepted, there is limited information on needs assessment in postgraduate medical education. We discuss the learning needs of postgraduate trainees and review the various methods of needs assessment such as: questionnaire surveys, interviews, focus groups, chart audits, chart-stimulated recall, standardized patients, and environmental scans in the context of post graduate medical education. 
Keywords: residents, medical education, needs assessment, questionnaire surveys, interviews, focus groups, chart-audit, chart-stimulated recall, standardized patients, environmental scans

Medical residents learn by several methods such as; self-directed learning, informal bedside teaching and structured teaching activities.1 Some of the structured learning activities are resident lecture series, morning reports, grand rounds, conferences, skill workshops, and special seminars or lectures. The educational activities planned for residents aim to help them gain the necessary knowledge and skills equal to those of their peers and, facilitate improved patient care. There are formative evaluations during the residency program and summative evaluations at the end of residency to become licensed to practice independently. 

The qualifying examinations are based on well-defined educational objectives determined by the professional body conducting the examination. These examinations attempt to ensure that newly qualified physicians have gained the necessary knowledge and skills equal to those of their peers.2 In the current climate of consumer-driven services, educators face increasing pressure to plan educational activities based on the identified needs of the target audience.3 We feel that assessing learning needs is a fundamental step to ensure the relevance of the educational activity to a target audience. If educators don’t use needs assessments, they may not know what the learners want and what will motivate them to learn. We have attempted in this paper to discuss residents’ learning needs; who determines their learning needs; and methods of assessing the learning needs for various educational activities.

Learning Needs 
Residents are adult learners engaged in postgraduate professional education. Their needs can be classified by two main criteria: who is determining the needs (learners, educators, or others) and what standards are used as the ideal. Normative needs are defined as the measured gap between the set standards and the individual’s or group’s current knowledge.4 In medical education normative needs encompasses knowledge, skills, attitudes and performance of the residents and are determined by the certifying bodies such as the Royal Colleges (United Kingdom, Canada) or the specialty boards such as the American Board of Pediatrics in the USA. These standards are set based on value judgement, expert opinion, or research information.

The opinion of those being assessed is not taken into account. Prescribed needs are those areas that educators or program planners determine as inadequate and that need educational intervention.4 Prescribed needs usually take normative needs into account. Felt or perceived needs are what the individuals or the group have identified as what they want to learn.4 Their knowledge, experience, and the environment they work in influence most of these needs. These are the learner’s needs as perceived by the learner. 

These needs are characterized by the sentence, “I know what I don’t know.” Expressed needs are what an individual or group express as their needs.4 It would be naïve to assume that all perceived needs are expressed because there may be several real or perceived barriers to expression. For example, learners may not want to be identified as lacking knowledge, or they may lack the opportunity to express their needs. Learners may also lack the motivation, communication skills, or assertiveness to express their needs. This lack of expression (or demand) can create an unhealthy situation, because it can be confused with the absence of a need for a particular educational intervention.4 

Comparative needs are those learning needs identified by comparing two similar groups or individuals rather than against normative standards. 4 For example residents from university X are less skilled in counseling compared to residents from university Y. Unperceived needs are discrepancies not perceived by learners as learning needs, characterized by the sentence, “I do not know what I don’t know.” Teachers, professional bodies, clients or patients, allied health professionals, and national and international organizations are often the bodies that identify these unperceived needs; for example, through epidemiological reviews of health care problems within the institution or community.6 All the above described needs are useful in identifying educational objectives and planning educational activities in postgraduate medical teaching (Table 1).

Needs assessment 
A needs assessment is a systematic process to collect and analyze information on what a target group needs to learn. Although the value of conducting a needs assessment is not well established in postgraduate medical education, needs assessment is being used by some medical educators to develop curriculum for the training programs. We feel that needs assessment should be conducted before any adult educational activity so that the available resources can be used to the maximum benefit of the learners. Learning needs assessments are often conducted to identify deficiencies in knowledge, skill, behavior, or attitude in the current teaching practices, or to anticipate deficiencies based on expected changes in health care needs.5 There are several methods of needs assessment described in the literature. We will discuss their applicability to postgraduate medical education.

Questionnaire Surveys Questionnaires elicit written responses to specific questions in order to gather information from the responders. They are considered a quantitative form of needs assessment because the frequency of responses can be counted and answers to questions can be weighted with a numerical value. The responses depend on the design and quality of questions asked.6 Questionnaire surveys are a popular form of need assessment because of their low cost and ease of administration. Questionnaires can address a wide array of topics, assess diverse educational needs, and sample a large population. Well-designed questionnaires provide useful information returned to the researcher in a standardized format. 

They are widely used as a needs assessment tool in continuing medical education. They have been used for broader general needs assessment such as, education in geriatrics for community physicians; and for disciplinespecific needs assessments such as, management of arrhythmia by emergency physicians. 7,8 Questionnaires can be used alone or in combination with other methods of needs assessment to assess the learning needs of residents to plan seminar topics or workshops objectives. Questionnaires are relatively inexpensive, can sample large numbers and can be returned anonymously. 

There are several books and articles that can be helpful in designing questionnaires. 6,9 Some of the disadvantages of questionnaire surveys are that they tend to have poor response rates and rely on the content and context of the questionnaire.9 The quality of the data is only as good as the quality of the questions in the questionnaire. Questionnaires have an inherent limitation of providing only self-assessed and self-reported needs. Responses may be difficult to generalize since they often reflect the needs, views, and wants of only the responders. Surveys can, however, be used in conjunction with other needs assessment methods to provide reliable information.（essay代写)

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