15 Chan DH, Leclair K, Kaczorowski J. Problem-based small-group learning via the internet among community family physicians: a randomised controlled trial. MD Comput 1999;16:54-8. 16 Heale J, Davis D, Norman G, Woodward C, Neufeld V, Dodd P. A randomized controlled trial assessing the impact of problem-based versus didactic teaching methods in CME.
(Accepted 20 September 2001)Learning needs assessment: assessing the need
Janet GrantLearning needs assessment has a fundamental role in education and training, but care is needed to prevent it becoming a straitjacket It might seem self evident that the need to learn should underpin any educational system. Indeed, the literature suggests that, at least in relation to continuing professional development, learning is more likely to lead to change in practice when needs assessment has been conducted, the education is linked to practice, personal incentive drives the educational effort, and there is some reinforcement of the learning. 1 Learning needs assessment is thus crucial in the educational process, but perhaps more of this already occurs in medical education than we suspect. The key lesson might be for those who design new systems of education and training: for example, the postgraduate education allowance system in general practice was felt to fail the profession because it did not include needs assessment and so led to ad hoc education to fulfil the time requirements of the system rather than the needs of individual doctors or the profession as a whole. On the other hand, basing learning in a profession entirely on the assessment of needs is a dangerous and limiting tactic. So a balance must be struck.
Learning needs assessment in medicineIn 1998 both individual and organisational needs assessment became part of government policy in relation to the continuing professional development and personal development plans of all healthcare professionals.2 Thus, it has a role in the clinical governance of the service 3 and is therefore much more than an educational undertaking. This integration of needs assessment, education, and quality assurance of the service was first made explicit in 1989 in relation to clinical audit, which would identify practices in need of improvement and ensure that educational and organisational interventions were made to address these needs.4 Accordingly, audit was described as "essentially educational" and the educational process surrounding it described.
5Long before these recent developments, needs assessment outside medicine was presented as an important part of managed education and learning contracts, which are the predecessors of the personal development plans to be developed for all NHS healthcare professionals. 6 In his descriptions of adult learning Knowles assumed (he did not claim to have research evidence) that learners needed to feel a necessity to learn and that identifying one's own learning needs was an essential part of self directed learning. 7 In medicine a doctor's motivation to learn would therefore derive from needs i...