Needs Assessment - NHS Education for Scotland
Needs Assessment - NHS Education for Scotland Needs Assessment - NHS Education for Scotland
Authors E A Hesketh J M Laidlaw Instructional Design J M Laidlaw Desktop Publishing L E Bell M C Gunn Computing N K McManus © Scottish Council for Postgraduate Medical and Dental Education � eeds Assessment Designed and produced by the Education Development Unit Scottish Council for Postgraduate Medical and Dental Education Initial development sponsored by the Scottish Higher Education Funding Council Forward
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Authors<br />
E A Hesketh<br />
J M Laidlaw<br />
Instructional Design<br />
J M Laidlaw<br />
Desktop Publishing<br />
L E Bell<br />
M C Gunn<br />
Computing<br />
N K McManus<br />
© Scottish Council<br />
<strong>for</strong> Postgraduate<br />
Medical and Dental<br />
<strong>Education</strong><br />
� eeds<br />
<strong>Assessment</strong><br />
Designed and produced by the<br />
<strong>Education</strong> Development Unit<br />
Scottish Council <strong>for</strong> Postgraduate Medical and Dental <strong>Education</strong><br />
Initial development sponsored by the<br />
Scottish Higher <strong>Education</strong> Funding Council<br />
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� nippets on <strong>Needs</strong> <strong>Assessment</strong><br />
The key steps in needs assessment are:<br />
Back<br />
n identifying the gaps between current<br />
and desirable practice and selecting<br />
areas that need to be addressed<br />
n analysing the gaps and determining<br />
what is causing them (needs analysis<br />
or identifying learning/training needs)<br />
<strong>Needs</strong> <strong>Assessment</strong>... Snippets: 1 of 2<br />
n identifying ways of satisfying these needs. This could<br />
range from simply providing a resource or ensuring a<br />
trainee gets exposure to a particular patient, through to<br />
a <strong>for</strong>mal training session.<br />
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The purpose<br />
n To identify shortcomings in trainee<br />
per<strong>for</strong>mance, ie the difference<br />
between the trainee’s competence<br />
and that required by the task, the<br />
profession or the stage of training.<br />
n To find out a trainee’s<br />
individual training needs.<br />
Back<br />
Why bother?<br />
<strong>Needs</strong> <strong>Assessment</strong>... Snippets: 2 of 2<br />
Assessing individual trainee needs<br />
is important because:<br />
n trainees come from different<br />
backgrounds<br />
n trainees vary in their strengths<br />
and weaknesses<br />
n some trainees might need more<br />
help to cope<br />
n it assists in monitoring whether<br />
or not trainees are reaching a<br />
proper standard at that stage of<br />
their training<br />
n it in<strong>for</strong>ms <strong>for</strong> future training<br />
planning<br />
n it encourages trainees to become<br />
aware of their own limits/<br />
knowledge – a sound base <strong>for</strong><br />
future learning.<br />
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n introduction to<br />
<strong>Needs</strong> <strong>Assessment</strong><br />
The process of assessing a person’s training needs is basically common<br />
sense.<br />
This unit will:<br />
Back<br />
Think back to when you were a trainee – some<br />
of the consultants intuitively recognised and<br />
organised or exposed you to what was<br />
needed, others maybe did not.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 1 of 15<br />
n help you to subconsciously pick up signs which will highlight<br />
your trainee’s learning needs.<br />
n give you insight into the whole needs assessment process.<br />
n perhaps introduce you to some of the educational terms you are<br />
likely to encounter in your job.<br />
continued. . .<br />
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An educational need is basically something we ought to learn <strong>for</strong> our own<br />
good.<br />
Note...<br />
Back<br />
For trainees the need is the gap between their<br />
present level of competence and a higher level of<br />
competence as required by the task, the<br />
standards set by your organisation or the<br />
profession itself.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 2 of 15<br />
The identification of the gaps between actual and desired per<strong>for</strong>mance is<br />
the focus of the needs assessment process, but it doesn’t stop there.<br />
The reason <strong>for</strong> the gap has to be analysed and steps taken to close it. This<br />
is the foundation <strong>for</strong> effective training. You are probably already using many<br />
of the methods <strong>for</strong> assessing needs and only require to be more systematic<br />
about the process.<br />
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� eeds assessment in action<br />
We will look at how to assess needs, prioritise needs and carry<br />
out needs analysis.<br />
How to assess needs<br />
Back<br />
If the per<strong>for</strong>mance has been specified in writing, eg<br />
the trainee must undertake four days per month of<br />
acute unselected emergency intake responsibilities<br />
then assessing needs becomes simple through a straight<br />
comparison between per<strong>for</strong>mance and the standard.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 3 of 15<br />
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Note...<br />
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In real life not everything has standards<br />
specified. Assessing needs there<strong>for</strong>e entails<br />
looking at a number of sources of in<strong>for</strong>mation<br />
– many in an in<strong>for</strong>mal way.<br />
Think <strong>for</strong> a moment what<br />
these might be.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 4 of 15<br />
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The good trainer intuitively makes use of the following.<br />
Observation<br />
Trainee’s perceptions<br />
Feedback from others<br />
Patient feedback<br />
Comparison with peers<br />
Critical incident<br />
Document analysis<br />
Testing<br />
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Observation<br />
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Feedback from others<br />
Patient feedback<br />
Comparison with peers<br />
Critical incident<br />
Document analysis<br />
Testing<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 6 of 15<br />
This can be carried out in<strong>for</strong>mally, eg<br />
simply walking through a ward, or more<br />
<strong>for</strong>mally, eg a planned event when the<br />
trainee knows per<strong>for</strong>mance is being<br />
observed. Don’t under-estimate casual<br />
observation as a means of identifying<br />
gaps in per<strong>for</strong>mance and potential<br />
learning needs.<br />
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Observation<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 7 of 15<br />
Trainees will have their own perceptions<br />
of their shortcomings. They are also likely<br />
to have views about the areas in which<br />
they feel they have not had sufficient<br />
experience or exposure.<br />
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Observation<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 8 of 15<br />
Other people will have observed the<br />
trainee in in<strong>for</strong>mal circumstances.<br />
Their views, opinions and perceptions<br />
can highlight areas of need. Any<br />
identified areas should be discussed<br />
with the trainee in a non-threatening<br />
environment.<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 9 of 15<br />
Comments from patients about their<br />
treatment as well as their physical state<br />
post treatment can also be used to<br />
assess needs.<br />
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Observation<br />
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Critical incident<br />
Document analysis<br />
Testing<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 10 of 15<br />
Comparison of trainees with their<br />
peers can help to highlight training<br />
needs. Trainees can be encouraged to<br />
do this comparison themselves<br />
through working with each other,<br />
reflecting on events and even<br />
observing each other.<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 11 of 15<br />
A critical incident is either a less than<br />
desirable event, or one that went very<br />
well, which is explored <strong>for</strong> any inferences<br />
on per<strong>for</strong>mance. Reflection on the event<br />
allows the practice of the trainee to be<br />
examined.<br />
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Critical incident<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 12 of 15<br />
Medical records, test results,<br />
per<strong>for</strong>mance checklists, incident<br />
reports are other sources of data which<br />
can be used in needs assessment.<br />
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Observation<br />
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Feedback from others<br />
Patient feedback<br />
Comparison with peers<br />
Critical incident<br />
Document analysis<br />
Testing<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Core: 13 of 15<br />
Testing can be individual or group;<br />
oral or written. It can be just a series<br />
of probing questions at the bedside<br />
or a review of a case or clinic. In the<br />
written <strong>for</strong>mat it can be in the <strong>for</strong>m of<br />
a self-assessment exercise <strong>for</strong> the<br />
trainee to complete.<br />
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Prioritising needs<br />
Having identified gaps in per<strong>for</strong>mances (needs) their importance is<br />
assessed and prioritised. This should be an almost intuitive process<br />
– especially if you know your trainee well and are receiving all the<br />
signals about their progress.<br />
<strong>Needs</strong> analysis<br />
The next step is to find a way to close the per<strong>for</strong>mance gap (needs<br />
analysis).<br />
Back<br />
Can you think of the type of actions<br />
that might be taken?<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 14 of 15<br />
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The type of actions that might be taken include:<br />
n feedback – especially where the trainee has been shown or is doing<br />
the task regularly, but still has a skill deficiency<br />
n further practice where the trainee has had little opportunity to practice<br />
a learned skill<br />
n <strong>for</strong>mal training or further study<br />
n in<strong>for</strong>mal training.<br />
This analysis should be agreed with the trainee. It should also try to<br />
identify, who, how, where and when the training might be best employed. If<br />
you are an educational supervisor this is likely to be your responsibility.<br />
Note...<br />
Back<br />
The trainee should also be encouraged to find<br />
experiences to address these gaps. They should<br />
be encouraged to self reflect and play their part<br />
in benefiting from the rich learning environment<br />
in which they are practising.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Core: 15 of 15<br />
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xamples in practice<br />
Here we look at:<br />
n Checking your techniques<br />
n Using the techniques.<br />
Checking your techniques<br />
Knowing the trainees<br />
How well do you know the trainees <strong>for</strong> whom you are responsible? Can<br />
you answer yes to most of the statements below? If not it’s time <strong>for</strong> at<br />
least a passing conversation with them!<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 1 of 9<br />
n I could describe their personality in a few words.<br />
n I know how they perceive their progress to date.<br />
n I am aware of their shortcomings.<br />
n Even when rotas make it difficult, I go out of my way to make<br />
brief contact.<br />
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Assessing the trainees’ needs<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 2 of 9<br />
Think of a trainee <strong>for</strong> whom you have some input or<br />
responsibility <strong>for</strong> training. Which sources of<br />
in<strong>for</strong>mation listed below do you use to help you<br />
identify his/her learning needs?<br />
In<strong>for</strong>mation from these sources may be obtained in both planned and<br />
in<strong>for</strong>mal/unsystematic ways:<br />
n personal observation n feedback from others<br />
n comparison with other trainees n patient comments<br />
n appraisal n reviewing documentation<br />
n trainee self assessment n assessment/testing<br />
n trainee reflection on practice n questionnaire<br />
You won’t use all these sources of in<strong>for</strong>mation 100% of the time. However, the<br />
more you use, the better able you will be to build up a profile of your trainee.<br />
Extrapolating in<strong>for</strong>mation from such sources will enable you to assess<br />
individual learning needs accurately and efficiently.<br />
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Using the techniques<br />
We look here at the following areas.<br />
Observation<br />
Trainee self-assessment<br />
Reflection in practice<br />
Reflection on practice<br />
Document analysis<br />
Testing<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 3 of 9<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 4 of 9<br />
This is a key route to finding out<br />
trainees’ strengths and weaknesses.<br />
Observe how they per<strong>for</strong>m tasks -<br />
are they carrying out them correctly<br />
or do they need more practice to<br />
become proficient? How do they<br />
relate to other members of the team?<br />
How do they relate to patients? Do<br />
they seem organised and managing<br />
their time reasonably?<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 5 of 9<br />
Encourage trainees to say to you<br />
(and others)<br />
‘What do you think of the way I<br />
handled that?’<br />
‘I need to do more of X/I want to<br />
learn more about X - I’d like to see<br />
these particular patients on your<br />
list’.<br />
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Questions such as:<br />
‘What are the options <strong>for</strong><br />
managing this?’<br />
‘You’ve made the correct<br />
decision but what is your<br />
reasoning underpinning that<br />
decision?’<br />
‘How will you be able to tell if…?’<br />
will help you to assess trainee<br />
understanding.<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 7 of 9<br />
Questioning can also assist in this<br />
area:<br />
‘How did that go?’<br />
How well do you feel you<br />
per<strong>for</strong>med?’<br />
‘Do you think the patient<br />
understood what you were<br />
saying?’<br />
’What do you see as the main<br />
problems you encountered?’<br />
‘Do you feel ready to take such<br />
cases unsupervised from now<br />
on?’<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 8 of 9<br />
Check the quality of the trainee’s<br />
documentation. Are the patient<br />
notes, requests <strong>for</strong> tests, reports<br />
etc both clear and adequate?<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Examples: 9 of 9<br />
For in<strong>for</strong>mal testing use questions<br />
appropriate to the event eg<br />
‘What could be the causes of X?’<br />
‘What are the other common<br />
complications associated with<br />
Y?’<br />
‘What are the key things you will<br />
monitor after Z is administered?’<br />
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� ractical tips<br />
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Any deficiencies in practice may be due to<br />
many factors eg lack of knowledge, no chance<br />
to practice, lack of feedback. Find out the<br />
reasons by talking to the trainee.<br />
Use a variety of methods to gain a<br />
comprehensive picture of a person’s<br />
per<strong>for</strong>mance eg observation, peoples’<br />
opinions, test results, patient feedback,<br />
critical incidents etc. Remember a large part<br />
of a trainee’s learning/training takes place<br />
away from yourself and often in isolation.<br />
Casual sources of in<strong>for</strong>mation are every bit as<br />
important as <strong>for</strong>mal sources <strong>for</strong> building up a<br />
profile of a trainee’s competence. Keep your<br />
eyes and ears open and be alert to signs that<br />
indicate a training need.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Practical Tips: 1 of 2<br />
continued. . .<br />
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Back<br />
Find out the trainees’ personal<br />
perceptions and involve them in the<br />
assessment and analysis of their learning/<br />
training needs. It will also encourage them<br />
to be self-directed learners.<br />
Any learning needs identified should be<br />
viewed in a positive way, not as a problem.<br />
Ensure the needs assessment and<br />
analysis leads to an agreed training plan.<br />
Remember a person’s training needs<br />
should be regularly reviewed, not just at<br />
the more <strong>for</strong>mal appraisal interview.<br />
Opportunities <strong>for</strong> in<strong>for</strong>mal reviews should<br />
be maximised eg a brief discussion after a<br />
clinic, encouragement of trainee selfassessment.<br />
<strong>Needs</strong> <strong>Assessment</strong>... Practical Tips: 2 of 2<br />
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ther learning opportunities<br />
<strong>Needs</strong> assessment is a well-documented subject. Here are a few<br />
suggestions if you wish to take the topic further.<br />
Diploma<br />
Books<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Opportunities: 1 of 6<br />
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<strong>Needs</strong> <strong>Assessment</strong>... Opportunities: 2 of 6<br />
Centre <strong>for</strong> Medical <strong>Education</strong> (1997) <strong>Needs</strong> Analysis <strong>for</strong><br />
curriculum development. Unit CD: 9 in the Diploma in<br />
Medical <strong>Education</strong>, Centre <strong>for</strong> Medical <strong>Education</strong>,<br />
University of Dundee, Dundee<br />
Why not build on your learning and gain accreditation<br />
towards a postgraduate certificate/diploma/Masters in<br />
Medical <strong>Education</strong>? All can be studied through distance<br />
learning. <strong>Needs</strong> analysis is one of the modules that can<br />
be studied towards anyone of these qualifications.<br />
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Kaufman R, Rojas A M, Mayer H (1993) <strong>Needs</strong> <strong>Assessment</strong>:<br />
a user’s guide. Englewood Cliffs, NJ; <strong>Education</strong>al<br />
Technology Publications<br />
A comprehensive book from one of the ‘gurus’ on needs<br />
assessment. It is not oriented towards the healthcare<br />
scene, but clearly covers the needs assessment/analysis<br />
process to identify needs and improve per<strong>for</strong>mance.<br />
Peterson R (1998) Training <strong>Needs</strong> <strong>Assessment</strong> 2nd Edition.<br />
London; Kogan Page<br />
A straight<strong>for</strong>ward, jargon-free book that takes you through<br />
the training needs analysis process stage by stage.<br />
Although applicable to any type of organisation rather<br />
than specifically to the healthcare sector, it is well worth a<br />
read.<br />
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Jazwiec R M (1991) Learning <strong>Needs</strong> assessment Part: 1<br />
Concepts and Process. Journal of Nursing Staff<br />
Development 7(2): 91-96<br />
The first of a pair of straight<strong>for</strong>ward articles aimed at<br />
nursing staff development educators to help them<br />
understand the needs assessment process.<br />
Van Rosendaal G, Lockyer J, Sutherland L (1994) Improving<br />
Course Content Through Multiple Methods of <strong>Needs</strong><br />
<strong>Assessment</strong>: A Demonstration Project. Teaching and<br />
Learning in Medicine 6(4): 269-273<br />
Although perhaps of more interest to course organisers/<br />
providers this paper highlights needs assessment<br />
strategies in action<br />
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The international database TimeLIT (Topics in Medical <strong>Education</strong><br />
Literature) www.timelit.org gives free access to articles relating to<br />
education in medicine, dentistry, nursing, patient health and the<br />
professions allied to medicine.<br />
Other useful websites <strong>for</strong> those interested in Medical <strong>Education</strong> are<br />
that of the Association <strong>for</strong> the Study of Medical <strong>Education</strong><br />
www.asme.org.uk and that of the Association <strong>for</strong> Medical <strong>Education</strong> in<br />
Europe www.amee.org<br />
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The skills of needs assessment are relevant to many other teaching roles<br />
and activities. Here are some other Developing the Teaching Instinct<br />
units you might wish to look at.<br />
Learning<br />
contracts<br />
Questioning<br />
& Listening<br />
Appraisal<br />
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Organise a ‘critical incident<br />
week’ which will involve trainees<br />
reflecting on an incident - one in<br />
which they could have done<br />
better. If you can get them all<br />
together try to make it fun - break<br />
the ice by recounting you own<br />
faux pas in the past. Alternatively<br />
have the reflection behind closed doors on a one to one<br />
basis - whichever suits you and the trainees best.<br />
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The qualities of a good supervisor apply to any<br />
good human relationship. They include:<br />
n being interested in people<br />
n an ability to facilitate rather than direct<br />
n an ability to challenge without being<br />
threatening.<br />
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