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In developing a curriculum for any program is it important to recognize that there
are different “levels” of the curriculum that need to be addressed. Any curriculum
must satisfy the requirements of the institution, the program, and the specific rota-
tion within the program and must also be effective at the instructional level as well.
Each aspect is important to the overall educational outcome, and each level should
be reviewed regularly.
Developing or changing an educational curriculum is an arduous task and
requires careful planning before any initial work to ensure the curriculum achieves
the desired results and that efforts are focused and streamlined. The initial phase in
the process is a thorough needs assessment, which is crucial in the development of
a successful curriculum. The needs assessment will identify differences and gaps
between the existing knowledge of the learner and the goal of the learning encoun-
ter. In essence, the needs assessment provides a blueprint that will give guidance
during curriculum development.
To conduct a quality needs assessment, one must first determine the needs of the
target population (the learners) and the current results of the existing situation.
Then, articulate what the desired outcome looks like. The distance between the cur-
rent results and the desired outcome is the actual need [ 2 ]. Determine what concepts
and skills are required for the resident to learn during the training period based on
the desired range of mastered knowledge and skills expected by each milestone and
by the time of graduation from the program.
The advantages of performing a needs assessment include validation of the need
for the curriculum itself or for a change in the curriculum [ 2 ]. A well-developed
needs assessment will make every other phase of curriculum development much
simpler as this is the most opportune time to anticipate problems and difficulties in
the remaining phases of curriculum development and implementation. The needs
assessment will improve educational efficiency and affords measurable outcomes to
confirm curriculum effectiveness. It also allows for identification of curricular strat-
egies and methods for testing knowledge and skills at educational intervals. A ben-
eficial side product of the needs assessment is that it creates an opportunity for those
interested to design and develop educational research.
There are a number of ways to conduct a needs assessment. These can include
primary data acquisition through direct surveys, informal discussions, in-depth
interviews, focus group discussions, self-assessments, and pre- and post-test assess-
ments from cohorts of current residents, students, academic faculty, and community
faculty. An often even more valuable resource to tap is the cohort of graduates from
the program, as their experience and perceptions of the program provide a unique
perspective and significance to curriculum improvement efforts. The advantage of
using primary data lies in the direct relevance of the information obtained to the
specific program and will answer the exact questions of the curriculum planners as
focused on the needs of the learners. Additionally, secondary data can be helpful to
the curriculum developers during the needs assessment. Secondary data is informa-
tion that is readily available and has already been collected by another source.
Sources of secondary data include expert reviews, graduate medical education
guidelines and resources (e.g., ACGME and RRC), and medical and educational
C.F. McCammon and K. McCammon