Determination of need and gap

State the best practice. A best practice may be from a national guideline or consensus statement from a credible organization, from peer-reviewed medical literature where more than one source agree on the practice, or from the considered opinion of the expert-planner in the case when no published guideline exists. This becomes the end goal for the activity.

• State the source used that provided you with the best practice (i.e., article from peer reviewed journal, name of consensus statement or clinical guideline, etc.).
• State the current practice of the group of learners to which your educational activity is targeted. You can determine this based on interviews (formal or informal) with members of the target audience, a questionnaire, or a published article that reports on findings from learners. The key is to go beyond expert perception of the gap and to include the perception of the learner.
• State the source used that provided you with current practice (i.e., from questionnaire of specialty, interviews with physicians from target audience, etc.).
• State the gap based on the difference between best practice and current practice. This resulting gap will define the learning objectives you will develop, which in turn leads to the content of the activity. Indicate the type of gap [i.e., did the gap you isolated indicate learners lacked knowledge, competence, or that implementing it in practice or performance was the issue].
• The gap should inform you of the type of outcomes that are appropriate for this activity (i.e., does the gap indicate a need to improve learner competence and/or performance-in-practice). Once designated, this will define your choice of evaluation (outcome) measurement tools.
• Prepare a learning objective for each identified gap. Each objective should include a verb that is chosen to describe something a physician will do in practice (and not what the teacher will teach). For example, do not use verbs such as “learn” or “understand.” Use words such as apply, develop a strategy to …, etc. Ensure that the objective clearly states a standard against which one can judge the success in achieving the objective.
• Evaluation - Standard evaluation form asks for learners intent to change or consider change. Please consider developing the next level of evaluations. You may already have a tracking or trending system developed. Please provide.

• Prepare evaluation/outcomes questions depending on the intended outcomes you stated earlier. For example, if improvement in competence was indicated, then you must prepare outcomes questions related to demonstrating an improvement in competence. In addition, if improvement in performance-in-practice is indicated, you must also prepare questions relative to performance. To measure a change in competence, consider a case study with questions relating to the learner’s ability to apply knowledge with a strategy related to patient care. Present the case study and ask 3-5 related questions prior to the start of the activity to establish a base line level of competence. Use the same case study and questions post-activity to measure the change in competence. You may decide to measure competence by using paired questions. These questions ask the learners how they are currently managing their patients and based on the educational intervention, how they intend to manage them in the future.
• Performance questions are very specific and are related to what the learner has done in his practice since completing the activity. State your questions that relate to the objectives referenced above in terms of multiple choices or yes/no format. In a multiple choice format, indicate with an asterisk which option is correct.