Problem Identification and Needs Assessment PDF

Problem Identification and Needs Assessment Course code: 610 Curriculum Planning Learning Objectives By the end of this session, you will be able to: 1. Identify the health care problem that can be addressed by the curriculum. 2. Discuss the general needs assessment for curriculum development. 3....

Problem Identification and Needs Assessment Course code: 610 Curriculum Planning Learning Objectives By the end of this session, you will be able to: 1. Identify the health care problem that can be addressed by the curriculum. 2. Discuss the general needs assessment for curriculum development. 3. Differentiate between the current and ideal approaches to the problem. 4. Describe the importance of problem identification and general needs assessment. 2 Problem Identification Overview: Building the foundation for meaningful objectives 3 Identification of the Healthcare Problem A clear definition of the problem provides a focus for curriculum’s goals and objectives, which in turn helps in focusing the educational and evaluation strategies. A comprehensive definition of the problem includes consideration of epidemiology, impact on patients, healthcare professionals, and society. 4 Identification and Critical Analysis of the Health Care Problem To address the deficiency in knowledge, we can carry out research in many fields like: Public health Epidemiology Health care system Utilization and resources Emerging knowledge of disease Patient support groups Educational theory and practice. 5 Identification and Characterization of the Healthcare Problem We need to identify: Who is suffering from the problem we are identifying? And how? Whom does it affect? Patients Health care professionals Medical educators Society What does it affect? Clinical outcomes Quality of life Quality of healthcare Use of healthcare and other resources Medical and nonmedical costs Patient and provider satisfaction Work and productivity Societal function 6 Problem Identification for Poverty in Health Care Curriculum Example from your readings: Problem Identification for a Poverty in Health Care Curriculum Thirty-seven million Americans live below the federal poverty threshold, representing 12.6% of the U.S. population. Even more, nearly 90 million Americans live below 200% of the federal poverty threshold, an income at which many struggle to make ends meet. Given these realities, most physicians will work with low-income patients, regardless of their specialty or practice location. Countless studies have shown that lower socioeconomic status (SES) is associated with unique challenges to health, higher disease burden and poorer health outcomes” 7 Problem Identification for Poverty in Health Care Curriculum (Cont.) How common and how serious are these 12.6% of the U.S. population, even more— effects? nearly 90 million Americans—live below 200% of the federal poverty threshold Quality of life, Most physicians will work with low-income Quality of health care, patients, regardless of their specialty or Use of health care Services practice location Medical and nonmedical costs, patient and Countless studies have shown that lower provider satisfaction, work and productivity, socioeconomic status (SES) is associated with the functioning of society unique challenges to health, higher disease burden, and poorer health outcomes 8 General Needs Assessment Definition: The general needs assessment is usually stated as: the knowledge, attitude, and performance deficits that the curriculum will address. The difference between how the problem is currently being addressed and how it should ideally be addressed is the general needs assessment. 9 Difference between the Current Approach and Ideal Approach IDEAL CURRENT Needs Approach. approach Assessment Problem Identification 10 Key Differences between the Current Approach and Ideal Approach 11 Example of the Current Approach (Job Analysis): Treatment of Diarrheal Illness Among the Private Practitioners in Nigeria. Ninety-one doctors in Nigeria, who had heard of oral rehydration therapy (ORT) and expressed belief in its efficacy were interviewed using a structured questionnaire to determine their knowledge of, attitude toward, and practice of treatment of diarrheal illness. 50% said that they would recommend salt-sugar solution (SSS) over standardized ORT due to availability and cost-effectiveness. However, only 55% knew how to prepare SSS correctly. Even though 76% of the doctors believed that viral infections were a common cause of diarrhoea, antibiotics were commonly used. The study revealed a high rate of inappropriate drug use and a deficiency in the knowledge and practice of ORT. 12 Example of the Current Approach (Job Analysis): what is being done currently by each of the following A. Patients (including their families, Dehydrated patients are receiving inappropriate treatment significant others, caregivers) B. Health care professionals 91 doctors in Nigeria, were interviewed using a structured questionnaire 50% said they would recommend salt-sugar solution (SSS) over standardized ORT C Medical educators a deficiency in the knowledge and practice of ORT D. Society (including community a high rate of inappropriate drug use networks, health care payers, and policymakers) 13 Factors that may Aggravate or Alleviate the Problem of Interest Important Factors: To decide the ideal approach to the problem, you need to examine the same items that may aggravate or alleviate the problem: Predisposing factors Enabling factors Reinforcing factors 14 Approach to Deal with Problems Example: Role of Patients/Families Parents of children discharged from a neonatal intensive care unit (NICU) generally have not received any instruction about the developmental milestones that should be expected of their children. To foster timely and appropriate developmental assessment of the children discharged from a NICU, neonatologists need to address the role that parents play in observing their children’s development 15 Approach to Deal with Problems (Cont.) what each of the following groups should do to deal most effectively with the problem (appropriate developmental assessment)? Patients The families will play a role in observing a child’s development Health care professionals Neonatologists will work with families to address their role Medical educators To prepare the health practitioners on the family centered care module Society Less burden on the health system by early diagnosis and treatment of the developmental delays 16 Ideal Approach The ideal approach should serve as an important, but not rigid, guide to developing a curriculum. One needs to be flexible in accommodating others’ views. Also, should be more flexible in espousing an “ideal” approach based on individual opinion than an “ideal” approach based on strong scientific evidence. 17 Collecting Information 18 Collecting Information (Cont.) How to obtain the necessary information? Published literature Reports/document (government/regulatory bodies) Public health statistics Hospital data Meeting of experts Surveys Focus group Nominal group technique Delphi technique Reviews 19 Problem Identification and General Needs Assessment: Other Importance Builds a rationale for your curriculum Grounds it in patient and societal needs Focuses a curriculum’s goals and objectives In turn focus on the educational and evaluation strategies Prevents duplication of effort Makes you an expert and a scholar 20 Problem Identification and General Needs Assessment: Other (Cont.) A well-prepared needs assessment will impact the future steps by identifying: educational methodologies, faculty development resources, potential funding resources, and opportunities for the dissemination of the curriculum. 21 Summary It is necessary to assess the specific needs of one’s targeted learners and institution(s) before proceeding with further development of a curriculum To address a health care problem effectively and efficiently, a curriculum developer must define the problem carefully Reach to the current and ideal approaches to the problem. The difference between the ideal and current approaches. Highlight deficiencies in the knowledge, attitudes, or skills of practitioners. Educational efforts can be directed toward closing those gaps. 22 References Textbook reading: Thomas, P. A., Kern, D. E., Hughes, M. T., & Chen, B. Y. (Eds.). (2015). Curriculum development for medical education: A six-step approach (3rd ed.). Johns Hopkins University Press. Plus: Doran, K. M., Kirley, K., Barnosky, A. R., Williams, J. C., & Cheng, J. E. (2008). Developing a novel poverty in healthcare curriculum for medical students at the University of Michigan Medical School. Acad Med., 83, 5–13. Okeke, T. A., Okafor, H. U., Amah, A. C., Onwuasiqwe, C. N., & Ndu, A. C. (1996). Knowledge, attitude, practice, and prescribing pattern of oral rehydration therapy among private practitioners in Nigeria. J Diarrhoeal Dis Res., 14(1), 33–36. Wennberg, J. (2004). Practice variations and health care reform: Connecting the dots. Health Aff (Millwood). Suppl Web Exclusives: VAR140–44. https://doi.org/10.1377/hlthaff.var.140 (The example is adapted based on permission from the curricular project of Vera J. Burton, MD, PhD, and Mary L. Leppert, MBBCh, for the Johns Hopkins Longitudinal Program in Faculty Development, Cohort 26, 2012–2013.) 23 Credits The following faculty is attributed with the slides and ideas of this session: Abdellatif Abdelwahab, MD 24