ACMD 615 Unit 4 Needs/Change 

Michael Brown, Fred Giberson, Sig Abelson 

6/28/2010 

Part 1: Needs:

1. Identify your most useful definition of Need

A need is an externally or internally perceived deficit in required knowledge or skill that compels the individual to act to resolve it.

2. Develop a teaching/learning case scenario that contains a need(s) assessment, a learning plan, and a learner assessment. Be sure that the learning does reflect and support the identified actual need translated to practice and that the learning method and content are reasonable for the level of the learner and the learner's practice. Please support and justify your decisions.

1. Needs Assessment: PERFORM A "GAP" ANALYSIS.

• Current situation: Determine the current state of skills, knowledge, and abilities and also examine section/departmental goals, climate, and internal and external constraints.
• Desired or necessary situation:  identify the desired or necessary conditions to achieve success. Distinguish actual needs from the perceived needs, or wants.

The difference is the "gap" between the current and the necessary and will identify needs, purposes, and objectives.

2. IDENTIFY PRIORITIES AND IMPORTANCE.

            Learner assessment:

3. IDENTIFY CAUSES OF PERFORMANCE PROBLEMS AND/OR OPPORTUNITIES.

            Learner assessment:

4.IDENTIFY POSSIBLE SOLUTIONS

Learning plan for:

Training in deficient knowledge or skill

Organizational change

1. Teaching/Learning Case Scenario:

A PGY-2 surgical resident is deficient in basic laparoscopic skills including knot-tying, tissue manipulation and bilateral hand coordination.

Needs Assessment:

            Actual -

• Routine faculty evaluation of Operating Room performance indicates insufficient manual dexterity in basic laparoscopic skills.
• Simulation laboratory exercise using standardized laparoscopic skills trainer and skill set indicates time overage and missteps, consistent with entry level surgical resident
• Review of operative log reveals deficiency in laparoscopic cases as surgeon junior (as opposed to first assistant)
• Self evaluation indicates uneasiness with laparoscopic skills resulting in case avoidance

Expected -

• PGY-2 residents are expected to demonstrate manual dexterity in basic laparoscopic skills including knot-tying, with efficiency. 

Learning Plan:

            Deficiency in laparoscopic skills will be addressed by this resident participation in:

1. Didactic DVD reviewing basic laparoscopic techniques including knot-tying
2. Proctored demonstration and practice of basic laparoscopic techniques in simulation lab
3. Independent practice of basic laparoscopic techniques in simulation lab
4. Proctored practice of basic laparoscopic techniques in simulation

Learning Assessment:

This resident’s achievement of learning basic laparoscopic techniques will be assessed by:

• Timed performance of basic laparoscopic skills in simulation lab, with comparison to peer group;

Once acceptable,

• Monthly self-evaluation of actual performance of basic laparoscopic skills in operating room
• Case by case faculty evaluation of actual performance of basic laparoscopic skills in operating room

               Reinforcement of Learning:

Quarterly simulation lab sessions with basic and then advanced laparoscopic skills proctored lessons.