Step #2: Targeted Needs Assessment

Determine the specific learning needs of the struggling resident to guide the development of the plan.

A. Data Gathering & Analysis

Two main sources of information are reviewed to identify the main areas of struggle for the learner:

  1. Assessments: A series of formal and summative assessment documents (EPAs, ITERS, field notes, written comments to the learner, OSCEs, exams, and other documented feedback) are reviewed to identify trends flagged in comments or lower Likert scale scores. Reviewing any other informal documentation or information (i.e. e-mails, conversation notes, etc.) that can contribute to understanding the learner’s issues is helpful. The information used MUST have been shared directly with the learner. Otherwise, it cannot be used in deciding if the resident should go on Remediation or Probation.
  2. Consultation Interviews: After a review of assessments, the Program Director is consulted (individually, or with evaluating preceptor(s)) to provide additional context and clarity around some of the assessment data. The focus is on identifying what the learner is not achieving in the objectives defined by the program. Other preceptors who have worked with the learner may also be invited for clarification and feedback. Finally, the learner themselves should also be consulted to provide additional information and input into the development of their learning plan.

 

B. Identifying Gaps in Competence

It is important make an accurate educational diagnosis and identify specifically the performance deficiencies to be targeted through a remediation plan.

Refer to the following key sources:

  • Royal College Objectives of Training or Discipline Competencies for your program
  • Your program’s training objectives for each rotation
  • The CanMEDS Milestones guide
  • The CanMEDS-FM roles and the Six Skill Dimensions of Family Medicine

It is common that a learner will encounter more than one difficulty in more than one domain. Difficulties identified in one domain can sometimes be symptoms of a larger problem in another domain (i.e. professionalism or communication issues can be identified at the root of deeper issues in the Medical Expert domain). Taking time to identify the core of the problem and establishing clear areas of focus sets up the next phase: developing learning objectives.

In general, Learning Support Plans address no more than 5 learning objectives at a time to optimize the chance of success. Remediation Plans, at times, have more learning objectives. It is recommended that these be kept below 10.