Designing a Simulation Curriculum

Fig. 34.1

Systematic educational design. Source: Sherbino J, Frank JR. Educational design: a CanMEDS guide for the health professions. Ottawa: Royal College of Physicians and Surgeons of Canada; 2011 [3]. Reproduced with permission

Needs Assessment

The first step in designing a relevant, comprehensive, and effective educational program is to conduct a needs assessment (NA). This serves as the foundation from which the curriculum structure flows. The curriculum’s goals and objectives are written based on the results of the NA. The instructional methods are then chosen to meet these goals and objectives.

NA refers to the systematic process of collecting and analyzing information to define the educational needs of the target group [4]. The NA can target individual learners or entire programs. The main point of the NA is that it makes systematic a process that before was largely based on assumptions. The NA identifies the target group’s learning needs. Learning needs refers to the gap between a learner’s current and desired ability that can be overcome by a learning activity [5].

Learning needs can be considered from several viewpoints including the learner, educator, institution (including accreditation or licensing bodies, specialty societies, or hospitals) and society [6]. Historically, educators often adopted the idea that they knew best the learner’s needs. However, taking the learner’s perceived needs into consideration not only addresses gaps that the learners themselves identify but may also increase their engagement in the learning activity. Ultimately, it is necessary to strike a balance that considers the perspectives of learners and educators, and also ensures that institutional and societal perspectives are represented.

NAs can be conducted using information from a number of different sources (Table 34.1). Each source has its own complexities, advantages and disadvantages, and resource requirements. Some of the desired information may already be in existence and easily accessible. In other cases, it may have to be acquired, which may add time and costs to the process.

Table 34.1

Information sources that can be used for a needs assessment

Source	Description	Strengths	Weaknesses
Questionnaire or survey	Set of written questions or items	• Low cost, relatively easy to administer • Can assess wide variety of topics and sample a large population • Quantitative and/or qualitative data	• Skill is required to write questions because the quality of data is dependent on the design and quality of the questions • Time and costs of administering, collecting and analyzing data • Responses may be difficult to generalize without an adequate response rate • Self reported data
Individual interviews	Individual face-to-face or telephone interviews	• Useful to get in-depth insight into participants’ perspectives • Can allow for open ended questions to assess broader range of topics or clarify/elaborate on responses • Qualitative data	• Resource and time intensive; requires trained interviewers to collect data and often high level expertise to data analysis • Often sample a limited number of participants • Self reported data
Focus group interviews	Group interview, usually 4–10 participants per group	• Allows interviewing several participants at a time • Many of the same advantages as individual interviews but group interaction can allow participants to express perspectives that they might otherwise not express in individual format • Qualitative data	• Resource and time intensive; requires trained interviewers and often high level expertise to analyze data • Data can sometimes be skewed by participants who dominate the discussion • Some participants may be reluctant to disclose information in nonanonymous group settings • Self reported data
Internal environmental scans	Examination of data generated within the organization; sources of data can include: • Course evaluations • Faculty assessments • Performance data from previous student cohorts • Mortality and morbidity rounds • Chart audits	• Much of this data has already been collected (with the exception of some chart audits)	• Data quality and utility can be variable • Data must be reinterpreted and repurposed • Chart audits can sometimes be time consuming and costly
External environmental scans	Examination of externally generated data; sources of data can include: • Accreditation surveys • Literature searches • Reports or practice guidelines from accrediting bodies or professional organizations	• Can provide a starting point for data collection • Can be low cost since data is usually already collected and accessible • Can identify new topics from outside organizations	• May not be applicable at local context • Data may have to be reinterpreted and repurposed
Strategic planning	Activities can include: • Review of organization’s mission and vision • Reviews of survey and interviews, internal and external scan results • Brainstorming of participants and stakeholders	• Usually involves a range of participants and stakeholders, including learners, teachers, educators, and administrators • Allows leadership to develop and prioritize needs • Useful for large scale curriculum development or renewal	• Resource and time intensive; requires skilled leadership and facilitation

Adapted from: Ratnapalan et al. (2002)[4], Kern et al. (2009)[2], and Sherbino and Lockyer (2011) [6]

Sources of information that are commonly used for NAs include external sources, internal sources, as well as data generated from questionnaires, surveys, or interviews. These information sources are further described below:

External sources include literature searches for original studies, reviews, or practice guidelines; published reports or statements from accrediting bodies (e.g., CanMEDS Roles put forth by the Royal College of Physicians and Surgeons of Canada or the core competencies defined by the Accreditation Council for Graduate Medical Education); and the results of accreditation surveys. External sources are often a good starting point because they can be fairly encompassing, yet readily available at a low cost.

Internal sources refer to data from within the institution that can be used to identify learning needs. These data sources include direct observation and faculty assessments, mortality and morbidity rounds, examination results from previous student cohorts, and chart audits. Some of this data may already be available at the institution level, but the quality can be variable and the data usually has to be repurposed and reinterpreted.

Questionnaires, surveys, interviews or focus groups can be used to gain insight into the learner’s, educator’s, and other stakeholders’ perspectives. These tools can be used when the available information is insufficient or when there is a need to collect new or more specific information.

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