Example_of_discrepancy_analysis_needs_assessment_questionnaire.doc

Example_of_discrepancy_analysis_needs_assessment_questionnaire.doc

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Example of discrepancy analysis needs assessment questionnaire comparing current and desired level of knowledge 1. For each of the medical areas listed below, please rank your current level of knowledge and your desired level of knowledge from 1 to 5, with 1 being the lowest level of knowledge and 5 being the highest. In the last column please specify topics within the subject area that would be of the most interest to you. SUBJECTS Current Level of Desired Level of Specific Topics Knowledge Knowledge of Interest (Rank 1 to 5) (Rank 1 to 5) DERMATOLOGY Skin infections 1 2 3 4 5 1 2 3 4 5 Melanoma/Other Skin Malignancies 1 2 3 4 5 1 2 3 4 5 Skin Manifestations Of Systemic Disease 1 2 3 4 5 1 2 3 4 5 Hair and scalp Disorders 1 2 3 4 5 1 2 3 4 5 Leg Ulcers 1 2 3 4 5 1 2 3 4 5 Dermatological Surgery 1 2 3 4 5 1 2 3 4 5 Other (specify) 1 2 3 4 5 1 2 3 4 5 INFECTIOUS DISEASE Urinary Tract Infections 1 2 3 4 5 1 2 3 4 5 Lower Respiratory Tract Infections 1 2 3 4 5 1 2 3 4 5 Upper Respiratory Tract Infections 1 2 3 4 5 1 2 3 4 5 Viral Infections 1 2 3 4 5 1 2 3 4 5 Other (specify) 1 2 3 4 5 1 2 3 4 5 GENERAL Office Management 1 2 3 4 5 1 2 3 4 5 Patient Counselling 1 2 3 4 5 1 2 3 4 5 Cost Effective Prescribing 1 2 3 4 5 1 2 3 4 5 Other (specify) 1 2 3 4 5 1 2 3 4 5 OTHER Please specify 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 ____________________________________________________________________________________ © 2004 Ian Anderson Continuing Education Program in End-of-Life Care University of Toronto Opinion Leader Workshop Learning Needs Assessment and Pretest 1
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2. If a continuing education program is accredited by the College of Family Physicians in Canada, to what extent would this increase your interest in participating in the program? [check only one box below] Definitely more likely to participate [ ] Somewhat more likely to participate [ ] Does not make a difference at all [ ] Please explain your response. 3a. Which of the following formats for continuing education programs are useful to you? [check as many as apply] b. Which type do you prefer? [check only one] 3a. 3b. Are Useful Preferred Short video [ ] [ ] Short video with reference [ ] [ ] materials A user friendly computer program [ ] [ ] compatible with your system A user friendly computer program [ ] [ ] compatible with your system PLUS reference materials Paper format only [ ] [ ] c. Would either of the following be of any interest to accompany any of the above? Yes No A series of short questions for self testing [ ] [ ] An accredited written program [ ] [ ] ____________________________________________________________________________________ © 2004 Ian Anderson Continuing Education Program in End-of-Life Care University of Toronto Opinion Leader Workshop Learning Needs Assessment and Pretest 2
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4. The Ontario Government has sponsored the development of anti-infective prescribing guidelines for community acquired infections and these have just been introduced. a. Have you seen these new guidelines? Yes [ ] No [ ] b. What do you feel is the role of anti-infective prescribing guidelines, in family practice?
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