participated as readers. In total, 123 questions andanswers were generated. The type and content of thequestions referred to issues affecting PHC andgeneral practice worldwide. Dozens of importantscientific references were exchanged.

This conference was a very fruitful experience thatallowed for the gathering of several generations ofGPs and general practice trainees, as well as thespecial guest.

We conclude that a virtual conference organisedon an e-mail list server can be an extremely powerfultool of professional development. It is also worthemphasising the temporal flexibility of this event andits lack of rigid schedules, which allows participants toengage in the event at times convenient for themand free of charge. Furthermore, other than the timespent on its organisation, the conference did not incurany financial expense, sponsorship or other outlay.

Correspondence: Luıs Filipe Cavadas, Centro de Saude de Senhora daHora, Rua da Lagoa sem numero, 4460-352 Senhora da Hora,Portugal.Tel: 00 351 967 241978; Fax: 00 351 22 9568562;E-mail: luisfilipemcavadas@gmail.com

doi: 10.1111/j.1365-2923.2010.03649.x

Needs assessment as a strategic planning tool

Payal K Bansal, Savita Marathe, Prakash M Shere &Mrudula A Phadke

Context and setting Faculty staff development andtraining opportunities in health professions educa-tion in developing countries are limited. The need forfaculty development programmes has been expressedin various taskforce recommendations and by regu-latory authorities.Why the idea was necessary As a recently establisheduniversity department of medical education, weenvisaged a multi-tiered faculty development pro-gramme that would fill identified gaps in healthprofessions education. To define the focus andcontent of this programme, we conducted a needsassessment targeting key stakeholders.What was done Three stakeholder groups, namely, acore team of university leadership, workshop facultymembers and participants in existing programmes,took part in a survey. The survey instrument listed 39competencies under nine education-related themes:learning; curriculum; teaching; assessment; contin-uing professional development; administration;mentoring; education research, and leadership.Participants were asked to rate each competency for

its importance and their ability in it using a 4-pointLikert scale. Additionally, structured interviews wereconducted for the core group.Evaluation of results and impact For each of the threegroups, competency means for importance and abilitywere ranked in descending order. Teaching andassessment received the highest importance rankingsand teaching received the highest ability ranking. Theimportance–ability gap was greatest for assessmentacross all three groups. The interviews identifiedfaculty motivation and communication skills as keyareas of deficiency. The participant group’s high self-ratings on teaching and education research were anindicator of the existing programme’s impact.This study identified perceived gaps in specificcompetencies, thus indicating directions for futureprogrammes. It provided evidence of the positiveimpact of existing programmes and also broughtfunding. Most importantly, it established trust withstakeholders and built a foundation for futurecollaboration and support.

Strategic planning is a complex process. Forprogrammes to succeed, plans must be evidence-based and have the consensus of key stakeholders.Needs assessment can be used as a powerful strategicplanning tool.

Correspondence: Payal K Bansal, Department of Medical Educationand Technology, Maharashtra University of Health SciencesRegional Centre, 3rd Floor, ESIS Hospital Building, Aundh, Pune411027, India. Tel: 00 91 9850 266705; Fax: 00 91 20 2728 0454;E-mail: payal_pune2000@yahoo.com, payalkbansal@gmail.com

doi: 10.1111/j.1365-2923.2010.03640.x

A novel learning experience: case-based,evidence-based debate

Caroline C P Ong & Kannan L Narasimhan

Context and setting We hold an inter-hospital,paediatric surgery joint journal club every 2 monthsas part of our postgraduate continuing medicaleducation programme. The audience comprises allgrades of doctor, from medical officer to seniorconsultant.Why the idea was necessary Traditional postgraduateteaching methods include lectures and journal clubs.Lectures are efficient for summarising anddisseminating large amounts of information, but aredisadvantaged by learner passivity. Journal clubs areuseful for helping attendees keep up with medicaladvances, but answer only specific questions.Problem-based tutorials, although popular in

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undergraduate teaching because of learnerengagement, are limited by group size and timeconstraints. We trialled a novel teaching method thatcombined a popular teaching tool, ‘debate’, with acase-based, evidence-based format. The aim was toensure learner engagement in a large group withemphasis on the clinical application of publishedevidence.What was done Two trainees were given the sameclinical case to prepare 1 month ahead of the debate.The case chosen was suitable for both surgical andconservative treatments based on current acceptedpractice, so the debaters were assigned to argueopposite positions. Rules were specified that restrictedthe presentation format and time in order to encour-age detailed literature review and audience participa-tion. Each trainee was asked to summarise the case,management and relevant articles in 10 minutes usinga maximum of five slides, and to allow 2 minutes forrebuttal. The debate outcome was judged by anaudience vote for the more convincing speaker basedon the quoted literature. We collected feedback using a5-point Likert scale response on whether the debatemet learner needs.Evaluation of results and impact There were 16responders, of whom seven were medical officers andregistrars, four were specialists and five did not specifytheir grade. A total of 87% found it a new andenjoyable style of learning and 75% wanted more ofsuch sessions. Compared with a lecture, more thanhalf the audience felt that the debate helped them tounderstand the literature better and to apply theevidence to actual patients. Compared with a regularjournal club, 69% felt that it helped them tounderstand the topic better.

This method engaged the interest of most of theparticipants, which is typically difficult on a Fridayevening after work. We chose a controversial topic,vesico-ureteric reflux, because of marked variations inmanagement worldwide. Prior to this session, severaljunior doctors were unaware of recently publishedlandmark articles. The case was deliberately con-structed to maximise the opportunity for debateusing published evidence. Similarly, in other disci-plines, suitable debate topics with conflicting evi-dence can be chosen. The structured format of thedebate, with its arbitrary restrictions on time andthe number of slides used, kept the debate succinctand lively. Overall, 94% of the audience agreed thatthe timing was just right.

The preparatory work required of the organisersand debaters was substantially more than thatrequired by the usual journal club. We do not thinkthis format can replace lectures for global topicunderstanding, nor evidence-based journal clubs. It

should be considered as an entertaining, educationalalternative to regular journal clubs.

Correspondence: Dr Caroline C P Ong, Consultant, Department ofPaediatric Surgery, K K Women’s and Children’s Hospital, 100Bukit Timah Road, Singapore 229899, Singapore.Tel:+ 65 6394 1113; Fax: +65 6291 0161;E-mail: Caroline.Ong.CP@kkh.com.sg

doi: 10.1111/j.1365-2923.2010.03644.x

Using a commitment-to-change strategy to assessfaculty development

Douglas L Myhre & Jocelyn M Lockyer

Context and setting ‘Cabin Fever’ is an establishedUniversity of Calgary faculty development programmeoffered annually to help rural educators improvetheir teaching and assessment skills. Teachers partic-ipate in five 80-minute workshops (out of 22) and oneplenary session and interact informally with col-leagues during lunches and dinners. Workshop topicshave included: teaching procedural skills; teachingprofessionalism; teaching empathy; teaching multiplelevels of learners; the resident as teacher; assessmentand feedback; learning technologies; patient safety,and building effective workplaces.Why the idea was necessary Post-course evaluationsindicated the course was successful. There was noinformation about the programme’s ongoing impacton teaching staff and therefore potentially on learn-ers. Data were required to defend the programme’scontinuance after 10 years because it requires signi-ficant resources.What was done We adopted ‘commitment-to-changestatements’ (CTCs) to enhance course evaluation.At the end of the programme, doctors were asked toidentify three changes they planned to make in thenext 3 months and their level of commitment tomaking each change (using a scale of 1–4, where1 = low and 4 = high). Three months later, partici-pants were asked whether the intended changes werecomplete, still in progress, incomplete or would notbe undertaken. We analysed the quantitative datadescriptively and themed the commitments.Evaluation of results and impact Approximately 40%(35 ⁄ 81) of the participants completed CTCs at theend of the programme. Over 75% (n = 27) providedcomplete data for 79 changes (2.9 per doctor)3 months after the course. Initial commitment tomaking the changes was high at 3.36 ⁄ 4. At 3 months,33 (41.8%) of the changes had been implemented, 24(30.4%) had been partially implemented, 21 (26.6%)

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