An Educational Needs Assessment for Urban and Rural Primary Care Clinicians
in Eastern Ontario: Focus on Youth Mental Health
Dr. Helen Spenser, Psychiatry, Mental Health Patient Service Unit, Children’s Hospital
of Eastern Ontario
Study Rationale
Since the 1980’s, Medical Educators such as Abrahamson (1999), and Davis, et al.
(1992), have introduced principles of Adult Learning and Problem Based Learning into
CME. The purpose of this study was to pilot a needs assessment surveying groups of both
rural and urban health care providers (rural = population served <50,000) as to preferred
learning format, and perceived gaps in knowledge with respect to ability to provide
comprehensive mental health care to youth.
Background
A survey done in the Mayo Clinic showed only 27% GP’s were satisfied with CE courses
attended in psychiatry (Tinsley, et al. 1998). An Australian study (Veit, et al. 1996),
surveyed 57 rural and urban GP’s finding 82% to have concerns about knowledge and
competence to treat adolescent patients who made up 10% of their practice. Many
Educational Programs for physicians are offered without assessing their learning needs.
Method
A two-page educational needs assessment questionnaire was developed following a focus
group with eight academic family doctors. Six questions polled clinicians for their
preferred learning format, for example, large group lecture versus live supervision by a
psychiatrist. Thirteen possible topics for Continuing Education with respect to Child and
Adolescent Mental Health were given using descriptive rather than a diagnostic frame.
Demographics
Ninety five health care professionals (61 urban and 34 rural; 74 physicians, 6 nurses, 3
social workers, one child care worker, and 2 others) were surveyed using multiple
sources for questionnaires including: rural Grand Rounds (2), mail out to rural
physicians, pediatric updates at urban university (2), and mail out to urban physicians (2).
Results
Urban physicians were significantly more likely to request educational sessions on
dealing with aggressive and “wild” behaviour in youth (Z=3.54) P<.001. Rural health
care providers showed a trend towards more eclectic and variable learning needs with top
three choices ADHD, Mood Disorder, Learning Disability and Anxiety. Rural attendees
were less likely to be physicians and more likely to request hands-on counseling skills
teaching. Both Urban and Rural clinicians show a preference for small group interactive
learning format.
Implications
This study reinforces the importance of evaluating the demographics and interests of both
the physician and his or her patient population prior to launching an educational program.
There is a clearly identified need for more education of clinicians in Adolescent Mental
Health. Further study will consider adding measures for yet unperceived needs. For future
studies, equal numbers of rural and urban clinicians surveyed with a larger total number
would be preferable for more statistical power.
References
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Hardoff, D., Tamir, A., Palti, H. (1999). Attitudes and practices of Israeli physicians
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