Chart audit and chart stimulated recall as methods of needs assessment in continuing professional health education

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This article describes the chart audit (CA) and chart stimulated recall (CSR) needs appraisal methods, outlines their strengths and limitations, and provides examples of their applications in the continuing education (CE) environment. Both CA and CSR can be valuable tools for continuing educators and learners in the following activities: the assessment of needs prior to education, the identification of educational needs specific to a particular condition, the reassessment of needs posteducation, the study of needs arising from factors influencing management choices, needs assessment associated with professional competence and performance, and the assessment of educational needs specific to practice guidelines. Providing personalized and individualized feedback around actual practice and patients' charts are attractive features shared by both procedures. CA has been used across disciplines and care sites and is viewed as less costly and less intrusive than most needs assessment tools. Its true value lies in the choice of appropriate explicit and implicit criteria and the definition of valid standards, along with the availability of trained abstracters. When compared to CA, CSR potentially increases the content validity and types of information accessible. As well, it explores the reasoning around diagnostic, investigative, and management decisions. Further, CSR permits patient, environmental, system, and other factors that can influence clinical decisions to emerge. Opportunities for professional educators and learners to acquire knowledge and skills about these needs appraisal approaches are required. As well, further studies regarding the impact, feasibility, acceptability, cost effectiveness, reliability, and validity of these tools in new care environments are required. Last, it is important that the results of CA and CSR studies require diffusion to those in CE worksites. In this way, such findings can be translated and imbedded into professional practice.

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