Continuing medical education (CME) program development and needs assessment have historically been practiced within the tradition of Ralph Tyler's education model. In light of transformational social, political, economic, and technical forces that demand greater account-ability and responsiveness from physicians, CME units are challenged to transform their cultures and structures from models that deliver education to models that support the facilitation of learning for enhanced competence and performance. This article describes key change forces for physicians and brings program development and needs assessment into focus for the discussion. The impact of change forces on program development and needs assessment are examined, and some techniques to move beyond the traditional approach of felt needs are presented as a way of enabling strategic administrative planning and change management.
The full development and potential contribution of university extension is limited by confusion about its basic nature and misunderstanding about its relationship to other concepts such as public service and outreach. This article addresses the evolution, role, and basic characteristics of university extension, as well as various sources of uncertainty and confusion about it and the importance of achieving greater common understanding about its function. A framework and definition are provided for developing a shared perspective on the concept of university extension in the context of scholarship and public service.
Gordon Thompson and Wayne Lamble published an article in Vol. 26, No. 1 of this Journal titled "Reconceptualizing University Extension and Public Service." That issue also contained an invited response from Allan Lauzon titled "University Extension and Public Service in the Age of Economic Globalization: A Response to Thompson and Lamble". The present article is an invited rejoinder to the comments by Lauzon.
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