Building a Better CME Program: A Guide to Needs Assessment, Learning Objectives, and the Kirkpatrick-Barr Model

This article outlines the importance of needs assessments for physicians and how to write learning objectives using Bloom's taxonomy of measurable verbs.

It also discusses how to evaluate CME programs for maximum effectiveness using the Kirkpatrick-Barr model.

Why needs assessments matter: The case for improved physician competence

A needs assessment should be the first step in any educational program development process.

The needs assessment allows us to identify what educational activities need to be developed in order to improve physician competence.

It is a systematic process for identifying the gaps between the current state of physician competence and the desired state of physician competence.

The process begins with a review of the literature and existing data sources.

We then identify experts in the field who can help us understand the problem and develop potential solutions. These experts may be physicians, other healthcare providers, or patients.

Once we have a good understanding of the problem, we develop educational objectives that will address the identified gaps in physician competence.

We then design educational activities that will help physicians to achieve the objectives.

These activities may include didactic sessions, small group discussions, case studies, or simulations.

We also develop methods for assessing whether or not the educational activities have been successful in improving physician competence.

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How to write good learning objectives: Bloom's taxonomy of measurable verbs

When it comes to creating measurable learning objectives, many CME planners turn to Bloom’s Taxonomy of Measurable Verbs.

This handy tool provides a list of verbs that can be used to create objectives at each level of Bloom’s Taxonomy, from the most basic level of knowledge to the highest level of critical thinking.

One of the great things about using Bloom’s Taxonomy to create learning objectives is that it forces you to think about the level of complexity you want your learners to reach.

For example, if you want your learners to simply remember a list of facts, you would use lower-level verbs such as “know” or “define.” However, if you want your students to apply that knowledge to a real-world situation, you would use higher-level verbs such as “analyze” or “evaluate.”

You can use this list as a guide when creating your objectives, and you’ll be sure to craft objectives that are clear, measurable, and achievable.


  • Know • Define • State • Identify


  • Describe • Explain • Interpret • Summarize


  • Demonstrate • Implement • Use


  • Differentiate • Organize • Relate


  • Assess • Recommend
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Evaluate your CME programs for maximum effectiveness: The Kirkpatrick-Barr model

When planners are trying to improve their training programs, it is important to have a framework in place to guide the process.

The Kirkpatrick-Barr model is a framework that can help you evaluate the effectiveness of your training. This model for training evaluation was developed by Dr. Donald Kirkpatrick and Dr. James Barr in the early 1970s.

The Kirkpatrick-Barr model is based on four levels of evaluation:

  1. Reaction
  2. Learning
  3. Behavior
  4. Results


The first level of evaluation is reaction. This is simply a measure of how participants reacted to the training.

Did they like it? Did they find it helpful? Were the materials and instructions clear?

This level of evaluation can be gathered through surveys and interviews.


The second level of evaluation is learning. This is a measure of what participants learned from the training. This can be evaluated through tests and quizzes.

It is important to note that reaction and learning are not the same. Just because participants liked the training does not mean they learned anything from it.


The third level of evaluation is behavior. This is a measure of whether participants are actually using what they learned from the training in their everyday work. This can be evaluated through observations and interviews.

It is important to ensure that participants are using the knowledge and skills they have learned in the workplace.


This is a measure of whether the training had a positive impact on the organization as a whole. This can be evaluated through KPIs and other measures of success.

It is important to ensure that the training program is actually making a difference in the organization.

The Kirkpatrick-Barr framework is a valuable tool for evaluating training programs.

It can help organizations determine whether a program is effective and identify areas that need improvement.

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