Having adopted this mind set, the student/teacher should go about the business of discovering what he does and doesn’t already know. Residency training has provided the baseline knowledge and a context with which to learn new knowledge. But in a given person, the knowledge base may be spotty, and will have changed over time. Indeed, some things which we "knew for sure" in training, turn out not to be the case. And, of course, there are new areas of knowledge, which were not even a part of the knowledge base during our training. How does one go about assessing a student’s needs? (Again bearing in mind that you may be your only student?) There are external ways of going about this, using self assessment or other examinations. Examples are the FOCUS self assessment exam, the PIPE exam of the American College of Psychiatry, and for Board Certified physicians, the Examination in Advanced Psychopharmacology of the American Society of Clinical Psychopharmacology.
Another approach is the "journal club" approach. In this form of needs assessment, a group of clinicians discusses articles or their own cases; each person makes a note of areas in which they find themselves asking a lot of questions or in which they are hearing a number of new or unfamiliar facts. (In the proper atmosphere, the participants can also give their colleagues feedback on apparent areas of need.)
Another way for the clinician to assess need is to go through their case load, and make a note of cases in which they seem to be less effective or efficient. These cases may point to areas in which more education is needed. Similarly, there may be areas which are not represented in a caseload (e.g., particular diagnoses, genders, racial/ethnic groups, etc.). The clinician can ask herself whether this is because she feels less confident about patients in these groups, pointing therefore to an educational need.