The establishment of student needs: an important internal factor affecting course outcome.

Ensuring effectiveness in teaching and learning requires that those features of a programme threatening maximal student achievement be identified. Learner involvement in establishing these features is important in ensuring programme success and student motivation.This study aimed to identify these features through assessment of self-perceived needs and concerns, and to establish strategies for their resolution. A survey instrument, developed from a pilot study, was administered to secondand third-year medical students. Students were asked to identify and rank the 10 needs or concerns that caused most distress for them and suggest solutions.Both groups identified content overload as their most serious concern followed by learning problems and time management. Other problems for junior students were failure to cope with work and fear of failure. Senior students identified financial matters, time constraints on recreation and sport and the general medical school atmosphere as problems.The commonest solutions offered were: introduction of a study skills course; curriculum rearrangement; provision of transport; and improvement in lecturing skills. Many of the data are transferable and useful for the general understanding of student needs and concerns in teaching institutions.