Dr Richard Eve from Taunton developed PUNS and DENS.
Extract from North Thames Deanery Site
I have changed the last acronym to PENS (Personal Educational Need), as I feel this to be more inclusive.
PUNs are Patient Unmet Needs (NOT patient’s unmet wants!)
Keep a diary and record episodes when you come up against a PUN! This could be done by each member of the practice team and could be useful in developing the PPDP.
Alternatively you could record just one PUN that was particularly significant to you, these have been coined “Sticky Moments” (Robin While & Margaret Attwood)
Generate either during consultation or indirectly. Ultimately we are here to provide for our patients needs, anything hampering our work therefore is a PUN.
They may be Clinical, Non-Clinical, Skills or Attitudes, For example:
§ Lack of knowledge about a subject.
§ What are current guidelines?
§ How do I refer appropriately?
§ Child protection
§ How to access voluntary services
§ How to work the computer!
§ Poor time management
§ Dysfunctional practice team
§ Poor communication within practice
§ How do I inject joints?
§ Lack of confidence in examining fundi
§ Poor consultation
§ Difficulty in handling conflict
PUNs help focus and direct your learning needs; they show you some of your Personal Education Needs, PENs.
Plan specific group or individual learning activities that will resolve your PENs. Use the PUNs diary or sticky moments worksheets.
Discuss your PUNs and PENs with appropriate members of your practice team. This in itself is a group learning exercise that qualifies for PGEA.
The following flow sheet shows how it could be incorporated into group learning activity.