Increasing interest in continuing medical education is reflected in gr
eater demand for educational programmes. Content and educational strat
egies should be appropriate to the needs of the target audience. Prope
r matching of content and strategies to target needs of users requires
the instructional design to be carefully planned and based on a needs
-assessment study. We illustrate the influence of educational needs on
content and learning strategies through an educational programme for
general practitioners on the subject of malignant melanoma. Its design
includes: i. a trigger leaflet; ii. a core text; iii. a set of intera
ctive case studies; iv. a job-aid card; v. a follow-up leaflet; and vi
. recorded messages available by telephone. It addressed, in particula
r, the key decision to be taken by the general practitioner: 'When sho
uld I refer a patient with a suspected early melanoma: when should I m
erely reassure the patient?' Doctors were invited, in the programme, t
o make decisions about referral of patients. They received immediate f
eedback on their decisions. Various strategies reinforced this feedbac
k.