Needs assessment identifies "real world" problems to result in priorities for action. It is used for educational planning, but is inconsistently practiced and poorly researched. This paper describes how 14 novices conducted needs assessments and explains the outcomes. The research context was a year-long fellowship in medical education in which the 14 physicians conducted needs assessments in preparation for creating a medical curriculum. Twenty findings document: (1) activities conducted and sources contacted; (2) facilitating and hindering factors; (3) what participants learned about the process; and (4) changes to the product (curriculum) resulting from the needs assessment. The conceptual framework of C. Argyris and D. A. Schon for theories of action was used to derive four conclusions, which taken together, stress the ways in which theoretical and ideal needs assessments differ from "real world" needs assessment. The paper suggests methods practitioners across the professions can use to conduct needs assessments more effectively and efficiently. (Contains 7 tables and 32 references.) (Author/SLD)