Problem Analysis Worksheet
Student: Cohort: ______________ Date:
___/____/02
1.State the problem in as clear and concise a
manner as possible:
2.Why is this a problem?
3] Where is the problem located or centered?
4] Who is affected by the problem?
5] Analyze the above for symptoms of a
problem. Ask yourself what causes the
condition that makes you think there is a real problem. Is this really the problem or only the
manifestation of a symptom
SYMPTOMS OF THE PROBLEM
a] _________________________________________________________________
b] _________________________________________________________________
c] _________________________________________________________________
d] _________________________________________________________________
e] _________________________________________________________________
Problem Analysis Page 2
6] List all possible explanations (causes) for the
problem. Use complete sentences, such
as: “The problem is a result of ineffective communication between departments.”
A) _______________________________________________________
B) _______________________________________________________
C) _______________________________________________________
D) _______________________________________________________
7] Specifically, in what practical ways do you
expect the situation to improve after the intervention?
How
will your organization benefit from this change? Think of this as the “BEFORE” and
“AFTER” of the intervention.
How it is Now How it Will Be (Objectives)
____________________________________ ____________________________________
____________________________________ ____________________________________
____________________________________ ____________________________________
____________________________________ ____________________________________
8] What are the first two or three steps you need
to take to get started?
a]
b]
c]
APPROVAL
PROCESS:
Action
Research Project Advisor: Date:
/ /2002
(Signature)
Student
/ Site Contact: Date: /
/2002
(Signatures)
Phone
Number: ( ) _____ - ________ Ext.
______