Role/position in Personnel involved in Professional Specialty and Length of Professional development related program program certification/ courses taught time in to role in program (and designated time, (dean/administrator, registration (if applicable) current role in (clinical updating, skill enhancement in educational if not full time) coordinator, faculty) designation (or program techniques, preceptor training, etc.) academic qualification) Activities, and duration (last 3 years) Overview of clinical/practicum sites* (personnel and learning resources) (See criteria 3.1, 3.2, 3.5) Note: A separate form should be completed for each clinical/practicum site. Clinical/practicum site [Name] of clinical/practicum site
Personnel involved in program (dean/administrator, coordinator, faculty) Professional certification/ registration designation (or academic qualification) Role/position in program (and designated time, if not full time) Specialty and courses taught (if applicable) Length of time in current role in program Professional development related to role in program (clinical updating, skill enhancement in educational techniques, preceptor training, etc.) Activities, and duration (last 3 years) Overview of clinical/practicum sites* (personnel and learning resources) (See criteria 3.1, 3.2, 3.5) Note: A separate form should be completed for each clinical/practicum site. Clinical/practicum site [Name] of clinical/practicum site