Physical Therapists Endocrinology Pediatrics Respiratory Therapists Family Medicine Psychiatry Others (specify): Internal Medicine Radiology Neurology Surgery Neurosurgery Urology OB/GYN (specify): Education Format Based on the identified educational needs and desired results, what are the best educational formats for this education activity? Please select all that you intend to use. Competence/ knowledge Performance Patient Outcomes Didactic lectures Hands-on procedural/skills workshops Reinforcing materials such as pocket cards, mobile instruments, etc. Small groups / Panel discussions Interactive case-based presentations Reinforcing activities such as chart audits, hospital QI data review, etc. Demonstrations Simulation lab Other: Interactive (Audience Response System Standardized patient Other: Desirable Physician Attributes Please select all of the core competencies that apply to the content of this activity. Institute of Medicine Inter-professional Education ACGME/ABMS Competencies Competencies Collaborative Competencies Patient care and Procedural skills Provide patient-centered care Values/Ethics for Interprofessional Practice. Medical knowledge Work in interdisciplinary Roles/Responsibilities Practice-based Learning/Improvement Employ evidence-based practice Interprofessional Communication Interpersonal and Communication skills Apply quality improvement Interpersonal and Communication skills Professionalism Utilize informatics Teams and Teamwork Systems-based Practice Other: Outcomes Measurement What type of evaluation method/tool(s) will you use to determine the activity’s effectiveness for achieving the desired results and creating change in the learner’s competence, performance or in patient outcomes? Competence/ knowledge Performance Patient Outcomes Post-activity survey Peer Review / Direct Observation Patient Audits
Physical Therapists Endocrinology Pediatrics Respiratory Therapists Family Medicine Psychiatry Others (specify): Internal Medicine Radiology Neurology Surgery Neurosurgery Urology OB/GYN (specify): Education Format Based on the identified educational needs and desired results, what are the best educational formats for this education activity? Please select all that you intend to use. Competence/ knowledge Performance Patient Outcomes Didactic lectures Hands-on procedural/skills workshops Reinforcing materials such as pocket cards, mobile instruments, etc. Small groups / Panel discussions Interactive case-based presentations Reinforcing activities such as chart audits, hospital QI data review, etc. Demonstrations Simulation lab Other: Interactive (Audience Response System Standardized patient Other: Desirable Physician Attributes Please select all of the core competencies that apply to the content of this activity. ACGME/ABMS Competencies Institute of Medicine Competencies Inter-professional Education Collaborative Competencies Patient care and Procedural skills Provide patient-centered care Values/Ethics for Interprofessional Practice. Medical knowledge Work in interdisciplinary Roles/Responsibilities Practice-based Learning/Improvement Employ evidence-based practice Interprofessional Communication Interpersonal and Communication skills Apply quality improvement Interpersonal and Communication skills Professionalism Utilize informatics Teams and Teamwork Systems-based Practice Other: Outcomes Measurement What type of evaluation method/tool(s) will you use to determine the activity’s effectiveness for achieving the desired results and creating change in the learner’s competence, performance or in patient outcomes? Competence/ knowledge Performance Patient Outcomes Post-activity survey Peer Review / Direct Observation Patient Audits
RSS_Application_2017.docx