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55th Annual CME Meeting

June 4 - 6, 2010

Ritz-Carlton, Amelia Island, Florida

SPEAKER FORMS

Contact Info, Bio, Itinerary | Educational Objectives | Presentation Requirements | Disclosure

Gap Analysis and Educational Objectives

 PLEASE SUBMIT BY February 28

These forms are for faculty that have been invited to speak at the GSD Meeting and

are currently on the program agenda as chosen by the GSD Program Director.

 

Speaker Name *

Email Address *

 

Required entries with every submission*

 

EDUCATIONAL OBJECTIVES

The GSD Education Committee has provided you with basic objectives for the topic(s) that you will be presenting. As an expert in the field however, please expand upon the provided objectives by completing this form.  Objectives should include a verb that is chosen to describe something a physician will do in practice (and not what the teacher will teach). For example, do not use verbs such as “discuss” or “describe, learn or understand.” Use words such as “apply, develop a strategy to…, etc.” Ensure that the objective clearly states a standard against which one can judge the success in achieving the objective. You must provide objectives for each talk.

 

Title of Presentation 1: 

Upon completion of this lecture/workshop/panel, the participant should be able to:

Example: administer ABC procedure so that patients see a decrease in ABC symptom

1)

2)

3)

 

Question - Please submit a multiple-choice question to test attendees' knowledge or competency of each topic pre- and post- presentation(s). Your question should be straightforward; no trick questions please!

 

 

Answers - please enter 1 per line
   
   
   
   
   


  

 

 

If you have more than one presentation, please continue with objectives and questions for presentations two and three. Otherwise, please skip to the last question at the bottom of this form.

 

 

Title of Presentation 2: 

Upon completion of this lecture/workshop/panel, the participant should be able to:

1)

2)

3)

 

 

 

Answers - please enter 1 per line
   
   
   
   
   


  

 

 

Title of Presentation 3: 

Upon completion of this lecture/workshop/panel, the participant should be able to:

1)

2)

3)

 

 

 

Answers - please enter 1 per line
   
   
   
   
   


  

 

In an effort to focus our funding efforts, please assist us by listing companies that might find your topic(s) of interest and might want to support the meeting financially: