Session Documentation - Other Series

* Presentation Date:

* Presentation Time:

* Location:

* Event Topic/Title:

* Planner:

Phone:

Email:

Coordinator/Liaison:

* Phone:

* Email:

* Speaker(s):

Phone:

Email:

Yes No Need Commercial Support? If Yes, contact CME Coordinator below

Professional Practice Gap

Gap: State which gap from the RSS planning document will be addressed, or design an event-specific topical gap:

Educational needs that underlie the gap:
Medical Knowledge Competence Performance

Learning Objectives

Identify 1-3 specific steps to be experienced by participants designed to address the needs and close the gap. These statements will describe the learner actions required to achieve the educational needs - the outcomes. Begin each statement with a measurable, action-oriented verb.

Session Specific Analysis

Please develop 2-3 Yes/No questions that can assess the participants' achievement of the event's educational objectives. They will be distributed 2- 3- months post-event. Enter each question on a separate line.

Barriers

Other Stakeholders

Contacts: Email Us

Kim Kremer, MS
CME Coordinator
O: 937-232-2476
F: 937-522-8930

Martin Jacobs, MD
CME Chair
937-395-8611

Kettering Med Ed CME Contact

* Your Name:

* Your Email:

Phone: (Optional)

* Message: