LM-056 Activity Planning Document

    Select all that apply—see Appendix for specific credit statements
  • See Appendix for specific credit statements and partner wording

  • 1. ESTABLISHING NEED


  • 2. SOURCES FOR IDENTIFYING GAPS IN KNOWLEDGE

    Must include at least 2
  • Max. file size: 50 MB.

  • 3. APPLICATION OF IDENTIFIED GAPS TO PLANNING CONTENT

    List each identified need with the result you anticipate to achieve relative to that need, and select the appropriate Content Focus box: knowledge, performance, competence, or patient outcomes

  • 4. PHYSICIAN COMPETENCIES AND ATTRIBUTES

  • 5. EDUCATIONAL FORMAT

    Select one of the following
    Select all that apply

  • 6. PREPARING LEARNING OBJECTIVES


  • Learning objectives are tools to assist you in identifying the specific steps that will be taken to address the gap between an identified need and the desired result (as identified above in question 3). Learning objectives also assist learners in understanding the specific result they can expect to achieve as a result of participating in the educational activity. Learning objectives should address what the learner will apply in the practice setting with the information gained through this educational activity and should also directly relate to the method of instruction. If constructed properly, learning objectives will enable you to prepare outcomes questions that will measure results (see Evaluation section).

  • 7. FACULTY SELECTION

    Faculty whom you select should have demonstrated expertise in the therapeutic field, strong presentation and communication skills, and the ability to address the needs and objectives expressed in this planning document. You should select faculty with the most expertise and teaching skills and the fewest conflicts of interest. Faculty chosen to achieve the objectives of this activity and their qualifications are:

  • Please insert an X when the Bio and Disclosures have been received from each faculty member. Faculty information should be highlighted red until all paperwork has been received and faculty information verified below.
  • Additionally, all persons with the ability to influence activity content must be identified and financial conflicts resolved. This includes Course Director, Planning Committee, Content Editors/Reviewer
  • Max. file size: 50 MB.

  • 8. SELECTION OF EVALUATION TOOLS

    Evaluations are used to determine whether the result you intended for learners has actually been achieved. The choice of which evaluation tools to use depends on (1) the goal of the activity (e.g., knowledge transfer and competency), (2) the mode of education and applicability of the tool (e.g., live activity, online, and print), and (3) available resources. Please indicate the evaluation tools selected for this activity and the rationale for their selection:

  • 9. SYSTEM/EDUCATIONAL BARRIERS AND OPPORTUNITIES

    Planners are encouraged to give consideration to the system of care in which the learner will incorporate new or validate existing learned behaviors. Planners must be sure to address anticipated barriers that could block implementation (e.g., behaviors, formulary restrictions, organizational policy issues, lack of time allotted for implementation of new skills, lack of organizational support for educational efforts, lack of resources, or lack of insurance reimbursement for treatments).

  • 10. PATIENT SAFETY CONSIDERATIONS

    Planners should, in accordance with serving the national public interest, examine planned activities for patient safety concerns. Please list issues of patient safety associated with these educational interventions that need to be addressed in this activity.

  • 11. TOOLS THAT SUPPORT LEARNERS IN ACHIEVING RESULTS

    Useful tools that support the achievement of intended results for this activity should be developed whenever possible. The ACCME terms these these tools “non-educational strategies to enhance change” through interventions.” List any non-educational interventions/strategies that this activity will use to enhance the potential for physician change or reinforce the desired educational results (e.g., follow-up mechanisms and patient handouts). Specify where they can be obtained or who will develop them.