___ Organization/web sites: (Organization must use current available evidence within past 5-7 years as resource for readers, may be published on unpublished content; examples: Agency for Healthcare Research and Quality, Centers for Disease Control, National Institutes of Health). ___ Peer reviewed journal (most should be within the last 5-7 ___ Clinical guidelines (like listed at: ): ___ Expert resource (may include individual, organization, educational institution, book article or website): ___ Textbook reference: Example Planning Table (notice that there are multiple presenters for this 30 minute activity in this example): OBJECTIVES CONTENT (Topics) TIME in MINUTES PRESENTER TEACHING METHODS List learner’s objectives in behavioral terms: “Learner will be able to:” Provide an outline of the content for each objective. Be specific, give bullets of covered content- no justifications of need State the time frame for each objective List the Faculty for each objective. Describe the teaching methods, strategies, materials & resources for each objective 1. Identify the most common microbial pathogens in health care facility cultures 2. Describe common microbial pathogens causing hospital acquired infections 1. Site specific cultures and organisms typically seen (urine, sputum, blood, wound, and sterile body sites) 2. Gram Positives (staph, strep, etc.); gram negatives (E.coli, etc.); misc. 15 minutes 15 minutes Thomas RN Gina Cody, MS, MPH, RN Slide presentation, lecture Slide presentation, lecture, Q & A ANCC’s revision of Blooms Taxonomy of Objectives: Use verbs from the list below. DO NOT use “understand” or “learn” or the title of the categories below. Do not use the title of the category (for example, “remember”) as your verb. Category: Remember Category: Understand Category: Apply Category: Analyze Category: Evaluate Category: Create
define repeat record list recall name relate translate restate discuss describe recognize explain express identify interpret employ use demonstrate dramatize practice illustrate operate schedule distinguish analyze differentiate appraise calculate experiment test compare contrast criticize diagram inspect compose plan propose design formulate arrange assemble collect construct create set up organize manage judge appraise evaluate rate compare value revise score select choose assess estimate measure Note: Time evaluating the learning activity may be included in the total time when calculating contact hours. Southern NH AHEC Educational Planning Table – Live Title of Activity: Identified Gap(s): Description of current state: Description of desired/achievable state: Gap to be addressed by this activity: Knowledge Skills Practice Other: Purpose: (write as an outcome statement, e.g. "The purpose of this activity is to enable the learner to…..” OBJECTIVES CONTENT (Topics) TIME FRAME PRESENTER TEACHING METHODS List learner’s objectives in behavioral terms Provide an outline of the content for each objective. It must be more than a restatement of the objective. State the time frame for each objective List the Faculty for each objective. Describe the teaching methods, strategies, materials & resources for each objective
Consultant * *All conflicts of interest, including potential ones, must be resolved prior to the planning, implementation, or evaluation of the continuing nursing education activity. Section 5: Statement of Understanding Completion of the line below serves as the electronic signature of the individual completing this Biographical/Conflict of Interest Form and attests to the accuracy of the information given above. Signature: Name and Credentials (Required) Date Section 6: Conflict Resolution (to be completed by Nurse Planner) Procedures used to resolve conflict of interest or potential bias if applicable for this activity: Not applicable since no conflict of interest. Removed individual with conflict of interest from participating in all parts of the educational activity. Revised the role of the individual with conflict of interest so that the relationship is no longer relevant to the educational activity. Not awarding contact hours for a portion or all of the educational activity. Undertaking review of the educational activity by a content reviewer to evaluate for potential bias, balance in presentation, evidence-based content or other indicators of integrity, and absence of bias, AND monitoring the educational activity to evaluate for commercial bias in the presentation. Undertaking review of the educational activity by a content reviewer to evaluate for potential bias, balance in presentation, evidence-based content or other indicators of integrity, and absence of bias, AND reviewing participant feedback to evaluate for commercial bias in the activity. Other - Describe: Nurse Planner Signature (*If form is for the activity Nurse Planner, an individual other than the Nurse Planner must review and sign). Completion of the line below serves as the electronic signature of the Nurse Planner reviewing the content of this Biographical/Conflict of Interest Form. AHEC to sign here Typed or Electronic Signature: Name and Credentials (Required) Date