Session/Speaker Application Form InstructionsSession TitleName the title of the presentation given by the speaker(s). Session Length in minutesGive the length in minutes of the presentation not counting breaks or meals. Discussion time, time for demonstrations and testing is included. List names of any speakers involved in giving this particular presentation.If there will be more than one speaker, each speaker must fill out the top part of the form with name, address etc. List each speaker's name in this field so we can easily match up forms with the session, and each speaker must fill out the curriculum vitae/resume question at the bottom of the form. List Measurable Behavioral Objectives or Learning Outcomes:These terms basically mean describe what the outcome of the program instruction will be; what the learners will accomplish, what learners will gain in knowledge, skills or attitudes. The ultimate test when writing a learning outcome is whether or not the action taken by the participant can be assessed. The outcome must be observable, measurable and done by the learner.Words that convey a clear measurable objective are words like:
Other verbs to use include:
as opposed to: Words that DO NOT convey a measurable objective are:
Other verbs NOT to use:
Describe Session Content:Write in outline form the content of the presentation, noting minutes of time for each subject area. Each statement here should support and relate to the Behavioral Objectives listed above. The content should be organized in order to be appropriate for the target audience and learning environment. Our target audience will include: Midwives, CPM's, LM's, CNM's, CM's, L&D Nurses, Obstetricians, Doulas, Childbirth Educators, Massage Therapists and any other Health or Maternity Care Providers working with prenatal, birthing and lactating women and their families. List approximate time in minutes spent on each subject. The presenter needs to consider the identified needs of the learner and then include information and teaching strategies that will ensure that the learning outcomes have been attained or demonstrated by the participants. Assessment of Learning Outcomes:Explain and give an example of how learner achievement of the objectives is to be assessed. Program planners and presenters should choose types of learner demonstrations that best suit the topic. Such demonstrations of knowledge may be in the form of:
Learners rely on feedback to clarify and reinforce their own learning. It is also a primary source for building learner confidence, which will be critical in transferring the learned information beyond the classroom. Has this session been approved for continuing education credits before? When and where?Tell us if this particular session has ever received CEUs, when the session was given and where. List Three (3) Pre and Post Session Test Questions and Answers:These questions and answers are required as a method of evaluating what a group of learners has gained from the program content. These questions should relate to and come directly from the Measurable Behavioral Objectives listed above and measure the knowledge, skill or attitude session attendees have attained or demonstrated as a result of session content and teaching methods. List current references or documentation you have used in preparing this course:List current references or documentation you have used in preparing this session. A 1 hour presentation should contain at least 5 references; a 4 hour presentation should contain between 5-10 references; and an 8 hour presentation should contain between 10-15 references. Remember that continuing education means new. Three-quarters of these references MUST be current (within the last five years) updated information that is meant to build upon knowledge of the participants. Current references can include journal articles, books or research projects that discuss and validate the new information. Noted classics will be accepted. Articles published by the presenter may be included. Give title, author, name, and date of publication. THESE REFERENCES MUST BE PROVIDED NOW, NOT AT A LATER DATE. Attach brief resume(s) of presenter(s):Please describe why you are qualified to teach the content of this workshop. Include a brief list of relevant educational degrees, continuing education workshops, professional credentials, work experience, publications or other presentations relevant to the session topic. Please limit this description to a maximum of one page. If you are presenting more than one session in the program/conference for which you are applying, submit a resume with the first session you are presenting and note where the resume is (i.e., “Qualifications are listed in the Session/Speaker Application Form for Baby Blues: An Epidemic? ”) in subsequent session applications for that conference. We must have a resume for each speaker for this session. Click here to fill out the on-line form for speakers at MANA 2005. |