2018 San Diego Professional Palliative Care Conference

Workshop Presenter or Poster Session Application
DUE WEDNESDAY FEBRUARY 28, 2018

Thank you for applying to serve as a presenter (workshop or poster) at the Third Annual San Diego Professional Palliative Care Conference. Our 2018 theme is "Palliative Care: High Tech, High Touch." This conference will take place from 8:30 a.m.-5:00 p.m. on Friday, June 15th, 2018 on the campus of California State University San Marcos. The CSU Institute for Palliative Care at CSUSM and the San Diego Coalition for Compassionate Care are very excited to be hosting this opportunity for local professional health care providers to come together to share experience and wisdom about Palliative Care in San Diego county. Last year we had a great slate of presenters from a variety of health care professions. We look forward to reviewing this year's applications. APPLICATIONS ARE DUE BY 5:00 p.m. PST, Wednesday, February 28th, 2018.

In keeping with this year’s theme, we are seeking presentations that address Palliative Care emerging, innovative, or best practices in one of the following categories:

High Tech: Using technology to improve service delivery in palliative care including e-POLST registry, use of video and electronic media to facilitate and document palliative care conversations

High Touch: Integrating compassionate, palliative care into the family-centered care model and across the continuum of healthcare providers and services

Updates: Palliative Care Legislation, the End-of-Life Option Act and Voluntary Stopping Eating and Drinking (VSED)

The best presentations are a good blend of didactic presentation and interaction. Above all, they must be actionable – providing attendees with real-life tools and learning they can immediately use to improve their understanding and practice of Palliative Care. Palliative Care includes advance care planning, pain & symptom management, relief of suffering in all dimensions, improved quality of life, and support for persons with serious illness and their families. Breakout sessions will be one hour in length, but we strongly recommend allowing 10 to 15 minutes of the time for questions.

If your proposal is selected, all presenters will receive a 25% discount off the regular registration fee. We welcome single or co-presenters for workshops, but no more than three per presentation and only one designated presenter per poster, please. Workshop and poster presenters will receive no travel or expense reimbursements. You will be notified of the status of your application by March 19, 2018.

PowerPoint/Poster Materials: We will be providing continuing education units for doctors, nurses, social workers, psychologists, and chaplains. Final presentation materials (slides, handouts, etc.) must be submitted for CME/CE review by a hard deadline of May 1st, 2018; if your materials are not submitted by the deadline, your presentation will be dropped from the program. Permission to use any material borrowed in whole or substance from another source, especially graphics, video or audio clips, must accompany your final materials, and all data, facts, models, and other items of substance not of your own creation must be properly cited. Please note, presenters are responsible for furnishing any handouts to be disseminated with their presentation.

We look forward to reviewing your application and assembling a rich program for the conference! If you have any questions about the application or approval process, please contact us at ipc-csusm@csusm.edu or by phone at 760-750-3550. Thank You!

Question Title

* 1. Please enter your contact information

Name *

Organization or Facility *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

Question Title

* 2. Please share a 150 word bio, including your experience with presenting at a conference.

Question Title

* 3. Co-Presenter Contact Information (if applicable)

Name

Organization or Facility

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 4. Co-Presenter: Please share a 150 word bio, including their experience with presenting at a conference.

Question Title

* 5. Additional Co-Presenter Contact Information (if applicable)

Name

Organization or Facility

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 6. Additional Co-Presenter: Please share a 150 word bio, including their experience with presenting at a conference.

Question Title

* 7. Preferred presentation type

45 Minute Workshop with 10-15 Minutes for Q&A

Poster Session Entry

Question Title

* 8. Which of our conference topics does your presentation align with most closely? (Please check all that apply)

High Tech

High Touch

Legislative Update/ End-of-Life-Option Act/VSED

Bioethical dilemmas in Palliative Care

Other (please specify)

Question Title

* 9. Title for your presentation (brief--20 words or less)

Question Title

* 10. Session Narrative (Detailed summary of presentation--250 words or less)

Question Title

* 11. Please create three learning objectives for your session using the list of verbs provided here. (click to view)

Learning Objective One

Learning Objective Two

Learning Objective Three

Note: Conference leadership reserves the right to edit bios, session title, topic, narrative or learning objectives for formatting, brevity and clarity.

Question Title

* 12. Technology: Breakout rooms vary in size and technical capabilities. Each room will have 1 projector, 1 screen, 1 laptop with PowerPoint presentations pre-loaded, and 1 presenter clicker. CSUSM IT will be available to assist as needed. Please tell us about your specific audio/visual needs:

Wifi for showing video/internet access during presentation

Sound for showing video or other reason

Wireless Microphone

Podium with Microphone

Wifi access for the audience during presentation

Poster Applicant, no IT needs (Posters will be clipped to free-standing fabric boards that have locking wheels and be visible during lunch and the dessert reception.)

Other (please specify)

Question Title

* 13. Please confirm that you acknowledge the following:

If selected to present, I understand I will need to register for the conference. Each presenter will be offered a 25% discount code (lowering their registration to $131.25) and they will be offered CME/CE's at no charge.

If selected to present, I understand my final slides and/or other presentation materials must be provided to the conference organizers by a hard deadline of May 1, 2018. I further acknowledge that if my materials are not provided by the deadline, my presentation will be dropped from the program.

If selected to present, I understand I must be available for any time slot between 8 a.m. - 5 p.m. on Friday, June 15, 2018

If selected to present, I agree to complete a disclosure form as required by the CME provider and I will not promote my personal business, or my place of employment during the presentation

If selected to present, I agree to obtain permission for any graphics, images, videos, or music borrowed from other sources included in my presentation, and to provide proper citation for any data, facts, models, or other substantive material not of my own creation.

Thank you! We look forward to reviewing your presenter application. Please expect to hear back from conference organizers no later than March 15, 2017.