Application for
Acute Care (AC) CORE Master Instructor

There are three requirements for AC CORE Master Instructor (MI) status:
1. Certification as AC CORE IP.
2. A point for each Question #6,7,8,9,10.
3. A reference from a Master Instructor in Question #11.

Applications are processed within 30 days.
Asterisk denotes answer required.

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* 1. Please choose one of the following options for your AC CORE MI application:

I am applying for modular AC CORE MI status. This is for modular AC CORE IP members.

I am applying for AC CORE MI status. This is for AC CORE IP members.

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* 2. Please enter date:

Select date below

Date

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* 3. Please enter your name:

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* 4. Please identify your profession:

Nursing professional

Paramedical

Resident

Physician Assistant

Medical student

Other (please specify)

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* 5. Please enter your IP Number:

You must answer affirmative for each Question #6,7,8,9,10 in order to be certified as an AC CORE MI and proceed to the next question.

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* 6. Please confirm that:
(1 point)

I have been an AC CORE IP for at least one year

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* 7. Have you taught at least two CPoCUS/non-CPoCUS accredited AC CORE courses or taught individuals? Please list names and dates of courses.
(1 point)

Yes

Please list two course names and dates or individuals

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* 8. Have you given the CPoCUS AC CORE exams (Written, Visual, Practical) three or more times?
(1 point)

Yes, I have given the CPoCUS AC CORE exams (Written, Visual, Practical) three or more times

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* 9. Have you provided 40 or more hours of AC CORE IP training in the past year?
(1 point)

Yes, I have provided 40 or more hours of AC CORE IP training in the past year

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* 10. Are you competent in the use of and ability to teach pelvic scanning?
(3 point)

I have taught abdominal (pelvic) scans to 2-4 learners simultaneously over 2-3 hours with 12-15 models.

I have taught abdominal (pelvic) scans under direct observation by a Master Instructor

A Master Instructor can attest to my competence in the ability to teach pelvic scanning (see Q#10 to attach reference)

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* 11. Please provide a short reference from a CORE Master Instructor.

I have provided an online reference by sending the following link to the Master Instructor:https://www.surveymonkey.com/r/MIMref

I have provided a hardcopy of a reference letter in Question #12

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* 12. Attach additional material (if applicable).

Please label your file with your full name

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 13. Attach additional material (if applicable).

Please label your file with your full name

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 14. Attestation:

I pledge to uphold CPoCUS values including rigorous standards of POCUS training and non-distribution of certification exams prior to examination.

Application for Acute Care (AC) CORE Master Instructor

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* 1. Please choose one of the following options for your AC CORE MI application:

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* 2. Please enter date:

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* 3. Please enter your name:

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* 4. Please identify your profession:

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* 5. Please enter your IP Number:

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* 6. Please confirm that: (1 point)

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* 7. Have you taught at least two CPoCUS/non-CPoCUS accredited AC CORE courses or taught individuals? Please list names and dates of courses.(1 point)

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* 8. Have you given the CPoCUS AC CORE exams (Written, Visual, Practical) three or more times?(1 point)

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* 9. Have you provided 40 or more hours of AC CORE IP training in the past year?(1 point)

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* 10. Are you competent in the use of and ability to teach pelvic scanning?(3 point)

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* 11. Please provide a short reference from a CORE Master Instructor.

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* 12. Attach additional material (if applicable).

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* 13. Attach additional material (if applicable).

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* 14. Attestation:

Application for
Acute Care (AC) CORE Master Instructor

* 6. Please confirm that:
(1 point)

* 7. Have you taught at least two CPoCUS/non-CPoCUS accredited AC CORE courses or taught individuals? Please list names and dates of courses.
(1 point)

* 8. Have you given the CPoCUS AC CORE exams (Written, Visual, Practical) three or more times?
(1 point)

* 9. Have you provided 40 or more hours of AC CORE IP training in the past year?
(1 point)

* 10. Are you competent in the use of and ability to teach pelvic scanning?
(3 point)