SurveyMonkey Powered Online Survey

Thank you for your interest in presenting your work! Please fill out this form completely and submit it by April 17, 2026. If you have any questions, please contact Kelly Anastasio at kanasta2@bidmc.harvard.edu.

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* 1. Please tell us about yourself:

Name: *

Professional degree(s): *

Department: *

Division (if applicable): *

Email Address:

Cell Phone Number:

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* 2. Role:

Student

Intern/Resident

Fellow

Attending/Faculty

Postdoctoral Fellow

Allied Health Professional (e.g., Social Work, RRT, PHA)

RN/NP/DNP

Other

Allied Health Professional or Other - please specify here:

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* 3. Please list your co-authors here, if applicable

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* 4. What is the category of your poster? (check all that apply)

Continuing Medical Education/Faculty Development

GME/Resident Education

Nursing Education

Interprofessional Education

Simulation

Student Education

Other - please specify:

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* 5. Title of Project

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* 6. Abstract (250-300 words)

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* 7. A selection committee will identify the top 20 posters for live e-poster display during the session. If your project is selected for e-poster display, can you or one of your colleagues commit to attending the June 1, 2026 poster session from 4-5:30pm?

Yes