Questionnaire for collaborators in phases, task forces & roles of ICC-USME International Consensus Conference on Ultrasound in Medical Education Survey

Question Title

* 1. Dear ICC-USME collaborator,

The process of this guidelines is planned to run through 3 major phases :
I. Undergraduates (medical school),
II. Graduates in-training (residency and other training program) and
III. Practicing clinicians (CME).

Each phase will have multiple task forces for domains and sub-headings within this phase.

In addition there are many roles for the ICC_USME collaborators throughout this process (few mentioned in item G of the questionnaire).

To better utilize your expertise, please provide (Copy/Paste) a complete CV below and then answer the following brief questionnaire.

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* 2. Are you committed to devote the time needed for this process (estimated to be minimum 6 hours /week) with monthly conference calls that may last for 1 year in each phase?

Yes

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* 3. Please indicate the number of years you have been involved in each of the following:

	0 years	1-3 years	4-5 years	5+ years
Teaching medical students	Teaching medical students 0 years	Teaching medical students 1-3 years	Teaching medical students 4-5 years	Teaching medical students 5+ years
Teaching residents	Teaching residents 0 years	Teaching residents 1-3 years	Teaching residents 4-5 years	Teaching residents 5+ years
Teaching practicing clinicians	Teaching practicing clinicians 0 years	Teaching practicing clinicians 1-3 years	Teaching practicing clinicians 4-5 years	Teaching practicing clinicians 5+ years
Teaching ultrasound	Teaching ultrasound 0 years	Teaching ultrasound 1-3 years	Teaching ultrasound 4-5 years	Teaching ultrasound 5+ years

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* 4. Please describe your area of expertise:

Basic scientist and which discipline

Clinician and which specialty

Current clinical application of ultrasonography? General? Emergency? Small parts? Vascular? OBGY? Interventional? Other?

Educator and which role

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* 5. Please describe the percentage of your work time you are currently spending in each of the following:

undergraduates (medical school)

graduates in-training (residency and other training program)

Practicing clinicians (CME).

Others (please specify)

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* 6. Please describe previous involvement in each of the following:

undergraduates (medical school)

graduates in-training (residency and other training program)

Practicing clinicians (CME).

Others (please specify)

	unfamiliar				neutral				extremely familiar
undergraduates teaching (medical school)	undergraduates teaching (medical school) unfamiliar	undergraduates teaching (medical school)	undergraduates teaching (medical school)	undergraduates teaching (medical school)	undergraduates teaching (medical school) neutral	undergraduates teaching (medical school)	undergraduates teaching (medical school)	undergraduates teaching (medical school)	undergraduates teaching (medical school) extremely familiar
graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs) unfamiliar	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs) neutral	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs)	graduates in-training (residency and other training programs) extremely familiar
Practicing clinician’s education (CME)	Practicing clinician’s education (CME) unfamiliar	Practicing clinician’s education (CME)	Practicing clinician’s education (CME)	Practicing clinician’s education (CME)	Practicing clinician’s education (CME) neutral	Practicing clinician’s education (CME)	Practicing clinician’s education (CME)	Practicing clinician’s education (CME)	Practicing clinician’s education (CME) extremely familiar

unfamiliar

neutral

extremely familiar

undergraduates teaching (medical school)

undergraduates teaching (medical school) unfamiliar

undergraduates teaching (medical school)

undergraduates teaching (medical school) neutral

undergraduates teaching (medical school)

undergraduates teaching (medical school) extremely familiar

graduates in-training (residency and other training programs)

graduates in-training (residency and other training programs) unfamiliar

graduates in-training (residency and other training programs)

graduates in-training (residency and other training programs) neutral

graduates in-training (residency and other training programs)

graduates in-training (residency and other training programs) extremely familiar

Practicing clinician’s education (CME)

Practicing clinician’s education (CME) unfamiliar

Practicing clinician’s education (CME)

Practicing clinician’s education (CME) neutral

Practicing clinician’s education (CME)

Practicing clinician’s education (CME) extremely familiar

	prefer no involvement				neutral				extremely prefer involvement
Determination of the domains and topics in each phase	Determination of the domains and topics in each phase prefer no involvement	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase neutral	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase	Determination of the domains and topics in each phase extremely prefer involvement
Collecting literature about each topic	Collecting literature about each topic prefer no involvement	Collecting literature about each topic	Collecting literature about each topic	Collecting literature about each topic	Collecting literature about each topic neutral	Collecting literature about each topic	Collecting literature about each topic	Collecting literature about each topic	Collecting literature about each topic extremely prefer involvement
Drafting recommendation	Drafting recommendation prefer no involvement	Drafting recommendation	Drafting recommendation	Drafting recommendation	Drafting recommendation neutral	Drafting recommendation	Drafting recommendation	Drafting recommendation	Drafting recommendation extremely prefer involvement
Voting on recommendation	Voting on recommendation prefer no involvement	Voting on recommendation	Voting on recommendation	Voting on recommendation	Voting on recommendation neutral	Voting on recommendation	Voting on recommendation	Voting on recommendation	Voting on recommendation extremely prefer involvement
Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation prefer no involvement	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation neutral	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation	Writing the rationale and explanation the recommendation extremely prefer involvement
Internal review	Internal review prefer no involvement	Internal review	Internal review	Internal review	Internal review neutral	Internal review	Internal review	Internal review	Internal review extremely prefer involvement
External review	External review prefer no involvement	External review	External review	External review	External review neutral	External review	External review	External review	External review extremely prefer involvement
Publication process	Publication process prefer no involvement	Publication process	Publication process	Publication process	Publication process neutral	Publication process	Publication process	Publication process	Publication process extremely prefer involvement
Endorsement process	Endorsement process prefer no involvement	Endorsement process	Endorsement process	Endorsement process	Endorsement process neutral	Endorsement process	Endorsement process	Endorsement process	Endorsement process extremely prefer involvement
Dissemination process	Dissemination process prefer no involvement	Dissemination process	Dissemination process	Dissemination process	Dissemination process neutral	Dissemination process	Dissemination process	Dissemination process	Dissemination process extremely prefer involvement

prefer no involvement

neutral

extremely prefer involvement

Determination of the domains and topics in each phase

Determination of the domains and topics in each phase prefer no involvement

Determination of the domains and topics in each phase

Determination of the domains and topics in each phase neutral

Determination of the domains and topics in each phase

Determination of the domains and topics in each phase extremely prefer involvement

Collecting literature about each topic

Collecting literature about each topic prefer no involvement

Collecting literature about each topic

Collecting literature about each topic neutral

Collecting literature about each topic

Collecting literature about each topic extremely prefer involvement

Drafting recommendation

Drafting recommendation prefer no involvement

Drafting recommendation

Drafting recommendation neutral

Drafting recommendation

Drafting recommendation extremely prefer involvement

Voting on recommendation

Voting on recommendation prefer no involvement

Voting on recommendation

Voting on recommendation neutral

Voting on recommendation

Voting on recommendation extremely prefer involvement

Writing the rationale and explanation the recommendation

Writing the rationale and explanation the recommendation prefer no involvement

Writing the rationale and explanation the recommendation

Writing the rationale and explanation the recommendation neutral

Writing the rationale and explanation the recommendation

Writing the rationale and explanation the recommendation extremely prefer involvement

Internal review

Internal review prefer no involvement

Internal review

Internal review neutral

Internal review

Internal review extremely prefer involvement

External review

External review prefer no involvement

External review

External review neutral

External review

External review extremely prefer involvement

Publication process

Publication process prefer no involvement

Publication process

Publication process neutral

Publication process

Publication process extremely prefer involvement

Endorsement process

Endorsement process prefer no involvement

Endorsement process

Endorsement process neutral

Endorsement process

Endorsement process extremely prefer involvement

Dissemination process

Dissemination process prefer no involvement

Dissemination process

Dissemination process neutral

Dissemination process

Dissemination process extremely prefer involvement

Questionnaire for collaborators in phases, task forces & roles of ICC-USME International Consensus Conference on Ultrasound in Medical Education

Question Title

Question Title

* 2. Are you committed to devote the time needed for this process (estimated to be minimum 6 hours /week) with monthly conference calls that may last for 1 year in each phase?

Question Title

* 3. Please indicate the number of years you have been involved in each of the following:

Question Title

* 4. Please describe your area of expertise:

Question Title

* 5. Please describe the percentage of your work time you are currently spending in each of the following:

Question Title

* 6. Please describe previous involvement in each of the following:

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* 7. Please Rank 1 -9 your familiarity with the following (1=unfamiliar - 9= extremely familiar):

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* 8. What is your preference role of involvement in the following roles, please rank 1-9 . You may choose as many as you want (1= prefer no involvement, 9= extremely prefer involvement).