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CANOSC 2020 Speaker Information Form
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1.
Session Title
(Required.)
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2.
Speaker (enter position and organization as you would like them listed in the program)
(Required.)
Name
Position
Organization
Email
Phone
3.
Audio-Visual Equipment
A computer and data projector will be provided. Please specify any additional equipment required:
*
4.
Educational Objectives: Please list 3 or more. The objectives should be written from the perspective of the learner, descriptive of what the learner will gain in knowledge, skills and attitudes as a result of participating in the event; and written to enable evaluation of achievement by the planners and participants.
Please use verbs that denote an observable action, such as “list, explain, summarize, discuss, compare, etc.” NOTE: It is no longer permitted to use words that indicate emotions or feelings such as “know, learn, appreciate, understand, recognize, etc.”
At the end of the session, the participants will be able to:
(Required.)
1
2
3
4
5
6
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5.
Please indicate which
CanMEDS
roles you will address in this educational activity?
(Required.)
Medical Expert (the integrating role)
Communicator
Collaborator
Leader
Health Advocate
Scholar
Professional
6.
Description: Please provide a summary of your presentation. At the end of your summary please indicate your target audience, for example, “The session will be of value to: Physiatrists, Medical Students, Residents.”
7.
Biography: Please provide a short bio (1-2 paragraphs)
8.
Upload a Photo
Choose File
No file chosen
9.
NEURAM 2020 can make my presentation available to individuals who may be interested in accessing it by posting it on their national association website.
Yes
No
Comment:
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10.
Speaker Signature and Date: I, the undersigned, the author of this presentation, certify that I have obtained all customary and necessary permission to use and print any copyright material that appears in my presentation.
(Required.)
Speaker Name
Date
