Application for endorsement
as a Registered CME Provider
Name of responsible organisation: / Click here to enter text. /
Name of coordinator or contact person: / Click here to enter text. /
Address: / Click here to enter text. /
Phone: / Click here to enter text. / Fax: / Click here to enter text. /
Email: / Click here to enter text. /
Details of Educational Event
Who is your intended audience?
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Geographical area (local / national):
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How many meetings do you plan to hold each year?
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Are there any limits on attendance (e.g. only available to doctors employed by the PHO)?
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Event plan (what events are you planning to hold in the next 6 months)?
(Please include details of proposed dates, number of education hours for sessions(not including refreshment breaks) and locations. Details do not need to be finalised.
Please attach a separate document if required).
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Relevance to general practice
Please describe the relevance of this programme to improving the quality of clinical effectiveness in general practice:
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What steps have you taken or do you intend to take to identify the learning needs of general practitioners?
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Please give the names, qualifications and/or designation, and contact details for members of the programme planning team:
(Note: At least one of the planning team must be a vocationally registered (FRNZCGP) general practitioner)
Name: / Click here to enter text. /
Designation: / Click here to enter text. /
Contact details (including email):
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Name: / Click here to enter text. /
Designation: / Click here to enter text. /
Contact details (including email):
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Name: / Click here to enter text. /
Designation: / Click here to enter text. /
Contact details (including email):
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Please describe any additional efforts you have made to ensure a focus on the needs of general practitioners in programme design:
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Content
Who will present the programme?
(Please give names and brief background information of each of the presenters, if known.)
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How will you ensure that the educational content is current, and based on best available evidence?
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Professional or commercial bias
The RNZCGP does not endorse programmes that promote commercial, professional or scientific bias, or sessions run by pharmaceutical or medical device companies. Any other potential conflicts of interest must be disclosed to participants in advance of the session.
Please give details of any sponsorship arrangements linked to the programme.
(Please outline any input the sponsor has had in the choice of the presenter(s) or the educational content of the event.)
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Are there any potential sources of bias, conflicts of interest or contentious issues that could affect the impartiality of the programme?
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Teaching and learning
Please describe your processes for setting learning objectives for educational sessions (What will participants be able to do as a result of this learning)?
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Please include a brief description of the education techniques that will be employed to ensure that the learning objectives are met:
For example:
- Encouraging participants to identify their specific learning needs
- Encouraging active participation
- Encouraging reflection on the learning that has occurred
- Providing suggestions for how to implement the knowledge and skills learnt
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What guidance will be provided to session presenters regarding the needs of the audience,
and/or appropriate presentation methods?
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What venue/s will be used for events?
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Quality mechanisms and evaluation
Registered providers are expected to have a system in place for monitoring the success of individual events and of the programme as a whole and for gaining feedback that can be usedto improve future offerings.
Please describe your mechanism for feedback from individual events .
(Please attach a sample copy of a session event form, if relevant.)
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Please describe any plans that you have for evaluating the overall effective success of your CME programmes?
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CME provider workshop attendance
We require that registered providers are able to support and fund a CME Coordinator’s attendance at the College’s annual ‘CME Providers Workshop’. Do you have the capacity to do this?
☐Yes / ☐No
Annual report
We require that registered providers provide an annual report of their activities to the College in a prescribed format. Are you able to commit to providing this report?
☐Yes / ☐No
Certification
We require that Registered Providers are able to provide the administration necessary to record doctor attendance details on our online system. Records should also be maintained by the provider and certificates of completion for event attendance provided to doctors who request these. Do you have the capacity to undertake this administration?
☐Yes / ☐No
Signed: / Dated: / Click here to enter text. /
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