CEU Approval Certificate Program courses CEU Certificate Course Application NRRTS Internal Date* MM slash DD slash YYYY Marketing the EventNRRTS will market the learning event in DIRECTIONS, on the NRRTS website, social media, and through email blasts. We will use the information you provide as a part of the marketing campaign for this course. We encourage you to promote the webinar on your own social media channels. NRRTS will record the webinar and present it in the On-Demand Library for up to two years after the event provided the content and presentation style meets the NRRTS standard. Name of Primary Content Developer* Phone (optional)Target Audience*Hold CTRL key to for multiple selectionsPhysical TherapistsOccupational TherapistsSuppliersTechniciansManufacturerNeeds Analysis - the need for this course was determined by*Hold CTRL key to for multiple selections. Why were you asked to present this topic? Example: a specific outcome or need discussed when you were asked to present this course. It could have been shown in conversation, observations, surveys, evaluations, personal interviews, presenter evaluations, etc.Participant Surveys and/or EvaluationsPersonal InterviewRequested by NRRTS PersonnelJustification for this course*Hold CTRL key to for multiple selections. The topic includes new technologies that require updated informationTerminology for this topic has been changed and requires updated informationMethodology for this topic has changed and requires updated informationNeed identified among industry expertsOtherCEU Value requested*.1 CEU = 1 contact hour of instruction .1 CEU .2 CEU Qualifications needed to provide content for this topic:*Describe the qualifications and experience of the content developer. Learning DesignThis is a planning tool to help you organize your lesson. The learning outcomes provide you with a framework for developing content. You will note the following in the next steps: a. 3 learning outcomes are required. b. Accommodate a variety of learning styles: pictures, graphics, charts and graphs, polls, videos, case studies, etc. c. Include an estimated time frame for each learning outcome and manage your time accordingly d. Other references may be listed, but you must provide at least 3 references published during or prior to 2017.Title for Course* Course description/Abstract/Introduction*Maximum number of words is 100. Many people read abstracts and then decide whether to go through the rest of the paper. Well written abstract should be no more than 100-150 words. Highlight not just the problem, but also the results. The abstract must not contain references, as it may be used without the main article.Learning OutcomesUse the following words when writing your learning outcomes. List, Describe, Identify, State, Compare, DistinguishLearning Outcome #1* Approximate percentage of article dedicated to Learning Outcome #1The total percentage of 3 learning outcomes must equal 100%Instructional material used to present the content for this learning outcome* Original research included Case studies included Systemic review included Theoretical content included Other If you chose "Other", please explain Method used to accommodate learning styles* Select All Images Video links Charts Graphs Assessment Method - Quiz80% passing scoreLearning Outcome #2* Approximate percentage of article dedicated to Learning Outcome #2The total percentage of 3 learning outcomes must equal 100%Instructional material used to present the content for this learning outcome* Original research included Case studies included Systemic review included Theoretical content includede Other If you chose "Other", please explain Method used to accommodate learning styles* Select All Images Video links Charts Graphs Assessment Method - Quiz80% passing scoreLearning Outcome #3* Approximate percentage of article dedicated to Learning Outcome #3The total percentage of 3 learning outcomes must equal 100%Instructional material used to present the content for this learning outcome* Original research included Case studies included Systemic review included Theoretical content includede Other If you chose "Other", please explain Method used to accommodate learning styles* Select All Images Video links Charts Graphs Assessment Method - Quiz80% passing scoreLearning Outcome #4 Approximate percentage of article dedicated to Learning Outcome #4The total percentage of 3 learning outcomes must equal 100%Instructional material used to present the content for this learning outcome Original research included Case studies included Systemic review included Theoretical content includede Other Method used to accommodate learning styles Select All Images Video links Charts Graphs If you chose "Other", please explain What process will be used to communicate with the speaker, learner, or any other person or organization vested in the learning event?NRRTS Executive Director will communicate directly with the content developer for planning, promotion, and delivery of courses. NRRTS Director of Education will direct course registration, assessments, evaluations, and oversee the issue of certificates. Course evaluations will be shared with the NRRTS Certificate Program Development team for course improvements and future course development. Learners will have access to NRRTS representatives to answer questions and/or resolve conflictsAttendance will be documented and verified in the following way: Attendees register for courses through the NRRTS website. Attendance is documented when participants log in to complete the course requirements through the personal learning portal which houses the lesson details, quizzes, and certificates. The learning portal is password restrictedWhat measures are in place to ensure the presentations and/or program will be balanced, unbiased, and evidence-based without any real or perceived conflicts of interest on the part of the speakers?There are measures in place to ensure the educational program will be balanced, unbiased, and evidence-based without any real or perceived conflicts of interest on the part of the content developer. These measures include: The content developers are provided with NRRTS Non-discrimination Policy as a part of this application. Content is developed based on expertise and extensive literature review. Content developers have created the information to be balanced, unbiased and evidence-based. References to products are for the sole purpose of illustration of clinical application. Content developers are not provided with an incentive for sales or promotion of products and disclose such relationship prior to presentation. The following are NRRTS Policies. Category 6.3 NRRTS Non-discrimination Policy for NRRTS Continuing Education Program (NRRTSCE) Effective Date: 1 January 2016. Policy: Any individual involved in developing or delivering learning events (webinars, classroom learning event, articles for CEU credit) is prohibited from discrimination or making explicit references of a discriminatory nature based on gender, ethnicity, religion, age, disability, socioeconomic status, and/or sexual orientation. Purpose: NRRTSCE goal is to provide high quality education for anyone involved in the field of Assistive Technology. Any type of discrimination is counter-productive to that goal and thus will not be tolerated in any form. RESPONSIBILITY: It is the responsibility of the NRRTSCE Staff to monitor and report any violation of this policy to the Executive Director. All speakers and authors involved with NRRTSCE will be notified of this policy. PROCESS: Speakers and authors will sign their agreement with the NRRTSCE Non-discrimination policy prior to CEU approval. Failure to comply with this policy will result in exclusion from any NRRTSCE Program. REFERENCES: ANSI/IACET1-2013 Standard for CE/T 6.3 Category 6.4 Disclosure Policy for NRRTS Continuing Education Program Effective Date: 1 January 2016 RESPONSIBILITIES: It is the responsibility of the NRRTSCE Staff to monitor and report any violation of this policy to the Executive Director. All speakers and authors involved with NRRTSCE Programs will be notified of this policy. PROCESS: Speakers and authors will sign the NRRTSCE Disclosure policy prior to CEU approval. Failure to comply with this policy will result in exclusion from any NRRTSCE Program. REFERENCES: ANSI/IACET 1-2013 Standard for CE/T 6.4NRRTS Policies* I have read and agree to abide by the NRRTS Non-discrimination Policy and the NRRTS Disclosure Policy.Other Confirmations* I confirm the learning material is original work and that external supporting content will be acknowledged and properly referenced. I confirm that any necessary written permission has been obtained for the use of photos or copyrighted material. Signature on behalf of NRRTS*By my signature below I agree to the terms of this agreement. I further agree that my presentation will be non-commercial in nature and will present a balanced view of the concepts, technology and applications described. Please sign this document electronically: Reset signature Signature locked. Reset to sign again