CEU Course Application NRRTS Internal

Date*

Marketing the Event

NRRTS will market this learning event in DIRECTIONS magazine, on the NRRTS website, through 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 Speaker*

Speaker Credentials*

Describe the presenter's experience that qualifies them as a subject matter expert.*

Please upload bio or CV if available. PDF only.

Max. file size: 50 MB.

Speaker Email*

Phone*

Headshot

Upload a headshot

Max. file size: 50 MB.

Are there other speakers?*

Yes
No

Speaker Name*

List speaker here with credentials

Speaker Email*

Credentials*

Headshot*

Max. file size: 50 MB.

Sponsorship*

Not Sponsored
Sponsored with no compensation from NRRTS

In exchange for the Speaker's participation, the speaker will be paid a $300 honorarium upon completion of the webinar. I understand that if there are two or more speakers, the fee will be split evenly. An invoice must be submitted directly to Amy Odom at Aodom@nrrts.org for payment.

Learning Design

This 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.

Course Title*

Course description*

Maximum number of words is 100.

The first five words of the description will often determine if the reader will go on or pass to another course description.

The course description is vital to getting people to enroll in this course. To attract learners, the description should emphasize the benefits to the learner coming from either the results of attending the course or from the value of the subject matter itself.

Speaker Bio*

Maximum number of words is 100. Include your current position and a brief mention of work history and experience that is relevant to your speaking topic and audience Include academic qualifications, awards, and a reference to published work, but only if applicable to the material you are presenting.

Additional Speaker Bio*

Maximum number of words is 100. Include your current position and a brief mention of work history and experience that is relevant to your speaking topic and audience Include academic qualifications, awards, and a reference to published work, but only if applicable to the material you are presenting.

Learning Outcomes

Use the following words when writing your learning outcomes. List, Describe, Identify, State, Compare, Distinguish

Learning Outcome #1*

Number of minutes allotted for this learning outcome*

10 minutes
15 minutes
20 minutes

The total number of minutes for 3 learning outcomes must equal 60

Instructional materials used to present the content for this learning outcome*

Select All
Power Point
Lecture
Handout

Method used to accommodate learning styles*

Select All
Discussion
Images
Videos
Charts
Case Studies

Assessment Method - Quiz

80% passing score

Learning Outcome #2*

Number of minutes allotted for this learning outcome*

10 minutes
15 minutes
20 minutes

The total number of minutes for 3 learning outcomes must equal 60

Instructional materials used to present the content for this learning outcome*

Select All
Power Point
Lecture
Handout

Method used to accommodate learning styles*

Select All
Discussion
Images
Videos
Charts
Case Studies

Assessment Method - Quiz

80% passing score

Learning Outcome #3*

Number of minutes allotted for this learning outcome*

10 minutes
15 minutes
20 minutes

The total number of minutes for 3 learning outcomes must equal 60

Instructional materials used to present the content for this learning outcome*

Select All
Power Point
Lecture
Handout

Method used to accommodate learning styles*

Select All
Discussion
Images
Videos
Charts
Case Studies

Assessment Method - Quiz

80% passing score

References - Minimum of 3 references

List at least three relevant references Only 5 references are allowed. You may refer to more references in your presentation slide deck.

List References*

Click the plus sign to add references.

Level of Difficulty*

Beginner
Intermediate
Advanced

Course Category*

Seating and Positioning
Funding and Public Policy
Medical Terminology
Best Business Practice
Ethics

Mark Yes if you believe the content would be helpful for someone taking the RESNA ATP examination*

Yes
No

Mark Yes if you believe the content would be helpful for someone taking the RESNA SMS examination*

Yes
No

What process will be used to communicate with the speaker, learner, or any other person or organization vested in the learning event?

The NRRTS Director of Education will communicate directly with speakers for planning, promotion, and delivery of courses. She will also direct course registration, assessments, evaluations, and oversee the issue of certificates. Course evaluations will be shared with speakers and education team at NRRTS for course improvements and future course development. Learners will have access to contact information for NRRTS representatives to answer questions and/or resolve conflicts

How will attendance be documented and verified?

Attendance will be documented and verified in the following way: Attendees register for courses through the NRRTS website. Attendance is documented when participants sign into the webinar session. Attendance is also verified in the personal learning portal which houses the lesson details, quizzes, and certificates. The learning portal is password restricted

What 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 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. These measures include:

The Speakers are provided with NRRTS Non-discrimination Policy as a part of this application.

2. The speakers have developed these courses based on their expertise and extensive literature review. They have created these presentations to be balanced, unbiased and evidence-based. References to products are for the sole purpose of illustration of clinical application. Speakers 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 6.4

NRRTS 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.

This document represents the entire agreement between and the National Registry of Rehabilitation Technology Suppliers (NRRTS) for Speaker’s participation during the NRRTS Education Series. Speaker agrees to deliver one 60 minutes presentation on Eastern Time. Speaker agrees to follow the Speaker Guidelines as outlined on the NRRTS website at NRRTS Speaker Guidelines

Signature

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:

NRRTS Webinar Application

Marketing the Event

Learning Design

Learning Outcomes

References - Minimum of 3 references

What process will be used to communicate with the speaker, learner, or any other person or organization vested in the learning event?

How will attendance be documented and verified?

What 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?