Contact Information
Contact information provided will appear in promotional materials.
Activity Details
Please provide details of the activity
LIVE ACTIVITY INFORMATION
Submit a detailed CV via e-mail and write a short biography below for inclusion in the onsite
faculty introduction. Bio should be no longer than 250 words.
Educational Needs Assessment and Gaps in Knowledge
Faculty, along with the organization hosting the continuing education activity, should identify the problem or clarify the need (gaps in knowledge), the current state of pharmacy practice and the desired state of pharmacy practice. This should be evidence-based facts, rather than assumptions, and should be used to formulate what should be learned in order to move the learners from their current state of practice to the desired state and assist in developing learning objectives. References and citations should be provided where appropriate.
What is the problem (potential or actual) that needs to be addressed? Or, what new process or procedure (current or future), recent change or expected changes are happening that will affect this group?
What is the audience doing now that could or has led to this problem based on facts, rather than assumptions? Provide references or citations. Or, where is the audience currently in this skill, training, process or procedural aspect?
What should or could the audience be doing instead to solve or prevent this problem? Or, what information, skill or technique will the audience need to attain in order to implement this new process or procedure?
Learning Objectives
Michigan Pharmacists Association (MPA) will attempt to accredit your program for pharmacists and pharmacy technicians by following the ACPE accreditation standards. Programs that benefit pharmacists and pharmacy technicians must have specific and separate learning objectives for each audience. If your pharmacy continuing education activity (PCE) benefits only pharmacists, only pharmacy technicians or both, please complete the appropriate learning objective section below. See pages 24-25 for guidelines on how to develop specific and measurable learning objectives. MPA must approve learning objectives.
Pharmacist Learning Objectives
A minimum of three objectives are required. The majority of the objectives should be structured to meet identified educational gaps in knowledge that will move learners to a desired state of practice.
At the end of this activity, participants should be able to:
*Select an ACPE approved verb from the drop down menu
Pharmacy Technician Learning Objectives
A minimum of three objectives are required. The majority of the objectives should be structured to meet identified educational gaps in knowledge that will move learners to a desired state of practice.
At the end of this activity, participants should be able to:
*Select an ACPE approved verb from the drop down menu
Activity Materials
Sponsorship
In accordance with the commercialism policy, no funds can go directly from the commercial supporter to the speaker; therefore, the organization hosting the continuing education activity and/or MPA will not be held responsible for signing grant requests or funding applications of any kind should you seek funding on your own.
Disclosure
Accredited activities shall exhibit fair content balance, providing the audience with information of different perspectives from which to develop an informed professional opinion. All relevant financial relationships with anyone who is in a position to control the content, including commercial interest and spouses/partners must be disclosed. In addition, should it be determined that a conflict of interest exist as a result of a financial relationship you may have, this will need to be resolved prior to the activity. This information is necessary in order for us to be able to move to the next steps in planning this activity. If you refuse to disclose relevant financial relationships, you will be disqualified from being a part of the planning and implementation of this activity.
First, list the names of proprietary entities producing health care goods or services, consumed by, or used on patients, with the exemption of nonprofit or government organizations and non-health care-related companies with which you or your spouse/partner have, or have had, a relevant financial relationship in any amount within the past 24 months that create a conflict of interest. Second, describe what you received (ex: salary, honorarium, etc.) You do not need to reveal how much you received. Third, describe your role.
What was received: Salary, royalty, intellectual property rights, consulting fee, honorarium, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.
My role(s): Employment, management position, independent contractor(including contracted research), consulting, speaking and teaching, membership on advisory Committees or review panels, Board membership and other activities.
Compensation
Compensated shall be agreed upon between HOSTING ORGANIZATION and presenter.
Indemnification
Faculty will indemnify Hosting Organization and Michigan Pharmacists Association (MPA) from and against all claims, including, but not limited to intellectual property infringement, copyright, damages, liabilities, expenses and judgments recovered from or asserted against Hosting Organization and/or MPA as a result of faculty presentation, materials and activities under this Agreement. Hosting Organization and MPA agrees to indemnify faculty from and against all claims, damages, liabilities, expenses and judgments recovered from or asserted against faculty as a result of participation in Hosting Organization’s educational program accredited through MPA and based on willful, wanton or negligent conduct on the part of the Hosting Organization and/or MPA. Intellectual property includes photos, images, media and video.
I, hereby, confirm all information as set forth above, as true and correct, and agree to deliver the activity as I have stated above in both a professional and educational matter. I also acknowledge and accept the compensation as outlined above as payment in full for my services. MPA reserves the right to withhold reimbursement should an activity lend itself to a biased nature. Changes or alterations to this agreement are not valid unless initialed by both parties.
I further warrant and represent that this activity is my own original work, that I have the authority to enter into this agreement and that I am the sole copyright holder, or that I have obtained all necessary permissions or licenses from any persons or organizations whose material is included or used in my presentation.