First Name *

Last Name *

Email *

I agree to the terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Section 1:

Activity Description

1. Has the activity overview been completed with all necessary details including title, location, date(s), estimated hours, and estimated attendance? *

Yes, I've provided all the necessary details, including title, location, date(s), estimated hours, and estimated attendance.

No, I still need to fill in some details or finalize certain aspects.

2. Has the educational format been selected and described adequately, including the agenda with speakers, topics, and times for live courses? *

Yes, I've selected the format and described it thoroughly, including the agenda with speakers, topics, and times.

No, I still need to clarify the educational format and finalize the agenda details.

3. Have the appropriate educational formats/methods been selected based on the activity's objectives? *

Yes, I've chosen the formats/methods that align with the activity's objectives.

No, I'm unsure if the selected formats/methods match the objectives properly.

4. Is the joint provider information provided, including the organization name, contact person, and credit type requested? *

Yes, I've included all the necessary joint provider information.

No, I haven't provided all the required joint provider details yet.

Section 2:

Leadership and Administrative Staff Support

5. Are the Activity Director, Co-Director (if applicable), and Administrator/Coordinator identified with their respective roles? *

Yes, I've clearly identified the roles of the Activity Director, Co-Director (if applicable), and Administrator/Coordinator.

No, I need to clarify the roles of the Activity Director, Co-Director, and/or Administrator/Coordinator.

Section 3: Planning

6. Has a planning committee been established with all necessary members listed, and have they completed disclosure forms for potential conflicts of interest? *

Yes, I've established the planning committee and ensured they've completed disclosure forms.

No, I haven't formed the planning committee yet or some members haven't completed their disclosure forms.

7. Was the planning process conducted free of commercial influence, as attested to by the responsible party? *

Yes, the planning process was entirely free of commercial influence, as I've attested.

No, there might have been some commercial influence during the planning process.

8. Have the target audience and their scope of practice been clearly described, along with the overall learning objectives of the activity? *

Yes, I've provided clear descriptions of the target audience, scope of practice, and measurable learning objectives.

No, I need to improve the descriptions of the target audience, scope of practice, or learning objectives.

Section 4:

Needs Assessment and Educational Design

9. Is the activity aligned with CineMed's CME/CE mission statement? *

Yes, the activity aligns perfectly with CineMed's CME/CE mission statement.

No, the activity might not align well with CineMed's CME/CE mission statement.

10. Have desirable healthcare professional attributes/competencies been identified and addressed in the activity? *

Yes, I've identified and addressed the desirable attributes/competencies in the activity.

No, I'm uncertain if I've adequately addressed the desirable attributes/competencies.

11. Have factors outside of control impacting learner's outcomes been identified, and appropriate support strategies defined? *

Yes, I've identified external factors impacting learner outcomes and devised appropriate support strategies.

No, I might have overlooked identifying some external factors or defining support strategies.

Section 5:

Additional Information

12. Will the activity receive commercial support or exhibits from industry, and has an agreement with ACCME standards been made? *

Yes, I've made necessary agreements with ACCME standards regarding commercial support or exhibits from the industry.

No, I haven't finalized agreements with ACCME standards regarding commercial support or exhibits from the industry.

13. Are all required attachments included with the submission, including the agenda, CV of the Activity Director, proposed budget, and other supporting documents? *

Yes, I've included all required attachments, such as the agenda, CV of the Activity Director, proposed budget, and supporting documents.

No, I still need to gather or finalize some of the required attachments.

14. Have all additional requirements for ANCC and ACPE accreditation been confirmed to be met? *

Yes, I've confirmed that all additional requirements for ANCC and ACPE accreditation are met.

No, I need to double-check if all additional requirements for ANCC and ACPE accreditation are met.

Joint Provider - Planner Attestation

15. Does the planner agree to adhere to all standards and requirements for continuing education, including conducting activities free of proprietary interests and submitting all necessary documentation? *

Yes, I fully agree to adhere to all standards and requirements for continuing education.

No, I might not fully agree to adhere to all standards and requirements for continuing education.

After completing all sections, you will receive feedback on your readiness for CME accreditation.

This comprehensive quiz ensures your preparedness for a successful CME accreditation application, highlighting any areas needing further preparation or adjustments.