Activity Name Topic Format/ Event Activities and Expected Level of IPE Interactivity Specify all that apply - seminar, workshop, IP speaker panel, large group case discussion, breakout group activity, role-play, simulation, journal club, job shadow, Q&A, team exercises, etc. Are there any social aspects to the activity? E.g. icebreaker games, networking, dinner, etc. Host Name/Student Organization Host Description Student organization mandate, small group, etc. Sponsors Event Setting In person Virtual Event Date and Time Event Date and Time: Date Event Date and Time: Time Event Duration Speaker Please include name, title, discipline, practice site Intended Audience/ Expected Participants Expected Interprofessional Mix Number of pharmacy students out of total health care practitioner/student participants, e.g. ratio of low, equal, or high Student Role in this Activity Relevance to IPE While clinical information may shape the event the interprofessional competencies should be prominently incorporated and a central part of the expected learning outcomes. Please include at least 2 learning objectives related to Interprofessional Collaboration and specify what CIHC competencies students will have the opportunity to develop during this activity. In addition, please describe how the event will achieve the IPC learning objectives you have set out (this could include introductory comments, the facilitated questions you are using, the breakdown of roles in a case, guest speaker talking points, interactive survey questions, etc.) Learning Objectives How These Will be Achieved Your Agenda Event Materials Such as speaker slide deck, cases for discussion, facilitation questions, etc Other Pertinent Information Activity/Registration Link? Once Approved, We Would Appreciate Assistance in Promoting this Event To all pharmacy students To a specific cohort Medicine (McMaster) Nursing (Conestoga College) Social Work (Renison, Laurier) Optometry (UW) Pharmacy assistants or technicians (Wesetrvelt, Fanshawe) Other Which Cohort? Please Specify the Other IPE Partner(s) You'd Like to Promote to Name(s) of Students Applying for IPE Event Points Email(s) of Students Applying for IPE Event Points Event Poster? One file only.100 MB limit.Allowed types: gif, jpg, png, svg. Do you provide the School of Pharmacy consent to send you information? The University of Waterloo School of Pharmacy will use the information you provide on this form to email you details, news, reminders and updates about our programs and events. View our Privacy Policy for additional information. To stop receiving messages from us, click the unsubscribe link in the footer of any email or contact us at pharmacy.alumni@uwaterloo.ca Yes, I consent Leave this field blank
Activity Name Topic Format/ Event Activities and Expected Level of IPE Interactivity Specify all that apply - seminar, workshop, IP speaker panel, large group case discussion, breakout group activity, role-play, simulation, journal club, job shadow, Q&A, team exercises, etc. Are there any social aspects to the activity? E.g. icebreaker games, networking, dinner, etc. Host Name/Student Organization Host Description Student organization mandate, small group, etc. Sponsors Event Setting In person Virtual Event Date and Time Event Date and Time: Date Event Date and Time: Time Event Duration Speaker Please include name, title, discipline, practice site Intended Audience/ Expected Participants Expected Interprofessional Mix Number of pharmacy students out of total health care practitioner/student participants, e.g. ratio of low, equal, or high Student Role in this Activity Relevance to IPE While clinical information may shape the event the interprofessional competencies should be prominently incorporated and a central part of the expected learning outcomes. Please include at least 2 learning objectives related to Interprofessional Collaboration and specify what CIHC competencies students will have the opportunity to develop during this activity. In addition, please describe how the event will achieve the IPC learning objectives you have set out (this could include introductory comments, the facilitated questions you are using, the breakdown of roles in a case, guest speaker talking points, interactive survey questions, etc.) Learning Objectives How These Will be Achieved Your Agenda Event Materials Such as speaker slide deck, cases for discussion, facilitation questions, etc Other Pertinent Information Activity/Registration Link? Once Approved, We Would Appreciate Assistance in Promoting this Event To all pharmacy students To a specific cohort Medicine (McMaster) Nursing (Conestoga College) Social Work (Renison, Laurier) Optometry (UW) Pharmacy assistants or technicians (Wesetrvelt, Fanshawe) Other Which Cohort? Please Specify the Other IPE Partner(s) You'd Like to Promote to Name(s) of Students Applying for IPE Event Points Email(s) of Students Applying for IPE Event Points Event Poster? One file only.100 MB limit.Allowed types: gif, jpg, png, svg. Do you provide the School of Pharmacy consent to send you information? The University of Waterloo School of Pharmacy will use the information you provide on this form to email you details, news, reminders and updates about our programs and events. View our Privacy Policy for additional information. To stop receiving messages from us, click the unsubscribe link in the footer of any email or contact us at pharmacy.alumni@uwaterloo.ca Yes, I consent Leave this field blank