Pediatric Stroke Champions Goal Setting Exercise Pediatric Stroke Champions: Goal Setting Exercise Step 1 of 2 50% Consent for Use of Participation Data for Education ResearchDear Participants in “Pediatric Stroke Champions,” Throughout this course, you will be completing a number of exercises. These exercises are required for course completion regardless of your consent for us to use your responses for our study about the course, as described as follows: As is standard practice for continuing education courses, we will be eliciting your feedback at the end of this course offering to understand your learning experience and how we can continue to improve in future renditions; completion of course activities and this end of course assessment is required to claim credit. We will also be collecting standard demographic information about participants such as specialty, region, years in practice, and practice setting. Through our online learning platform, we are also able to collect participation metrics such as how often course materials were accessed, responses to knowledge questions and reflection exercises, and participation in longitudinal activities such as follow-up discussions. In addition to these standard practices in support of course evaluation and improvement, we also intend to use descriptions of and insights about the course’s curriculum design and implementation as the basis of health professions education research, results of which may be published in the health professions education scholarly literature. We are inviting all course participants to consent to the use of their existing participation data. No additional activities or information would be required of you specifically for research purposes, and there would be no risk to your participation nor any direct benefits to you. None of the participation data collected will impact your ability to enroll in and participate in the course or to claim continuing education credit. All information collected will be downloaded into a spreadsheet/database system (e.g. Excel, Qualtrics) and deidentified for subsequent use. You will be assigned a numerical identifier in the database so that we can track deidentified individual responses and other data. Results will only be reviewed by the course leadership and members of the education research team. This research is supported by a Professional Development Scholarship Grant from the Northeast Group on Educational Affairs of the Association of American Medical Colleges; no data will be shared directly with this organization. Any published data might incorporate demographic information but would only be in aggregate: for example, “X% of course participants from neurology were satisfied or very satisfied with the course compared to Y% of non-neurologist participants” or “Participants in the top quartile of engagement with online asynchronous learning resources demonstrated [X trend] on self-assessment questions compared to those in the bottom quartile.” Your consent for the use of course data for the above-described education research is entirely voluntary and you may choose at any time now or in future whether or not to consent. Please contact Miya Bernson-Leung at email@example.com with any questions about participation. “The Institutional Review Board (IRB) of Boston Children’s Hospital has reviewed this protocol IRB-P00033897 titled “Improving Pediatric Stroke Recognition and Management through Innovative Continuing Medical Education” and determined that it qualifies as exempt. Full notice of exemption available upon request.” Please Respond Here:(Required) I have read the above information and consent to the use of my existing course participation data for education research. I have read the above information and do not consent to the use of my existing course participation data for education research. Thank you for your response. Your answers to the following questions will not be used in our study about the course.Introductory Goal Setting ExerciseThe following exercise is a required part of your participation in the “Pediatric Stroke Champions” course, for which you will receive 0.5 hours of continuing education credits as we estimate it will take approximately 30 minutes to complete. Our intention as course faculty is for you to identify your learning goals for the course and reflect on how we can best help you achieve them. Please complete this exercise before the other course pre-work materials (articles, videos, and multiple-choice questions) and no later than 5:00PM EDT on Friday, June 3, 2022. Name(Required) Credentials(Required) Profession(Required)NursePhysicianAdvanced Practice Provider (e.g. APRN, NP, PA)Paramedic or EMTAdministratorOther (please specify)Other Specialty (May Select Multiple):(Required) General Pediatrics General Internal Medicine Family Medicine Pediatric Neurology Adult Neurology Pediatric Hematology Adult Hematology Pediatric Cardiology Adult Cardiology Pediatric Emergency Medicine Adult Emergency Medicine Pediatric Critical Care Medicine Adult Critical Care Medicine Pediatric transport/prehospital medicine Adult transport/prehospital medicine Other (please specify) Other Years since completion of training:(Required)Currently in training (e.g. student, resident, fellow)0-56-1011-1516 or moreInstitution Name(Required) Enrolled in course with other colleagues from the same institution(Required) Yes No Location of Institution: (City, State, Country)(Required) Practice Setting (Select all that Apply):(Required) Outpatient clinic Emergency room Inpatient Unit not including intensive care of step up Inpatient intensive care or step up Transport/prehospital Other (please specifiy) Other What motivated you to enroll in this course? What are your goals as a Pediatric Stroke Champion?(Required)Current state of pediatric stroke knowledge, skills/practice, attitudes, and outcomes at your institution(Required)Gaps between current state (“what is”) and desired future state (“what could or should be”) of pediatric stroke knowledge, skills/practice, attitudes, and/or outcomes you would like to address(Required)Proposed project to address this gap you will work on as part of this course (select all that apply):(Required)Educational intervention (e.g. formal teaching session, department/unit meeting, handout/poster, online module…)Practice project (e.g. development of a stroke response pathway, radiology protocol, orderset, documentation template…)Quality improvement or patient safety project (e.g. root cause analysis or process mapping of pediatric stroke cases, data tracking over time, pilot intervention…)Other (please describe below)Other Brief project description:(Required)How are you hoping this course will help you in achieving your goals?As a result of participating in this course, I hope to learn the following:(Required)As a result of participating in this course, I hope to be able to do the following:(Required)As a result of participating in this course, I hope to be able to address the following barriers or challenges:(Required)PhoneThis field is for validation purposes and should be left unchanged.