Activity Activity Title * Please copy and paste the title of the activity here Activity Content AAAAI Needs AssessmentAAAAI CME Mission Statement Does the topic of the activity align with the Needs Assessment and/or Mission Statement of the AAAAI? * Yes No If no, please explain. Does the content provided meet the learning objectives of the course? * Yes No If no, please explain. Did you identify any commercial bias in the content that was provided? * Yes No If yes, please describe the biased content and suggested revision. Validity of Clinical Content Is clinical content provided in this activity? * Yes No Are recommendations for patient care based on current science, evidence and clinical reasoning, while giving a fair and balanced view of diagnostic and therapeutic options? Yes No If no, please explain. Does the scientific research cited in this educational activity to justify patient care recommendations provide a range of evidence from credible sources? Yes No If no, please explain. Does the activity content address any potential risks or adverse effects that could be caused with any clinical recommendations? Yes No If no, please explain. Are new and evolving topics for which there is a lower (or absent) evidence base clearly identified as such within the activity content? Yes No Not Applicable If no, please explain. Competencies Select the physician competencies that this activity addresses. * The list below includes the competencies of: ACGME/ABMS, Institute of Medicine and Interprofessional Education Collaborative. Patient care and procedural skills Medical knowledge Practice-based learning and improvement Interpersonal and Communication Skills Professionalism Systems-based practice Values/Ethics for interprofessional practice Roles/Responsibilities Interprofessional communication Teams and teamwork Approval Approval * Approved Approved with revisions (enter below) Denied Recommended revisions: Comments re: denial: Please explain why you recommend denying CME for this activity. Reviewer's Name * Typing your name into this field is the electronic equivalent of your signature Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20232024202520262027 Leave this field blank
