IPNA TC FINAL REPORT

IPNA Teaching course

FINAL REPORT
GENERAL INFORMATION
Title of Teaching course*
Date (start)*

MonthDayYear
Date
Date (finish)*

MonthDayYear
Date
Country*
City
Course director*

TitleFirst NameLast Name
Your name and position - if different from the course director*
Contact email*
example@example.com
TEACHING COURSE DETAILS
Type of the Teaching Course:*
TC attendance (numbers):
Total attendance (If multiple days, identify only unique attendees for TC) *
Speakers: Local *
Speakers: International *
Pediatric Nephrologists *
Pediatricians *
Adult/General Nephrologists *
Non-Pediatric, non-Nephrologist Physicians *
Pediatric Nephrology trainees (Fellows) *
Residents and medical students *
Allied health professionals (nurses, dieticians, social workers, etc.) *
Other attendees *
TEACHING COURSE IMPACT
Has the course met your and attendees´ expectations?*

YESNO
Please provide details for the response*
Is there expected program development or changes in delivery of care in your region expected to result from the course*

YESNO
Please provide details for the response*
Are there existing programs that benefit from strengthening knowledge and/or competencies as a result of the course?*

YESNO
Please provide details for the response*
FINANCIAL REPORT

Please fill in expenditure items*

EVALUATION
Evaluation of the given presentations (include narrative feedback from attendees, or feedback from administrators/patients on the quality of the program, may attach supplement reports**
**supplemental reports

Cancelof
Would you apply for IPNA Teaching course again?*
How can the IPNA Teaching courses program be improved?*
Teaching material (to be available on the IPNA website)

Cancelof
Photos from the course

Cancelof
SIGNATURE: Teaching Course Organizer
Signature*
Date*

MonthDayYear
Date
Should be Empty:

IPNA Teaching course