1 Start 2 Complete First Name * Last Name * AOA Number Enter your AOA number. E-mail Address * Course Title/Rotation * Start Date * Start Date of your "Learning from Teaching/Precepting" experience. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028 End Date * End Date of your "Learning from Teaching or Precepting" experience. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028 Competencies * Which of the following AOA core competencies or osteopathic tenets were involved in your learning? (Please check all that apply.) Osteopathic Principles and Practice Medical Knowledge and its application into Osteopathic Medical Practice Osteopathic Patient Care Interpersonal and Communication Skills in Osteopathic Medical Practice Professionalism in Osteopathic Medical Practice Osteopathic Medical Practice-Based Learning and Improvement Systems-Based Osteopathic Medical Practice The body is a unity; the person is a unity of body, mind, and spirit The body is capable of self-regulation, self-healing, and health maintenance Structure and function are reciprocally interrelated Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function How was this material presented? * Formal (teaching, lectures, formal classroom setting) Precepting (Bedside, shadowing, clinical rotations) Who were your learners? * Select all that apply. Undergraduate Medical Education (i.e. medical students) Graduate Medical Education (i.e. residents and/fellows) Total # of hours spent teaching or precepting * Round to the nearest quarter hour. Attestation * I attest that the learning I completed was independent of control of an ACCME defined eligible company. ACCME's Standards for Integrity and Independence in Accredited Continuing Education - https://accme.org/rules/standards/ Yes No Leave this field blank
