Thank you for your interest in planning an accredited Regularly Scheduled Series (grand rounds) activity with GW's Office of Continuing Education in the Health Professions (CEHP). A Regularly Scheduled Series (RSS) is a live activity that is planned as a series with multiple, ongoing sessions, e.g., offered weekly, monthly, or quarterly; and is primarily planned by and presented to the accredited organization's professional staff. The first step in planning a CE activity is to complete this CE Planning Form. This short form requires you to submit basic information about your planned series. Upon receiving this form, a CEHP staff member will follow up with you within 3 business days. Please contact the CEHP Office should you have any questions while completing this form. Full Name Email Address Phone Which of the following best describes your relationship with GW? SMHS Faculty/Staff GW Hospital GW Medical Faculty Associates Children's National Health System Washington DC VA Medical Center Other, please describe: Which of the following best describes your relationship with GW? Other, please describe: Are you submitting this form on behalf of the Course Director/ Lead for the activity? Yes, I am not the Course Director/Lead for this activity No, I am the Course Director/Lead for this activity Course Director/ Activity Lead Course Director's First Name Course Director's Last Name Course Director's Email Address Which of the following best describes the Course Director's relationship with GW? SMHS Faculty/Staff GW Hospital GW Medical Faculty Associates Children's National Health System Washington DC VA Medical Center Other, please describe: Which of the following best describes the Course Director's relationship with GW? Other, please describe: Series Details Series/Grand Rounds Title Sponsoring Department Sponsoring Division RSS Coordinator (Day-to-day contact) RSS Coordinator's Email Series Type Grand Rounds - Didactic/lecture presentation by an expert Case Conference - Detailed discussion among healthcare providers of the management and treatment of a patient case Tumor Board - Collaborative review amongst specialists from surgery, medical oncology, radiation oncology, radiology, genetics, and pathology to discuss a patient's condition to determine the best treatment plan. Morbidity & Mortality (M&M) - Discussion of management and treatment details of particular cases where morbidity or mortality occurred Journal Club - Critical evaluation and discussion of recent articles in the academic literature, such as scientific literature, or medical literature Delivery Format In-Person Live-Streamed Both In-Person & Livestreamed Location (building, room #, etc.) Virtual Instructions Frequency Weekly Bi-Weekly Monthly Quarterly Other: Frequency Other: Day of the Week Monday Tuesday Wednesday Thursday Friday Start Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm End Time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm # Sessions Per Year: Series Start Date Enter the date on which your series will be offered for the first time. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028 Target Audience Select all that apply. Physicians Pharmacists Psychologists Physician Assistants Nurses Other: Target Audience Other: What practice-based problem (gap) will this education address? What is/are the reason(s) for the gap? What change(s) in strategy, performance, or patient care would you like this education to help learners accomplish? Learning Objectives Will this series have commercial support (grants or in-kind donations)? Yes No Uncertain Please provide any additional details that you would like CEHP to know about the planned series. Leave this field blank
