@csrf {{ method_field('PUT') }}
JAC 13
  • Includes planners who are patients and/or public representatives AND
  • Includes teachers who are patients and/or public representatives
jac13 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac13" id="jac13_1" @click="isJac13Show()">
jac13 == 0) checked @endif>
Name of Patient Planner:
Name of Patient Presenter:
Indicate the mechanism used to include patient as presenter :
Describe in what way the planners and presenters of the activity represent the patient or public, along with the role they played in the planning AND delivery of your CE activity. (maximum 250 words per example)
JAC 14
  • Includes planners who are students of the health professions AND
  • Includes teachers who are students of the health professions
jac14 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac14" id="jac14_1" @click="isJac14Show()">
jac14 == 0) checked @endif>
Name of Fellow/Student Planner:
Name of Fellow/Student Presenter:
Indicate the mechanism used to include Fellow/Student as presenter:
Describe the health professions’ students involved in the activity, including their profession and level of study (e.g. undergraduate medical students, nurse practitioner students, residents in general surgery) and how they participated as both planners and faculty of the activity. (maximum 250 words per example activity)
JAC 16
  • Conducts scholarly pursuit relevant to IPCE and/or CE; AND
  • Submits, presents, or publishes a poster, abstract, or manuscript to or in a peer-reviewed forum.
jac16 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac16" id="jac16_1">
jac16 == 0) checked @endif>
If yes, describe the project, how it was developed and strategies used to disseminate the findings, i.e., publication or presentation (maximum 250 words).
JAC 17
  • Teaches about collection, analysis, or synthesis of health/practice data AND
  • Uses health/practice data to teach about healthcare improvement
jac17 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac17" id="jac17_1">
jac17 == 0) checked @endif>
Describe how the activity taught learners about collection, analysis, or synthesis of health/practice data and how the activity used health/practice data to teach about healthcare improvement. (maximum 250 words per activity description)
JAC 18
  • Teaches strategies that learners can use to achieve improvements in population health
jac18 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac18" id="jac18_1">
jac18 == 0) checked @endif>
Describe the strategy or strategies used to achieve improvements in population health (maximum 250 words per example)
JAC 19
  • Creates or continues collaborations with one or more healthcare or community organization(s) AND
  • Demonstrates that the collaborations augment the provider’s ability to address population health issues
jac19 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac19" id="jac19_1">
jac19 == 0) checked @endif>
Describe the nature of the collaboration (new/continued) with one or more healthcare or community organization(s) AND demonstrate that the collaboration augmented MLI’s ability to address population health issues.
JAC 20
  • Provides IPCE/CE to improve communication skills; AND
  • Includes an evaluation of observed (e.g., in person or video) communication skills; AND
  • Provides formative feedback to the learner about communication skills.
jac20 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac20" id="jac20_1">
jac20 == 0) checked @endif>
If yes, describe the activity and mechanism used to provide feedback on learner communication skills (maximum 250 words).
JAC 21
  • Provides IPCE/CE addressing psychomotor technical and/or procedural skills; AND
  • Includes an evaluation of observed (e.g., in person or video) technical or procedural skill; AND
  • Provides formative feedback to the learner about technical and/or procedural skills
jac21 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac21" id="jac21_1">
jac21 == 0) checked @endif>
If yes, describe how this activity will help learners gain, retain, or improve technical and/or procedural skills, such as operative skill, device use, procedures, physical examination, specimen preparation, resuscitation, and critical incident management (maximum 250 words).
JAC 22
  • Tracks the repeated engagement of the learner/team with a longitudinal curriculum/plan over weeks or months, AND
  • Provides individualized feedback to the learner/team to close practice gaps.
jac22 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac22" id="jac22_1">
jac22 == 0) checked @endif>
If yes, describe the strategy or strategies that will be used to design an individualized educational plan for the learner and/or healthcare team to close the individual/or team’s professional practice gap over time; either through a customized curriculum, self-directed learning plan where the learner/team assesses their own gaps and selects content to address those gaps (maximum 250 words).
JAC 23
  • Collaborates in the process of healthcare quality improvement AND
  • Demonstrates improvement in healthcare quality
jac23 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac23" id="jac23_1">
jac23 == 0) checked @endif>
Describe how MLI collaborated in the process of healthcare quality improvement, along with the improvements that resulted. Include data (qualitative or quantitative) that demonstrates those improvements (maximum 500 words per collaboration).
JAC 24
  • Collaborates in the process of healthcare quality improvement AND
  • Demonstrates improvement in healthcare quality
jac24 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac24" id="jac24_1">
jac24 == 0) checked @endif>
Describe how MLI collaborated in the process of healthcare quality improvement, along with the improvements that resulted. Include data (qualitative or quantitative) that demonstrates those improvements (maximum 500 words per collaboration).
JAC 25
  • Collaborates in the process of improving patient or community health AND
  • Demonstrates improvement in patient or community outcomes
jac25 == 1) checked @endif class="form-check-input appearance-none h-4 w-4 border border-gray-300 rounded-sm bg-white checked:bg-blue-600 checked:border-blue-600 focus:outline-none transition duration-200 mt-1 align-top bg-no-repeat bg-center bg-contain float-left mr-2 cursor-pointer" name="jac25" id="jac25_1">
jac25 == 0) checked @endif>
Describe how MLI collaboration in the process of improving patient or community health that included CE, along with the improvements that resulted.Include data (qualitative or quantitative) that demonstrates those improvements (maximum 500 words per collaboration).
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