ANZCEN 'Unconference' Expression of Interest
This is an Expression of Interest (EOI) form for your attendance at the Australia New Zealand Clinical Educator Network 'Unconference' in Adelaide on Wednesday 10 October 2018. The Unconference is being held the day before the ANZICS/ACCCN ASM for 2018 (https://www.intensivecareasm.com.au/) and has organising members from within ANZICS, ACCCN, CICM and other academic and clinical bodies from disciplines across Intensive Care.

This 2018 Unconference is a single-day working event that will help develop an active network of inter-professional educators in Intensive Care Medicine in ANZ. The Unconference will enable the participant groups to examine aspects of Clinical Education in different Unconference 'streams' through a facilitated, collaborative process. The purpose is for us to learn and work together to create action plans that will improve the capacity and delivery of inter-professional intensive care education.

The EOI data you enter here will enable the organising group to select the correct group of experienced and developing educators to attend the Unconference. It will not be shared for other purposes. Attendance at the Unconference will be by selection (i.e. expression of interest does not mean you have a ticket). The attendee list will be a sample of all (selected based on enabling equity for all) levels of educator experience and expertise from all professions working within Intensive Care Units in Australia and New Zealand. Attendees may be sent preparatory materials prior to the Unconference to ensure that the day is as productive as possible.

Your attendance at the Unconference will be enabled through the subsequent receipt of a ticket for the event. Tickets for the event are anticipated to be delivered to selected participants after Friday, 10 August 2018.

Email address *
Title, First Name, Second Name *
Your answer
Contact mobile number (international format) *
Your answer
I would like to attend Unconference *
Required
My current professional field of practice within Intensive Care Medicine is: *
Required
My professional qualifications related to Intensive Care practice are: *
None
Bachelor degree level
Certificate level
Diploma level
Masters level
PhD
FCICM
FACEM
FANZCA
FRACP
FRACMA
Qualification
My highest qualifications in Health Professional Education are: *
My major interests in Health Professional Education are: *
Assessment and examinations
Bedside clinical teaching
Micro-skills teaching
Simulation-based education
Instructional design
Curriculum design and delivery
Needs assessment for ICU education
Educational scholarship and research
Education Leadership
Evaluation of education programmes
Faculty development of educators
Feedback in the workplace
Supervision
Mentorship
Interprofessional education (e.g. developing guidelines/ recommendations)
Workplace based learning
Interests
I have can contribute my interests, motiviations or expertise to the following Unconference streams *
Educator Faculty Development
Interprofessional Education
Workplace Learning
Educational Scholarship and Research
Intensive Care Education Needs Analysis
ANZ Intensive Care Education Position Statement
Educational programming
Streams
I would like to be considered to lead or facilitate an Unconference stream *
I would like to join the ANZCEN mailing list (by email, 1-2 monthly) *
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