Apply to Harvard Macy – Educators Course

Apply to Harvard Macy - Educators Course

Step 1 of 7 - Account Information

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Name(Required)

Prefix First Last Suffix

Email(Required)

Mobile Number(Required)

Profile Picture

Accepted file types: jpg, jpeg, png, Max. file size: 16 MB.

Alternative Phone Number

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How did you hear about this course?

Gender(Required)

Timezone(Required)

Twitter Handle

LinkedIn Profile Link

Degree(s)(Required)

Specialty/Specialties(Required)

Note: Enter your professional specialities - if not applicable, enter NA

Academic Title(Required)

Note: Enter your academic title - if not applicable, enter NA

Professional Institution Affiliation(Required)

Note: Enter the name of your institution/business/organization - if not applicable, enter NA.

Professional School Affiliation(Required)

Note: Enter the name of your school - if not applicable, enter NA.

Health Care Organization Affiliation(Required)

Note: Enter your organization name - if not applicable, enter NA.

Professional Organization Affiliations

Enter any professional organizations for which you are a member. Select '+' to list additional affiliations.

Education and Professional Experience(Required)

Scholarly Interest(Required)

Personal Background(Required)

Project Title(Required)

During Harvard Macy Institute programs, our attendees work on projects to improve their own institutions. Please enter a short title for the project you intend to work on during the course.

Focus of Project(Required)

What is the primary focus of your project? What question, concern, problem, or situation is addressed by your project? Describe the educational problem that your project is addressing and why is it important to your institution and / or health professions education overall.

Project Goals:(Required)

Note: List 1-3 specific goals for your scholarly project.

Brief Project Methods:(Required)

Briefly describe the methods that you will use to conduct your project.

Number of individuals who will be affected / participate in your project (teachers, learners etc):(Required)

Please explain each category included in your project.

Project Setting(Required)

Describe the specific educational setting (i.e., classroom, clinic, ward), institution / department setting where this project is being conducted (location, university affiliated or private, size and scope etc), as well as the larger system within which your project will occur (integrated 4-year curriculum, community health center service with diverse population ages and needs, etc.).

Who are the stakeholders/leaders who can influence its success?(Required)

What barriers do you anticipate in completing this project?(Required)

What target population do you think will be most impacted by your project implementation?(Required)

Other team members

What target population will your project implementation effect?(Required)

Undergraduate

Graduate

Continuing Professional Development

What is the educational focus of your project?(Required)

Teaching and Education

Curriculum Design

Faculty Development

Assessment and Evaluation

Educational Technology

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Accepted file types: pdf, Max. file size: 16 MB, Max. files: 5.