Acep National Emergency Medicine Faculty Teaching Award

American College of Emergency Physicians National Emergency Medicine Junior Faculty Teaching Award 2015

Nomination Form

Due Date: April 13, 2015

Please follow instructions closely, and make sure you have included all requested information listed on the checklist. Electronic submissions only. Please refrain from sending extraneous information. Application Packet

Please read these instructions carefully. Applications that do not follow these instructions with regard to format and supporting documentation cannot be accepted. If the application deadline has not passed, the application may be resubmitted after deficiencies are addressed. Extension of the deadline will not be granted to allow resubmission in the award cycle.

Also included for your reference are forms used by the reviewers to score and evaluate an application. The procedures for review are outlined below:

1. Reviews by ACEP staff to ensure all submission instructions have been followed.

2. Initial review of successful applications by the Academic Affairs Chair and Academic Affairs Teaching Awards Subcommittee Chair to ensure eligibility, suitability and general competitiveness for this category of award.

3. Successful reviewed applications by the Academic Affairs Teaching Awards Subcommittee for a recommendation on the award.

4. Award recommendations will be submitted to the ACEP Board of Directors for a final decision.

2 General Information

Deadlines

Deadline for receipt of application: April 13, 2015

Notification of award: July 10, 2015

Email electronic file of application to: [email protected] ACEP National Junior Faculty Teaching Award American College of Emergency Physicians 1125 Executive Circle Irving, TX 75038-2522

Introduction

The American College of Emergency Physicians sponsors a national junior faculty teaching award to honor outstanding educators in emergency medicine. This award is designed to support emergency medicine faculty in their efforts to achieve academic advancement, as well as support the continued academic development of the specialty. The award recognizes superior teaching activities including didactic lectures, clinical instruction, the development of innovative educational programs, community education, and contributions to regional and global programs, as well as the endorsement by faculty, residents, and students. While the documentation required for this award is extensive, the process is designed to mimic the procedure used by university promotion and tenure committees in their deliberations. Recipients of this award will receive national recognition that can be used as evidence of their teaching excellence.

The College will recognize award winners annually.

Recognition

Award winners will be recognized with a plaque during ACEP’s annual Scientific Assembly meeting, and by publication of their names in ACEP News or other College publications.

3 American College of Emergency Physicians National Emergency Medicine Junior Faculty Teaching Award Eligibility To be eligible for the award, faculty must: 1. Be a member in good standing of the American College of Emergency Physicians. 2. Hold an academic appointment at a US allopathic or osteopathic medical school. 3. Be board certified in emergency medicine by ABEM or AOBEM, may be board certified in pediatric emergency medicine under ABP. 4. Be at the instructor, or assistant professor level. (This award is recommended for applicants between three and seven years post-residency)

Process and Limitations 1. Faculty must be nominated by their academic chair, program director, or head of emergency medicine, and submit a complete official application form. Include a CV as part of the application form. 2. Individual faculty are not eligible for the award more than once. 3. Nominations are reviewed by a subcommittee of the Academic Affairs Committee. Subcommittee recommendations are presented to the ACEP Board of Directors for approval.

Criteria The Academic Affairs Committee will evaluate applications in each of the following categories:

1. Letter of endorsement by the program's academic chair, program director, or head of emergency medicine. 2. Endorsement by the program's residents. 3. Teaching awards or honors. 4. Documentation of excellence in educational activities (may consider undergraduate, EMS, GME, CME, invited lectures, and/or visiting professorships). 5. Documentation of excellence in teaching (may include local, state, national, or international ACEP sponsored programs). 6. Documentation of innovative educational programs for teaching clinical or research topics in emergency medicine. Nominees are scored in each category and numerical results tabulated. Prior to submission of their recommendations to the ACEP Board of Directors, the subcommittee scores each applicant based on review of final tabulations and all relevant data on each applicant.

4 Application Instructions

The application must be received electronically no later than the deadline date indicated under general information. Electronic files should be combined in one PDF or MS Word format.

All applications must be in English and free of jargon and unusual abbreviations. For terms not universally known, spell out the term the first time it is used with the appropriate abbreviation in parentheses; the abbreviation may be used thereafter. Type the application, single-space; type size should be 12-point font with headings no larger than 14 point.

Applications should not exceed 14 pages total, as specified by section in the instructions below. Incomplete or late applications will not be considered.

The application consists of eight sections and should be placed in this order:

1. Title Page Provide all information requested (template on page 8). Note that the academic chair / chief of emergency medicine or program director must sign the title page. The electronic file must include signatures. Not to exceed 1 page.

2. Endorsement by the Academic Chair / Chief of Emergency Medicine or Program Director The application must include a letter from the academic chair / chief of emergency medicine or program director concisely outlining their assessment of the applicant’s teaching ability, area of excellence, educational role within the department, and rationale for nomination of this award. The program director, academic chair or chief of emergency medicine is responsible for the verification of the truthfulness of the application material by signifying they have reviewed and verified the authenticity of the packet materials, especially with regard to authenticity of awards, educational efforts, etc. Major awards, educational efforts, etc, should be summarized in the endorsement letter. Not to exceed 2 pages.

3. Endorsement by the Program’s Residents The application should include documentation of endorsement by the program’s residents. This may include a letter of support from designated resident(s), a petition signed by the program’s residents or other expression indicating support of the application by the program’s residents. Not to exceed 2 pages.

4. Documentation of Teaching Awards The application should summarize any awards, certificates, evaluations, or other documentation indicating recognition of teaching excellence within the hospital, EMS system, university or extramural teaching venues with a concise description of the exclusivity and selection process (e.g.: “awarded once annually by vote of all EM residents.”) Not to exceed 1 page.

5 5. Documentation of Educational Efforts Applicant should briefly describe programs developed or courses taught, dates of instruction, approximate number of students enrolled, and a summary of the effectiveness of the teaching program. May include the following sections as relevant. Not to exceed 4 pages.

Undergraduate Medical School Education

Graduate Medical Education

Continuing Medical Education

EMS Education

Invited Lectureships and/or Visiting Professorships

Community programs (may include medical or lay person audience, including mass media.)

6. Documentation of ACEP Program Educational Programs The application should provide detailed information about ACEP educational program involvement. The application should briefly describe lectures with dates, the name of the program, approximate number in attendance and any summary of evaluations provided. Not to exceed 2 pages.

Local/State ACEP Sponsored Programs

National or International ACEP Sponsored Programs

7. Major Innovative Educational Programs The application may include here a concise description or examples of excellence in emergency medicine education not already detailed in the sections above and should provide detailed information about the nature of the innovation, dates the program was presented or implemented, results of the educational innovation, and any evaluation data available. Not to exceed 2 pages.

8. Photograph Please include a photograph of the nominee, preferably a professional picture or head shot in jpeg format as a separate attachment.

6 Application Checklist

Before submitting your application, please use this checklist to ensure you have complied with all application requirements.

□ Nominee meets eligibility requirements on page 4

□ Application includes all relevant sections in the order given on pages 5 and 6

□ Application includes signed title page (template on page 8)

□ Title page includes signature (electronic signatures are acceptable)

□ Application is in PDF or MS Word format

□ Application is submitted by the deadline

7 Title Page

Name of Nominee:

Business Address:

Telephone Number:

Fax Number:

E-Mail Address:

Years in Academics:

Academic Rank:

Institution:

Tenure Track: YES / NO

Submitted by (Academic Chair / Chief of Emergency Medicine or Program Director):

Address:

Name of Individual completing this application (if different from applicant):

Address:

 Is applicant aware of nomination? Yes__ No__

Is applicant Board certified? Yes__ No____

Academic Chair / Chief of Emergency Medicine or Program Director

Date Date