PNPSourCE Course Proposal Form

NAPNAP encourages our members to share their expertise and knowledge on PNPSourCE.

Please complete this form. Authors provide their contact information and an overview of their proposed online course to be considered for the PNPSourCE online course catalog. All information forms are peer reviewed by the NAPNAP Continuing Education Review Committee to ensure that the topic and content meets the needs of PNPSourCE participants.

* First Name

* Last Name

* Credentials

* Current Position

* Email Address

* Are you a NAPNAP member? (If no, please complete the address information below)

Yes

No

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Course Information

* Topic

* Brief description of the course content.

* Has this course been previously distributed through another e-learning website?

No

Yes, provide name of website.

* What do you want to teach in this online course?

* Why is the online format appropriate for this course?

* How will you engage the online learner in this course?

*

Who do you think would benefit best from this course ?

Primary care PNP

Acute Care PNP

Specialty Care PNP

Other

If specialty care PNP, list specialty.

* Please indicate the audience level of this course.

Beginner: no background or minimal training is necessary to understand course material

Advanced Beginner: basic understanding of topic is necessary to follow course material

Intermediate: prior knowledge of topic is necessary to appreciate course material

Advanced

* Please provide a brief biography demonstrating your expertise in this subject matter.

* Have you ever developed an online course before?

Yes

No

* Indicates Response Required