AAP Project ECHO Faculty Interest Survey

AAP Project ECHO Faculty Interest Survey

The American Academy of Pediatrics (AAP) is seeking subject matter experts (SMEs) to serve as faculty on a multi-disciplinary team for upcoming ECHO (Extension for Community Health Outreach) programs.

Project ECHO (Extension for Community Health Care Outcomes) is a tele-mentoring program designed to create communities of learners by bringing together learners and subject matter experts in topical areas using lecture and case-based presentations, fostering an "all teach, all learn" approach. To learn more about ECHO, visit www.aap.org/projectecho.

To ensure we have diverse and multidisciplinary faculty expertise, the AAP is inviting those interested in being considered as faculty to complete this interest form.

Family representatives and those with lived experiences are also welcome to complete this form

Compensation may be offered to those who serve on a faculty team.

Contact aapecho@aap.org with any questions. Thank you for your interest!

Date*

First and Last Name*

Please enter your first and last name.

Credentials

Please list your credentials below:

Email Address*

Please enter your personal email address:

Gender (Please Specify)

What gender do you identify as:

Select or enter value

Race/Ethnicity

What is your race/ethnicity (please check all that apply)

Select or enter value

Professional Training

What is your professional expertise/training?

Select or enter value

Other Training

If you selected 'other' please describe your professional expertise/training below:

Practice/Organization Name

What is the name of the current organization you work for?

ECHO Experience

Do you have any experience with Project ECHO programs (experience is not required)?

Select or enter value

Topics of Interest*

Our aim for upcoming ECHO programs is to increase participant knowledge and self-efficacy in topical areas for youth and pediatric patients.

What topics are you interested in and/or have expertise in?

How did you hear about this opportunity?

Send me a copy of my responses

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