Session Design Form "*" indicates required fields Session Chair*NOTE: The session chair/co-chair is the person(s) responsible for organizing the session. This may or may not be the session moderator. Please list the session moderator in the Session Outline grid towards the bottom of the form. First (Given) Name Last (Family) Name Session Chair Email*A copy of your final session design form will be sent to this email. Session Co-Chair (If applicable) First (Given) Name Last (Family) Name Session Co-Chair Email Session Title*As it will be published in the program and on the meeting app. Session Description*Provide 1-2 sentences describing the session, including who should attend. This will be listed in the program and on the meeting app. Practice GapsThe below information on practice gaps will be provided to our CME accreditor as part of our CME application process.1. What is the Problem that this session is trying to fix?How will this session address this problem?What are the barriers to fixing this problem and how will they be addressed?2. What is the Problem that this session is trying to fix?How will this session address this problem?What are the barriers to fixing this problem and how will they be addressed?3. What is the Problem that this session is trying to fix?How will this session address this problem?What are the barriers to fixing this problem and how will they be addressed?How did you determine the above listed problems existedPlease cite your sources.Session ObjectivesSession Objectives will be listed in the program and on the meeting app.Select the number of session objectives you will write:*12345Write at least three objectives focusing on what the learners will do as a result of this activity. Use ACTION words like: • Adjust • Articulate • Classify • Convey • Diagnose • Distinguish • Hypothesize • Infer • Organize • Prioritize • Relate • Apply • Assess • Compare • Create • Diagram • Employ • Identify • Integrate • Plan • Produce • Select • Appraise • Categorize • Conduct • Demonstrate • Differentiate • Evaluate • Illustrate • Interpret • Predict • Recognize • Solve • Arrange • Choose • Construct • Develop • Discriminate • Formulate • Implement • Manage • Prepare • Recommend • Use At the conclusion of this session, participants will be able to: Session Objective 1* Session Objective 2* Session Objective 3* Session Objective 4* Session Objective 5* Session OutlineThe information listed below will be used to build the published program and the meeting app. Once submitted if you have any changes to the speakers, talk titles, or speaker order please contact [email protected].Create the outline of your session below:*Use the + icon on the right side of the row to add another line to your session outline. Add as many lines as you require. Please include any introductions, breaks, discussion, Q&A, or Audience Response to the outline. For any moderators, please add them to the list and assign them with a 0 (zero) in the speaker order. Please make the total time allotted below match the time given for your session. For the Objective column, use the number from the objectives above.Presenter OrderPresentation TitlePresenter NamePresenter EmailTime Allotted (minutes)Objective Add RemoveReminders! Potential Bias/Conflict of Interest Review: You may be required to review the faculty presentation(s) in advance of the meeting if the ASC Conflict of Interest Committee determines that there may be potential bias due to the faculty member's relationship with an ACCME-defined ineligible company. Educational Delivery MethodCheck all that apply: Didactic lecture Panel or discussions Q&A session Case presentations Debate Roundtable discussion Webinar Interactive session Other Educational Delivery Method Other* Why did you select this type of delivery method? Knowledge conveyed in a short time Point/counterpoint for controversial topics Complicated topic, extra time for questions Application of knowledge to potential practice Interaction with audience is necessary Discussion of difficult or unusual cases or data Other Delivery Method Other* AVPLEASE NOTE: All AV requests are subject to approval by the ASC Core Committee.AV Special RequestsIf you have any specific requests for AV, please let us know below. If you are planning to use any audience response polling, please note that here as well as in the session outline above. Any AV additional requests must be submitted for approval by December 1, 2023. NameThis field is for validation purposes and should be left unchanged. Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)