TCEO Proposal

Application for Training

Attachment 3_Appl for Trng - TCEO Proposal

TCEO Proposal

OMB: 0920-0017

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Shape1

Attachment 4

Information Collection Instrument,

Training and Continuing Education Online Proposal













TCEO Proposal

2018
















  1. Introduction

The purpose of this document is to list the data elements collected online through the Training and Continuing Education Online Proposal module. The TCEO Proposal module is a mechanism for course developers and CE consultants of the Centers for Disease Control and Prevention (CDC) to request and submit their educational activities for accreditation review and approval.


The major pages, sections, and subsections of the TCEO Proposal are detailed in this document. Following the screenshots for each section is a table that shows the display properties of the collection of data elements.


  1. Login Page

Participants access the TCEO Proposal module by entering their username and password on the Login page (Figure 2). Those users accessing TCEO Proposal for the first time must register using the “Create Account” link displayed on this page.


The legal statements regarding CDC’s privacy act information and advisement and public burden information are clearly displayed near the bottom of the Login page.


Shape2

Form Approved
OMB No. 0920-0017
Exp Date 6/30/2019

Figure 2 – Login page with legal statements



Table 2 – Login Page Data Elements

Column Label

Display property

Figure

Username

Text

2

Password

Text

2

Create Account / Forgot Password

Links

2


  1. Activity Filter/Selection Page

Figure 3 – Activity Filter/ Selection Page



Table 3- Activity Filter/ Selection Page Data Elements

Column Label

Display property

Figure

Start Date

Numeric

3

Activity Number

Numeric

3

Title

Text

3

Role

Role Drop Down

3

User Name

Auto populate / Drop Down

3

Status

Status Drop Down

3

Credit Type

Multi Select- Credit Type

3

Activity Sub-Type

Multi Select – Activity Subtype

3


  1. Application Status Page

Figure 4a – Application Status Page: Activity


Figure 4b – Application Status Page: Activity Version








Table 4 – Application Status Page Data Elements

Column Label

Display property

Figure

Activity Number

Numeric

4a

Activity Title

Text

4a

Activity Type

Drop Down – Activity Type

4a

Contact Source

Drop Down – Contact Source

4a

Goal Statement

Text

4a

Activity Objectives

Text

4a

Activity Description

Text

4a

Directly Sponsored

Yes/No

4a

Activity Status

Drop Down – Activity Status

4a

Version Name

AutoPopulated

4b

Accreditation Start Date

Date/Time

4b

Accreditation End Date

Date/Time

4b

Credit Types

Multi-Select- Credit Types

4b

Activity Sub-Type

Drop Down – Activity SubType

4c

Activity Date

Date/Time

4c

UAN Number

Text

4c

Location

Text

4c

Address 1

Text

4c

Address 2

Text

4c

Address 3

Text

4c

City

Text

4c

State

Text or Drop Down State

4c

Postal Code

Text

4c

Country

Drop Down - Country

4c



  1. Practice Gap Page


Figure 5 – Practice Gap


Figure 5a – Gap Description


Figure 5b – Performance Impact & Supporting Documentation







Table 5 – Practice Gap Page Data Elements

Column Label

Display property

Figure

Practice Gap Address

Multi Select – Practice Gap

5

Continuing Pharmacy Education

Multi Select – Continuing Pharmacy Education

5

Identify Education Needs

Multi Select - Identify Education Needs

5

IOM Competencies

Multi Select – IOM Competencies

5

Competencies

Multi Select - Competencies

5

Gap Description

Text Box

5a

Performance Impact

Text Box

5b

Supporting Documents

Document Upload

5b


  1. Target Audience Page

Figure 6 – Target Audience Page


Table 6 – Target Audience Page Data Elements

Column Label

Display property

Figure

Target Audience

Multi Select - Target Audience

6

Audience Identification Method

Multi Select – Audience Identification Method

6

Prerequisite Skills and Knowledge

Text Box

6


  1. Facility Page

Figure 7 – Facility Page



Table 7 – Facility Page Data Elements

Column Label

Display property

Figure

Facility in which the education takes place

Multi Select Facility in which the education takes place

7

Appropriateness of Physical facilitates

Multi Select –Appropriateness of physical facilities

7

Prerequisite Skills and Knowledge

Text Box

7


Figure 8 – Promo / Eval Page

  1. Promo/Eval Page






Table 8 - Promo / Eval Page Data Elements

Column Label

Display property

Figure

Promotion Methods

Multi Select – Promotion Methods

8

Evaluation Categories

Multi Select –Evaluation Categories

8

Learner Feedback Strategies

Multi Select – Learner Feedback Strategies

8

Participant Evaluation Methods

Drop Down-Participant Evaluation Methods

8

Figure 9 – Timeline Page

  1. Timeline Page



Table 9 – Timeline Page Data Elements

Column Label

Display property

Figure

Version

Read only

9

Date Issued

Read only

9

Date Accepted

Read only

9

Reason

Text Box

9

Planning Tool

Date Field

9

Draft CE Proposal

Date Field

9

Final CE Proposal

Date Field

9

CME Review

Date Field

9

Contact TCEO Coordinator

Date Field

9

  1. Summary Page

Figure 10 – Summary Page


Table 10 – Summary Page Data Elements

Column Label

Display property

Figure

Section

Read only

10

Updated on

Read only

10

Updated by

Read only

10


  1. Objectives Page


Figure 11 – Objectives Page


Table 11 – Objectives Page Data Elements

Column Label

Display property

Figure

Description

Text Field

11

List Order

Numeric

11


  1. Planning Tool Page


Figure 12 – Planning Tool Page




Table 12 – Planning Tool Page Data Elements

Column Label

Display property

Figure

Session Title

Text Field

12

Session Description

Text Field

12

Segment Title

Text

12

Objectives

Multi Select (list is generated from Objective screen)

12

Content Addressing Objective

Text Field

12

Presenter/Content Expert

Drop Down – List is generated from Personnel screen

12

Duration Start

Time and Date

12

Duration End

Time and Date

12

Duration

Numeric

12

Location

Text

12

Instructional Strategies

Multi Select –Instructional strategies

12

CHES

Multi Select – CHES Competencies

12


Figure 13 – Credit Provider Page

  1. Credit Provider Page



Table 13 – Credit Provider Page Data Elements

Column Label

Display property

Figure

Joint Provider

Drop Down – List of Organizations that have been added TCEO application

13

Co-Provider

Drop Down – List of Organizations that have been added TCEO application

13



Budget Page


Figure 14 – Budget Page


Table 14 – Budget Page Data Elements

Column Label

Display property

Figure

Funding Source

Drop Down – List of Organizations that have been added TCEO application

14

Funding Recipient

Drop Down – List of Organizations that have been added TCEO application

14

In Kind

Drop Down – Yes/No

14

Funding User Description

Text Box

14

Funding Type

Drop Down –Funding Types

14

Grant Recipient

Drop Down – Yes / No

14

Funding User

Drop Down – Funding Use

14

New Organization

Hyperlink

14

Upload New Item

Button

14

File

Browse and Select File

14

Description

Text Box

14

















Figure 15 – Pilot Test List Page

  1. Pilot Test List Page






Table 15 – Pilot Test List Page Data Elements

Column Label

Display property

Figure

Include

Checkbox

15

Which Pilot Tester

Drop Down – List of Pilot Testers that have been added TCEO application

15

Pilot Test Date

Date Field

15

Which Credit for this activity

Drop Down – Available Credit Types

15

Minutes to complete

Numeric

15

Profession

Multi Select – Profession specific to selected Credit Type

15

Instructions Effective

Drop Down – Yes/No

15

Objectives – Effective

Drop Down – Yes/No

15

Course Content – Effective

Drop Down – Yes/No

15

Tables/Figures/Graphics – Effective

Drop Down – Yes/No

15

Quiz/Exercise Questions – Effective

Drop Down – Yes/No

15

Text/Exam

Drop Down – Yes/No

15

Instructions – Reason

Text Box

15

Objectives – Reason

Text Box

15

Course Content – Reason

Text Box

15

Tables/Figures/Graphics – Reason

Text Box

15

Quiz/Exercise Questions – Reason

Text Box

15

Text/Exam – Reason

Text Box

15

Willing to participate in future pilot testing

Drop Down – Yes/No

15

Comments

Text Box

15



  1. Pilot Test Summary Page


Figure 16 – Pilot Test Summary Page


Table 16 – Pilot Test Summary Page Data Elements

Column Label

Display property

Figure

Duration Method

Drop Down List – Duration Method

16

Relevance of Activity

Text Box

16

Feedback Documentation

Text Box

16

Results Statement

Text Box

16

Other Details

Text Box

16

Feedback Incorporation

Text Box

16





  1. Activity Testing Page


Figure 17 – Activity Testing Page


Table 17 – Activity Testing Page Data Elements

Column Label

Display property

Figure

Type

Drop Down List –

Test Type

17

Scope

Drop Down List – Scope

17

Learning Session

Drop Down List – Activity’s Sessions

17

Content Segment

Drop Down List – Activity’s Segments

17

Name

Text Box

17

Activity Version

Drop Down List – Activity’s Versions

17

Passing Score

Numeric Field for each selected Credit Type

17


  1. Activity Testing Group Page


Figure 18 – Activity Testing Group Page


Table 18 – Activity Testing Group Page Data Elements

Column Label

Display property

Figure

List Order

Numeric

18

Header

Text Box

18

Note

Text Box

18

Note Position

Drop Down – Above/Below

18

Select Graphic

Button / Browse

18

Graphic Position

Drop Down List – Above / Below

18


  1. Activity Testing Question Page


Figure 19 – Activity Testing Question Page


Table 19 – Activity Testing Question Page Data Elements

Column Label

Display property

Figure

List Order

Numeric

19

Question Type

Drop Down – Question Type

19

Question Display

Drop Down- Vertical / Horizontal / Drop Down List

19

Random Answers

Checkbox

19

Question Repeats

Drop Down List –Per Nothing /Per Objective / Per Presenter

19

Answer Required

Checkbox

19

Question Text

Text Box

19

Note

Text Box

19

Note Position

Drop Down – Above / Below

19

Graphic Select

Button / Browse

19

Graphic Position

Drop Down – Above / Below

19



  1. Activity Testing Answers Page


Figure 20 – Activity Testing Answers Page


Table 20 – Activity Testing Answers Page Data Elements

Column Label

Display property

Figure

List Order

Numeric

20

Correct

Drop Down –Yes/No

20

Answer Text

Text Box

20

Feedback Text

Text Box

20


  1. Supporting Documents Page


Figure 21 – Supporting Documents Page


Table 21 – Supporting Documents Page Data Elements

Column Label

Display property

Figure

Select File

Button / Select

21

Upload Type

Drop Down List – Document Type

21

Description

Text

21



Figure 22 – Activity Notes Page

  1. Activity Notes Page



Table 22 – Activity Notes Page Data Elements

Column Label

Display property

Figure

Notes

Text Box

22


Figure 23 – Non-CDC User Page

  1. Non-CDC User Page




Table 23 – Non-CDC User Page Data Elements

Column Label

Display property

Figure

Prefix

Text Box

23

Last Name

Text Box

23

First Name

Text Box

23

Middle Name

Text Box

23

Suffix

Text Box

23

Login id / email Address

Text Box

23

Primary Work Phone

Radio Button

23

Work Phone Country

Drop Down - Country

23

Work Phone – Phone Number

Numeric

23

Work Phone – Phone Number Extension

Numeric

23

Cell Phone – Primary

Radio Button

23

Cell Phone – Country

Drop Down - Country

23

Add as Role

Drop Down – Activity Role / System Role

23

Role

Drop Down –

Role

23



Figure 24 – Biography Page

  1. Biography Page











Table 24 – Biography Page Data Elements

Column Label

Display property

Figure

Job Title

Text Box

24

Relevant Experience

Text Box

24

Date Submitted

Date field

24

Resume Select

Button / Browse

24

Approved/Rejected

Drop Down – Approved / Rejected

24

Reason

Text Box

24


  1. Biography Degree Page


Figure 25 – Biography Degree Page


Table 25 – Biography Degree Page Data Elements

Column Label

Display property

Figure

Degree

Drop Down - Degree

25

Major

Text Box

25

School

Text Box

25

City

Button / Browse

25

Country

Drop Down – Country

25

State

Drop Down - State

25

Graduation Year

Date Field

25













  1. Disclosure Page


Figure 26 – Disclosure Page


Table 26 – Disclosure Page Data Elements

Column Label

Display property

Figure

Disclosed on

Date Field

26

Financial Relationship

Drop Down – Yes/No

26

Mechanism to Resolve

Drop Down – Discussion / Review /Planning Committee Review

26

Unlabeled Use

Drop Down – Yes/ No

26

Disclosure

Button / Browse

26

Disclosure Summary

Text Box

26

Approved/Rejected

Drop Down – Approved / Rejected

26

Reason

Text Box

26











  1. Organization Page


Figure 27 – Organization Page



Table 27 – Organization Page Data Elements

Column Label

Display property

Figure

Name

Text Box

27

Parent Organization

Drop Down – Organizations previously entered

27

Organization Type

Drop Down – Organization Types

27

Approved

Drop Down – Yes/ No

27

Reason

Text Box

27


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