FCE Student Designed Course Proposal AY 2013-2014

Part I Course Information

Your Name *
 Your email *
FCE Course Title 

Has this FCE been offered previously?


Course Faculty Sponsor

Hosting Department

FCE Location (include contact information if available)
 

 
Please provide contact information for supervisors who will evaluate student performance.

Faculty Evaluating Supervisor

email *
phone   

 Faculty Evaluating Supervisor

email
phone

Administrative Support

email
phone   


Category of FCE    

 

 Interdisiciplinary Interprofessional List other professional(s) and or additional discipline(s) here


 

 

FCE Discipline

FCE Discipline

FCE Discipline

FCE Discipline

AY 2013-2014 Course Date(s) [use <ctrl+click> to select more than one FE term]

 

FE-Special Dates (eg, Spring Break)

 

 

 Part II Course Description

Brief Course Description (attach further information via email to UMMSFCEprogram@umassmed.edu )

 

Course Objectives e.g., By the end of this session students should be able to name, explain, perform, demonstrate, describe... (list 3-5 objectives)

 
 UMMS Core Competencies (check all that apply) Evaluation Type & Criteria (select at least one from each list)
 

 Type
Criteria
Describe/explain evaluation(s) here
 

Explain any prerequisites for this Flexible Clinical Experience