SECTION 2A

							SECTION 2A: Continuing Educational Professional Development

Please complete in respect of each Provider / Instructor course on which you are the
Course/Medical director.

Type of Course                                  Provider                            Instructor
 (tick one)


Course Centre


Course Dates

                                ALS          EPLS          NLS        ILS          GIC           Other
Type of Course
 (tick one)


Course/Medical Director?                            Course Co-ordinator?
YES / NO                                            YES / NO


Course Director/Medical Director/Course Co-ordinator

Number of courses previously directed:              Number of courses previously
                                                    co-ordinated:

1 2 3 4 5 >5 (Circle please)                        1 2 3 4 5 >5 (Circle please)


Reflect on what went well:




What would you do differently next course?




PROFESSIONAL DEVELOPMENT RECORD                     January 2011                         SECTION 2A