2026 HHPF Pre-Conference - Multi-Modality Low Back Pain TX - Conference Response Form

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1. Title of Presentation *

2. Your Name/Credentials as you want them to appear on the course page: *

3. Your bio in a brief 2-3 sentences:

This information will be used to introduce you at the conference.

4. At least three measurable learning objectives specific to your presentation: *

Learning objectives should be statements that define what participants are expected to gain during your educational activity. They should identify a change in competence, skills, abilities, and/or performance. To help to write these learning objectives, think in terms of “By the end of this presentation, members of the healthcare team will [be able to]… (define, demonstrate, discuss, explain, identify, increase, illustrate, apply, compare, etc.)”

5. What active learning strategy will you use in your presentation to ensure the interprofessional team members attending this conference can learn with, from, and about each other to enable them to achieve your educational goals/objectives?

E.g. case presentation/discussion, small group discussion, polls (https://ce.icep.wisc.edu/sites/default/files/Interactivity_ActiveLearningStrategies_20200223.pdf)

7. Will this activity address factors that influence population health? *

Yes

Factor(s) addressed: *

E.g., housing instability, health literacy, transportation, access to care, environmental or economic factors, social determinants of health

Learner strategy: *

Describe 1-2 practical strategies learners will gain to address these factors in their practice.

8. Will this activity involve patients and/or public representatives as co-presenters? *

Yes

Please provide their name, who they are and their role in the planning or delivery of this activity: *

9. Does this activity use health or practice data? *

Yes

Data type/source: *

E.g., CDC surveillance, internal EHR quality metrics, clinical trial outcomes

Educational purpose: *

E.g., to highlight a clinical gap, benchmark current care, demonstrate therapy effectiveness

10. Will this activity include learners practicing communication skills and giving them feedback to help them improve? *

Yes

Please describe how you’ll observe the learner’s communication skills and how you will share feedback: *

11. Will this activity include learners practicing a technical or procedural skill and giving them feedback to help them improve? *

Yes

Please describe how you’ll observe the learner’s technical or procedural skill and how you will share feedback: *

12. Will this activity cover content on pharmacotherapeutics? *

Yes

To award pharmacotherapeutic credit, please give an estimated percentage of content in your presentation covering pharmacotherapeutics: *

Pharmacotherapeutic content may include, but is not limited to, drug specific information, safe prescribing practices, safe medication administration, prescribing methodologies, new regulations or similar content.

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2026 HHPF Pre-Conference - Multi-Modality Low Back Pain TX - Conference Response Form