My Learning Opportunities for Recertification

Instructions This form must be completed by all certificants who choose to recertify using a paper application. Please complete prior to submitting your recertification application. As part of ONCB's efforts related to continuing competence, please select one topic area in Category A and one topic area in Category B to identify continuing education activities of interest to you at the start of your recertification cycle.

Full Name *

Year of Recertification *

Address *

City *

State *

ZIP Code *

Email *

Instructions Select one Category A topic below. Click here for more details on each topic.

Category A (clinical orthopaedics) topic *

Why are you interested in this topic? Select one below. *

Current trendsHigh risk care areaLow volume care areaNew technology/equipment knowledge deficitOrganizational/employer goalPatient safetyPersonal interestRequired for role

Identify a Category B (general nursing) topic *These include any CE activities in non-orthopaedic areas of nursing practice. Examples include obesity, delirium, cardiovascular disease, organizational leadership.

Why are you interested in this topic? Select one below. *

Current trendsHigh risk care areaHigh volume care areaLow volume care areaNew technology/equipment knowledge deficitOrganizational/employer goalPatient safetyPersonal interestRequired for role

Category A topic *

How likely will the learning opportunities you achieved through CE change the way you practice?Did no activitiesHighly unlikelyUnlikelyPossiblyLikelyHighly likely

Category B topic *

How likely will the learning opportunities you achieved through CE change the way you practice?Did no activitiesHighly unlikelyUnlikelyPossiblyLikelyHighly likely

My Learning Opportunities for Recertification

My Learning Opportunities

Reflect on your original Category A and Category B topics of interest and the CE you completed over the course of your recertification cycle. Then complete the following questions.

Verification

Contacts