Non-Facilitated Application

Professional Development Opportunity (PDO)

Non-Facilitated Application

Boxes can be checked by double-clicking and selecting ‘Checked’

All questions/boxes are mandatory

Please ensure you read the Accreditation of Professional Development Opportunities (PDO) Guidelines, prior to completing this application. Guidelines can be found at ESSA > Professional Development > Accrediting Professional Development.

PDO Information

Professional Development Opportunity title
Organisation name of Provider
Contact details of Provider / Contact Name:
Organisation:
Postal Address:
Phone:
Fax:
Mobile:
Email:
Website:
Delivery Medium / Face to Face (Instructor Led)
Online
Webinar
Overview of PDO (max 250 words)
Steps taken to ensure that the PDO is contemporary and relevant to an ESSA member
Target Audience / Accredited Exercise Scientists (AES)
Specialise in the design, implementation and evaluation of exercise and physical activity for healthy people / provide programs for improving general health, the prevention of chronic diseases, health promotion and enhanced sports performance / deliver exercise programs for clients with pathology or injury that have been prescribed by an appropriately qualified health professional (e.g. AEP or physiotherapist)
Graduate
2 – 5 years’ experience
5+ years
Accredited Exercise Physiologists (AEP)
Allied health professionals who specialise in the prescription and delivery of exercise for the prevention and management of chronic diseases and injuries
Graduate
2 – 5 years’ experience
5+ years
Accredited Sports Scientists – Level 1 (ASpS1)
Specialise in applying scientific principles and techniques to assist coaches and athletes to improve their performance, either at an individual level or within the context of a team environment. They may also apply their knowledge and skills to relevant projects within the sports industry, for corporate bodies or in the community, with a minimum relevant Bachelor degree
Graduate
2 – 5 years’ experience
5+ years
Accredited Sports Scientists – Level 2 (ASpS2)
Specialise in applying scientific principles and techniques to assist coaches and athletes to improve their performance, either at an individual level or within the context of a team environment. They may also apply their knowledge and skills to relevant projects within the sports industry, for corporate bodies or in the community, with a minimum relevant Honours degree
Graduate
2 – 5 years’ experience
5+ years
Accredited High Performance Manager (AHPM)
Specialising in overseeing a team’s sports science/sports medicine services. They apply their knowledge and skills to lead programs for high performance, elite and professional sports and athletes, and has a minimum of 5 years FTE experience as an ASpS2
Graduate
2 – 5 years’ experience
5+ years
Other (please specify):
Did you note this professional development opportunity as suitable for Accredited Exercise Scientists (AES) above? / No
Yes - please complete the below
______% - Familiarisation/background of condition/topic
______% - Exercise prescription for the condition (not relevant to an AES)
______% - Exercise delivery for the condition
______% - Other (please specify below):
Provide the Prerequisites that are required to attend this PDO
Maximum number of Participants per course/workshop
Other Associations this PDO is currently accredited with
Has this PDO been previously accredited with ESSA / Yes No
If yes, please provide full name of previously accredited course:

Content

The tables must be completed in full with information on the modules that make up the PDO. Guidelines for each section are detailed below in the detailed example.

1 table per module. Please add additional tables if required.

Please note that in addition to this table, you must submit the full content of your proposed course, including references for review (Refer to checklist).

EXAMPLE:

Module Name
State the name of this module / Designing
Competencies / Design & implement exercise rehab services for patient waiting for or following total hip or knee replacement
Duration
Indicate the approximate time it will take for a participant to complete this module. This should include teaching, practical sessions and assessment. / 2 hours
Learning Outcomes
These outcome statements should be indicative and measurable of what the participant should be competent in upon completion of this module. Learning outcomes should be able to be assessed.
The learning outcomes should reflect the participant’s competencies when completing the PDO / ·  Understand the process of OA in the hip & knee;
·  Understand how exercise affects the musculoskeletal system around the hip & knee in people with OA;
·  Design & implement an exercise program for a patient prior to total joint replacement
Content
A summary of the information needed to be understood by participants in order to achieve the learning outcomes. / ·  What is an osteoarthritis joint
·  Pain – Inactivity cycle
·  Alleviating pain during exercise
·  Joint forces for different activities
·  From cartilage defects to OA
Delivery Strategies
Outline the intended methods of delivery for the module (there may be more than one). / Presentation
Discussion
Practical session
Module Name
Competencies
Duration
Learning Outcomes
Content
Delivery Strategies
Module Name
Competencies
Duration
Learning Outcomes
Content
Delivery Strategies
Module Name
Competencies
Duration
Learning Outcomes
Content
Delivery Strategies
Module Name
Competencies
Duration
Learning Outcomes
Content
Delivery Strategies

Presenters

Please provide details of each presenter and attach presenter/s CV/s.

One table per presenter.

Name
Contact details / Organisation:
Postal Address:
Phone:
Fax:
Mobile:
Email:
Website:
Post-nominal initials
ESSA member
Accredited Exercise Scientist
Accredited Exercise Physiologist
Accredited Sports Scientist – Level 1
Accredited Sports Scientist – Level 2
Accredited High Performance Manager / Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Qualifications in relation to topic
Years of industry experience in relation to topic
Years of industry experience in presenting/delivery of education
Module of PDO to be delivered
Brief overview of professional background
(max 250 words)

Checklist

The review process will take a minimum of 4 weeks. Incomplete applications will be returned and further details will need to be provided before review can begin.

Applications will only be accepted in softcopy. Hardcopy applications will not be accepted.

Completed application form

Presenters’ CVs

Complete PDO package including:

PDO outline, full text

Assessment

Reference listing

Completion certificates

Delegates’ evaluation form

Advertising materials (flyer & information for website) and any handouts

Enrolment/registration form

Certificate of public and professional liability insurance for all providers and presenters

Grievance and appeals process

Incident report form and an outline of how any incidences will be dealt with

Accreditation fee

Have read & will abide by ESSA’s Code of Professional Conduct and Ethical Practice

If the program includes any Pilates based information

Presenters’ Evidence of qualifications

No material submitted for the accreditation of PDOs will be used for any other purpose than review unless otherwise stated.

Do you authorise ESSA to promote your PDO to our members via the website and monthly professional development newsletter / Yes
No
What is your proposed first date of this PDO?

Payment

1 year accreditation application fees / 1 – 5 points / 6 – 10 points / 11 – 15 points
$195.00 / $245.00 / $295.00

All prices include Australian GST. Fees are valid until 31 December 2017. Fees are subject to increase at anytime without notice.

Billing Address
if different from previously advised
ABN
Payment Method / Please forward tax invoice
Accreditation will not be final until payment is received in full
Cheque
Made payable to “Exercise & Sports Science Australia”
Credit Card
Please note all credit card payments attract at 1.5% surcharge
Authorised amount to charge card: $ plus 1.5% surcharge
Card number: ______/ ______/ ______/______
Expiry: __ __ /__ __
Name of Cardholder: ______
Signature: ______

Declaration

I have read and understand all of the guidelines for PDO accreditation and verify that the information contained in this application is complete and accurately documented.

Printed name of PDO provider

Signature of PDO provider

Date

Send to

Exercise & Sports Science Australia

Locked Bag 102, Albion DC Qld 4010

Email:

Phone: 07 3171 3335

Fax: 07 3318 7666

Page 7 Professional Development Opportunities (PDO) Non-Facilitated Application

Version 16.07, last updated 1 December 2016