Abstract/Poster Submission Form

Abstract/Poster Submission Form

Submission of an abstract/poster does not constitute registration for the Second World Congress on Ultrasound in Medical Education. Authors with accepted abstracts are expected to register for the conference. New and previously presented abstracts (if relevant to the topic of ultrasound and/or medical education) can be submitted for review. However, authors are limited to participate as a “Presenter” in a maximum of three (3) abstracts to allow other authors to get a chance to present as well during the event. There are no restrictions on the number of abstracts an author may submit. There are also no restrictions on the number of accepted Posters from one author. Top of Form

Dates & Deadlines

The deadline for abstracts for presentations to be submitted is July 1, 2013.
Authors of presentations will be notified of acceptance or declination by August 5, 2013.

Authors of presentations will be asked to accept invitation and register for the conference by August 12, 2013.

Author Information:

Lead author:

Additional authors:Education level:

Address:City/State/ZIP:

Email address:

Phone:

FAX:

Institution:

Discipline:

Attestations

Presentation of original work is an important component of the Second World Congress on Ultrasound in Medical Education. Abstracts reporting results from original work will be reviewed by the Peer Review Committee. Abstracts that are selected will be presented in poster sessions and presentation sessions.

By submitting the presentation abstract form, the author/presenter is affirming the following:

Should my abstract be accepted for presentation or poster session, I fully understand that I will be required to register for the Second World Congress on Ultrasound in Medical Education scheduled for September 27-29, 2013 and will be expected to be present to show my work at the time selected by the Planning Committee.

Submitted abstracts should include only nonproprietary (generic) names or terms. If the poster or presentation is accepted, the author must present on the operational functionality when discussing medical devices and/or use only generic names when discussing medical devices or drug therapies.

The abstract complies with the principles set forth in DHHS Code of Federal Regulations #45 CFR 46 on Protection of Human Subjects.

The abstract complies with the guidelines of the American Association for the Advancement for Science in requiring assurances of the responsible use of animals in research (American Association for the Advancement of Science. Resolutions on Use of Animals in Research, Testing, and Education.Adopted by the AAAS Board and Council, February 19, 1990).

The abstract complies with the guidelines of the International Committee of Medical Journal Editors regarding publication ethics (International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Ann Intern Med. 1997; 126:36-47). In particular, I affirm that "all persons designated as authors qualify for authorship, and all those who qualify are listed. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content. Authorship credit is based only on 1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Conditions 1, 2, and 3 are met for all authors".

I am willing to disclose whether or not I have a financial relationship with commercial products or services relevant to the content of education I am presenting. Any such conflict of interest must be addressed and resolved prior to presenting at the Second World Congress on Ultrasound in Medical Education.

If compliance with the above guidelines has not been met, I will make recommended changes made by the Second World Congress on Ultrasound in Medical Education Peer Review Committee.

I am aware that violation of these submission guidelines may result in being prohibited from presenting at this conference and the next World Congress on Ultrasound in Medical Education.

Bottom of FormDisclosures

In order to accredit the Second World Congress on Ultrasound in Medical Education for CME, we must ensure balance, independence, objectivity, and scientific integrity in all of the educational activities. We must show that everyone in a position to control the educational content has disclosed all relevant financial relationships with any commercial interest and that any conflicts of interest are resolved.

The author/presenter must agree to:

Comply with all standards, guidelines, policies and procedures governing CME

Address the educational objectives specified for your session

Deliver balanced and objective evidence-based content

Present the source and/or level of evidence to participant by citing references within your presentation

Discuss all reasonable clinical alternatives when making practice recommendations

Disclose off-label / investigative uses of commercial products / devices.

When an individual has both a financial relationship with a commercial interest and the opportunity to affect the content of CME regarding products or services of that commercial interest, there is a conflict of interest that must be addressed and resolved. Relevant financial relationships are defined as a financial or resource support connections to an outside commercial interest that could possibly influence you or your spouse/partner. You are required to disclose whether or not you or your spouse/partner have had a relevant financial relationship in the past 12 months with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients with the exception of any non-profit or government organizations or non-health care related companies.

I do nothave any relevant financial relationships.I do have relevant financial relationships.

Name of companyRelationship

In light of any relationships/affiliations, you must attestto the following: (1) These relationships/ affiliations will not bias or otherwise influence your involvement in the activity; (2) Practice recommendations you make relevant to the companies with whom you have relationships will be supported by the best available evidence or, absent evidence, will be consistent with scientific standards and generally accepted medical practice. (3) You understand that if you (or your spouse/partner) have a relevant financial relationship, and therefore, a conflict of interest, USC SOM-PH CME will initiate a process to address and resolve the conflict of interest.

I attest to the above statement. PRINT NAME: ______

Abstract/Poster Submission Details

The abstract will be judged on and should contain: (1)content that is relevant to a physician’s (or other medical professional’s) scope of practice; (2) a purpose for the study or program that will change the knowledge, competence, or performance of medical professionals; (3) data and supporting statistics effectively to address a healthcare or educational need that underlies a gap in knowledge, competence or performance as it relates to ultrasound; and (4) a methodology that is appropriate for the objectives and desired results of the study or program. Abstracts describing innovative ultrasound educational programs or teaching tools should be given in sufficient detail to allow adequate review for acceptance.Statements such as "data will be presented" or "results will be shown" should not be included in submitted abstracts. The word count of the abstract should not exceed 450 words (including references). The maximum oral presentation time will be 15 minutes with 12 minutes allocated to actual presentation of abstract and 3 minutes for questions and answers. Author may choose to adjust the time distribution as per need.

Submission type: Abstract only ______Poster only ______Abstract or Poster ______

Title:

Detail:

References:

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