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    2020 Ihf Instructor Monitor Form 2020

    Uploaded by

    Bakr Alwaqfi

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    2020 Ihf Instructor Monitor Form 2020

    Uploaded by

    Bakr Alwaqfi
    5 views2 pages

    Original Title

    2020-ihf-instructor-monitor-form-2020

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    Copyright:

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    5 views2 pages

    2020 Ihf Instructor Monitor Form 2020

    Uploaded by

    Bakr Alwaqfi

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Irish Heart Foundation / American Heart Association Emergency Cardiovascular Care Program

    Instructor Monitor Form 2020


    By listing your name and email address below, instructors agree to the Irish Heart Foundation processing your IHF/ AHA instructor certification details on the
    secure IHF & Laerdal Learning Platform (https://ihf.eu.learning.laerdal.com/) and our secure database for up to 5 years after the date of your instructor
    certification. The information will be used to certify instructors and issue electronic IHF/AHA ACLS, BLS or Heartsaver instructor certificates via email.
    Anonymous statistical data in relation to this programme may be shared with our programme partners, American Heart Association and Laerdal Medical, for
    reporting and analysis purposes. If you have any requests concerning your personal information or any queries with regard to our processing, please contact
    [email protected] or visit https://irishheart.ie/privacy-policy/. IHF may also need to contact you by phone in relation to your CPR training during your
    certification as an IHF instructor – please provide details of a preferred phone number which will be processed on our secure database and will not be shared by
    us with any 3rd parties.

    I confirm that I have read the above statement and consent to my instructor certification information being processed on the LP and IHF database

    Instructor Name: ______________________________________________________________

    Instructor Email Address: ______________________________________________________________

    Instructor Phone Number: ______________________________________________________________

    Instructor IHF Number: _____________________

    Requested Discipline(s): Heartsaver AED BLS ACLS


    Heartsaver AED & CFR C BLS & CFR C ACLS EP

    Primary IHF-Affiliated Training Site: ________________________________________________________

    Reason for monitoring: Initial Monitoring


    Initial Course TC & Date: __________________________

    Recertification
    Instructor card Expiration Date: __________________________

    Remediation after unsuccessful monitoring


    Previous Monitor Date __________________________
    Previously Monitored By ___________________________________________

    Name of Reviewer: _____________________________________ Reviewer IHF Number: ____________

    Reviewer’s Status: BLS Faculty ACLS Medical Director ACLS Faculty

    Name of Course Taught (E.G. BLS Provider Course): ________________________________________________

    Instructions: Check appropriate box (E = Excellent, S = Satisfactory, NI = Needs Improvement, NA= Not Applicable) for all criteria that apply to the monitoring
    process. Instructor teaching and student evaluation skills need to be monitored. Please complete all areas. *Comment on all areas indicated as "Needs
    Improvement."
    E S NI* NA Comments

    Teaching Effectiveness

    Organizes physical set-up to facilitate


    learning by students

    Updated November 2020


    Introduces objectives/outline

    Covers core content following outline


    consistent with AHA guidelines
    Summarizes key information

    Demonstrates mastery of course content/ ability


    to respond to student questions
    Demonstrates willingness and ability to
    demonstrate skills (when applicable)
    Allows adequate time for skills practice

    Uses interactive teaching


    style/encourages student participation
    Manages time effectively (begins/ends on time,
    avoids digression from key points)
    Provides effective and ongoing feedback to
    students
    Demonstrates professionalism
    (appropriate attire, use of terminology, etc)
    Evaluation Effectiveness

    Uses performance checklists (as available)

    Evaluates fairly, using current AHA


    guidelines and materials
    Provides or recommends appropriate
    remediation
    Materials/Equipment

    Uses equipment that is clean and in good working


    order
    Uses appropriate standard (universal)
    precautions whenever applicable
    Uses current AHA materials (video, tool kit, etc) to
    deliver content
    All students are using appropriate AHA
    textbook
    Refers to AHA textbook during
    teaching and/or evaluation feedback
    Demonstrates ability to use and
    troubleshoot audiovisual equipment
    Signatures/Recommendations
    Reviewer’s Recommendations/Comments: Do you recommend new/renewal of Instructor status for this Instructor
    Candidate/Instructor? If no, please summarize your rationale and provide recommendations for remediation (please
    attach additional comments as needed) Yes No

    _______________________________________________________________________________________________

    Instructor’s Comments: ___________________________________________________________________________

    Signature of reviewer ____________________________________________________ Date _________________

    Signature of instructor ____________________________________________________ Date _________________

    Updated November 2020

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