The NEAR Conference Speaker and Session Leader Form 2024
Are you an expert in a particular area of anesthesiology, healthcare leadership, advocacy, innovation, or subject matter that you wish others knew more about? If so, the NEAR Conference 2024 wants to give you a platform to share! This is your chance to contribute to trainee education, advance the field of anesthesiology, and share your knowledge in an expert panel, round table breakout session, or skills workshop.

Whatever your area of expertise, the NEAR Conference 2024 wants to hear from you! 

Each session will last for approximately 30-45 minutes. Below are the types of sessions we will be hosting: 

Expert Panel: Formal presentations by two to three experts through a topic, followed by a question-and-answer session.

Round Table Breakout Session: Use your expert knowledge to lead and navigate an interactive and dynamic style round table discussion with conference attendees. 

Skills Workshop: Teach participants hands-on, technical, or non-technical skills such as POCUS, contract negotiation, etc. 

If you wish to be a speaker or session leader at the NEAR Conference 2024, please apply by completing the form below. 

Submissions deadline: May 1st, 2024.

For any issues or questions, please email us at: nearanesthesiaconference@gmail.com
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Email *
Full Name (First, Middle initial, Last) *
Degree / Credentials 
Ex: MD, DO, PGY - , MBA, PhD, FASA, etc.  
Title *
Ex: Medical student, chief resident, department chair, etc. 
Cell Phone Number *
Please enter as: (XXX) XXX-XXXX
Please select the institution with which you are affiliated. 
 *
If you selected "other", please specify your institution
Session type *
Which session format do you think best matches your content and the way you'd like to deliver it?
If choosing "expert panel", please list the names, titles, and email addresses of everyone (excluding yourself) who will be present on your panel. 
Only one presenter from the panel has to submit this form. 
You may have up to 3 total panel speakers (including yourself) 
What is the title of your session?  *
Ex: Avenues for Advocacy in Anesthesia During Residency
Ex: Techniques for Securing Difficult Airways 
What are 3 learning objectives of your session?  *
Please use a numbered list with short answers.
Ex: 
1. Recognizing factors resulting in difficult airways.
2. Developing strategies to secure difficult airways. 
3. Assessing criteria for safe extubation. 
Description  *
Please provide a brief description of your topic (1500 characters or less) 
Sources *
Please list all sources. These can be: 
  • Expert Opinion
  • Federal, state or institutional mandates
  • Society guidelines or recommendations
  • Journal articles
  • National databases or registries
  • Organizational policies or clinical guidelines
  • Peer reporting or review
  • Public Health initiatives
  • Research-based literature or reports
  • Surveys
  • Others
Goals *
What are your overarching goals / what do you hope to accomplish with your session? 
Ex: Engage more residents in policy. 
Ex: Involve medical students in leadership. 
Ex: Utilize environmentally conscious anesthesia practice techniques. Etc. 
Keywords
Please select at least one keyword from below 
Keywords 1. 
Keywords 2. 
Keywords 3. 
Please list your keywords here if they do not match any options above 
Is there anything else you'd like us to know or consider when making our selection? 
Submit
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