If you would like to request RAE Program participation for residents in your department, please use the form below.If you are referring an individual resident for instructional development and support, please use the Referral Form. Please provide your first and last names. * Please select your department. * - Select -PediatricsOB-GynFCMSurgeryPYSCHNeurologyCCU-ED-SelectiveImagingEmergency MedicineAnesthesiologyOpthalmology & Vision ScienceOrthopaedic SurgeryRadiation Oncology Please indicate your position. * - Select -Residency Program DirectorAssociate Residency Program DirectorClerkship co-Director (Tucson)Clerkship co-Director (Phoenix) Contact email * I am requesting participation... * for myself, one-on-one feedback on teaching or assessment first year residents (interns) junior residents senior and/or chief residents Please select the aspects of the Instructional Development Needs Assessment in which you would like to participate: * Shadowing: Observation of residents as they teach on serviceAnalysis of de-identified clerkship evaluation dataAnalysis of de-identified instructor evaluation dataInput from residentsInput from directorsInput from medical studentsAll of the above NOTE: To select multiple options, please hold down the CTRL key and click on multiple choices. For mac users, hold down the command key while making selections. Please provide a brief description of teaching skills you/residents identified above would like to develop or improve. * Please provide a brief description of the strengths for teaching you have observed in your department's residents. * Please indicate a time period (a month or weeks) when you would like this training to occur. * Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.