Dear ASE Member, If you would like to be considered as a reviewer for Global Surgical Education – Journal of the Association for Surgical Education, please complete the following form. We thank you in advance for your consideration. Journal Reviewer Form Name(Required) First Last Email(Required) Current Role(Required) Attending Physician (MD, DO) Scientist (PhD) Physician in Training (Residents, Fellows) Medical student Nurse Coordinator Advanced Practice Provider (Nurse Practitioner, Physician Assistant) Not Listed If not listed, please describe your current role.Clinical Area of Expertise (check all that apply)(Required) Bariatric surgery Cardiac surgery Critical care Endocrine surgery General surgery Nursing Pediatric surgery Plastic surgery Robotic surgery Surgical Oncology Thoracic surgery Transplant surgery Trauma/ acute care surgery Vascular surgery Not Listed If not listed, please describe the clinical area of expertiseEducation area of expertise/ interest (check all that apply)(Required) Artificial intelligence Assessment Curriculum development DEI Education outcomes Education Research methods Education technology Faculty development Instructional design Nontechnical skills Program evaluation Skill acquisition /Performance improvement Social media Surgical simulation Team training Technical skills Wellness Not Listed If not listed, please describe the education area of expertise/ interest.What level of learner are you interested in? (check all that apply)(Required) UME GME CME Not Listed If not listed, please describe what level of learner you are interested in.What gender do you identify as? Man Woman Nonbinary/Gender Diverse Not Listed Prefer not to answer If not listed, please describe what gender you identify as?What race do you identify as (check all that apply)? White Black or African American American Indian/Alaska Native Asian Native Hawaiian and Other Pacific Islander Not Listed Prefer not to disclose If not listed, please describe what race you identify as?What ethnicity do you identify as? Hispanic Non-Hispanic Prefer not to disclose What practice setting do you work in? Community-based Community-based university affiliated University-based Military-based Not Listed Osteopathic Recognition Prefer not to disclose If not listed, please describe what practice setting you work in.How many papers have you reviewed for other journals? 0 1-5 6-20 21-50 >50 Would you be interested in participating in a reviewer workshop? Yes No Unsure
