1 2 3 4 Did this activity: * Not at AllInsufficientlyNeutralSufficientlyCompletely Meet the stated learning objectives? Meet the stated learning objectives? - Not at All Meet the stated learning objectives? - Insufficiently Meet the stated learning objectives? - Neutral Meet the stated learning objectives? - Sufficiently Meet the stated learning objectives? - Completely Address the competencies/attributes relevant to your specialty? Address the competencies/attributes relevant to your specialty? - Not at All Address the competencies/attributes relevant to your specialty? - Insufficiently Address the competencies/attributes relevant to your specialty? - Neutral Address the competencies/attributes relevant to your specialty? - Sufficiently Address the competencies/attributes relevant to your specialty? - Completely Equip you with new information to overcome barriers to treatment? Equip you with new information to overcome barriers to treatment? - Not at All Equip you with new information to overcome barriers to treatment? - Insufficiently Equip you with new information to overcome barriers to treatment? - Neutral Equip you with new information to overcome barriers to treatment? - Sufficiently Equip you with new information to overcome barriers to treatment? - Completely Present the material in a format appropriate to the topic? Present the material in a format appropriate to the topic? - Not at All Present the material in a format appropriate to the topic? - Insufficiently Present the material in a format appropriate to the topic? - Neutral Present the material in a format appropriate to the topic? - Sufficiently Present the material in a format appropriate to the topic? - Completely I expect that my participation in this activity will improve my: * Not at AllInsufficientlyNeutralSufficientlyCompletely Competence (skills/abilities/strategies gained from the new information) Competence (skills/abilities/strategies gained from the new information) - Not at All Competence (skills/abilities/strategies gained from the new information) - Insufficiently Competence (skills/abilities/strategies gained from the new information) - Neutral Competence (skills/abilities/strategies gained from the new information) - Sufficiently Competence (skills/abilities/strategies gained from the new information) - Completely Performance (implementing the new skills/abilities/strategies) Performance (implementing the new skills/abilities/strategies) - Not at All Performance (implementing the new skills/abilities/strategies) - Insufficiently Performance (implementing the new skills/abilities/strategies) - Neutral Performance (implementing the new skills/abilities/strategies) - Sufficiently Performance (implementing the new skills/abilities/strategies) - Completely Patient Outcomes (the potential effect from gained skills/abilities/strategies) Patient Outcomes (the potential effect from gained skills/abilities/strategies) - Not at All Patient Outcomes (the potential effect from gained skills/abilities/strategies) - Insufficiently Patient Outcomes (the potential effect from gained skills/abilities/strategies) - Neutral Patient Outcomes (the potential effect from gained skills/abilities/strategies) - Sufficiently Patient Outcomes (the potential effect from gained skills/abilities/strategies) - Completely Please rate the following: * Not at AllInsufficientlyNeutralSufficientlyCompletely I would recommend this activity to others. I would recommend this activity to others. - Not at All I would recommend this activity to others. - Insufficiently I would recommend this activity to others. - Neutral I would recommend this activity to others. - Sufficiently I would recommend this activity to others. - Completely The instructional effectiveness and expertise of the faculty were excellent. The instructional effectiveness and expertise of the faculty were excellent. - Not at All The instructional effectiveness and expertise of the faculty were excellent. - Insufficiently The instructional effectiveness and expertise of the faculty were excellent. - Neutral The instructional effectiveness and expertise of the faculty were excellent. - Sufficiently The instructional effectiveness and expertise of the faculty were excellent. - Completely The learning format was appropriate for this activity. The learning format was appropriate for this activity. - Not at All The learning format was appropriate for this activity. - Insufficiently The learning format was appropriate for this activity. - Neutral The learning format was appropriate for this activity. - Sufficiently The learning format was appropriate for this activity. - Completely Based upon your participation in this activity, do you intend to change your practice behavior? * Yes, I plan to implement changes in my practice based on the information presented. No, my current practice is consistent with the information presented. Please specify the type of change you plan to implement. (Select all that apply.) Patient Care (e.g., apply compassionate, appropriate, and effective treatment to patients) Medical Knowledge (e.g., apply the latest clinical knowledge to patient care) Practice-based learning and improvement (e.g., assimilate new scientific evidence into patient care) Interpersonal and communication skills (e.g., communicate effectively with patients, families, and colleagues) Professionalism (e.g., employ ethical principles and a commitment to professional responsibilities) Systems-based practice (e.g., call on system resources to provide care of optimal value) Work in interdisciplinary teams (e.g., collaborate in teams to ensure care is continuous and reliable) Employ evidence-based practice (e.g., integrate best research for optimum care) Apply quality improvement (e.g., – identify errors and hazards in care) Utilize informatics (e.g., employ information technology to support decision making) Other (Please specify.) Please specify the type of change you plan to implement. (Select all that apply.) Other (Please specify.) Are there any barriers or problems that might prevent you from implementing changes in your practice? (Select all that apply.) * No Barriers Lack of evidence-based guidelines Lack of practice/patient based guidelines Organizational/institutional barriers Limited time Insurance/financial Increased workload Lack of patient adherence/compliance Other (please indicate below) Are there any barriers or problems that might prevent you from implementing changes in your practice? (Select all that apply.) Other (please indicate below) Leave this field blank
