For purposes of certification, please complete the following information. Please note that we will not forward or sell your contact information. 

Question Title

* 1. Participant Information

Question Title

* 2. What is your degree?

Question Title

* 3. What is your specialty?

Question Title

* 4. How committed are you to making changes in your practice based on your participation in this activity?

Question Title

* 5. Which new strategies/skills/information will you apply to your area of practice? Please select all that apply. 

Question Title

* 6. What barriers do you see to making changes in your practice?

Please rate your level of agreement with each of the following by checking the appropriate rating.
4 = Strongly agree, 3 = Agree, 2 = Disagree, 1 = Strongly disagree

Question Title

* 7. Upon completion of this activity, participants will be able to:

  Strongly agree Agree Disagree Strongly disagree
Outline best-practice indirect calorimetry to measure resting energy expenditure
Choose new digital tools and technologies to support patients’ nutrition needs
Recognize the complexities involved in ensuring amino acid needs are met with parenteral nutrition

Question Title

* 8. Please indicate the extent of your agreement with the following statement:

4 = Strongly agree, 3 = Agree, 2 = Disagree, 1 = Strongly disagree

  Strongly agree Agree Disagree Strongly disagree
The faculty for this activity were effective

Question Title

* 9. Please indicate the extent of your agreement with the following statement:

4 = Strongly agree, 3 = Agree, 2 = Disagree, 1 = Strongly disagree, 0 = Not applicable

  Strongly agree Agree Disagree Strongly disagree Not Applicable
The educational resources and/or handouts provided to me at the educational activity are useful to my practice.

Question Title

* 10. The content presented:

4 = Strongly agree, 3 = Agree, 2 = Disagree, 1 = Strongly disagree

  Strongly agree Agree Disagree Strongly disagree
Enhanced my current knowledge base
Addressed my most pressing questions
Promoted improvements or quality in health care
Was scientifically rigorous and evidence based

Question Title

* 11. Do you have access to IC in your practice setting?

Question Title

* 12. Overall, was this fair, balanced, and free from commercial bias?

Question Title

* 13. If you answered no, please explain:

Question Title

* 14. Of the patients you will see in the next week, about how many will benefit from the information you learned today?

Question Title

* 15. Based on what I learned today, I will improve my practice by incorporating the following (check all that apply):

Question Title

* 16. Please list any clinical issues/problems within your scope of practice you would like to see addressed in future educational activities related to optimizing nutrition support:

Question Title

* 17. Other comments:

Question Title

* 18. Credit Request Type

T