Increasing the Black Physician Workforce Evaluation

We are grateful for your participation and hope that you found the professional development series valuable and informative. Your feedback is essential, please take a few minutes of your time to complete the following evaluation.

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* 1. VALUE OF SESSION

	Extremely Valuable	Valuable	Satisfactory	Fair	Poor
Increasing the Black Physician Workforce	Increasing the Black Physician Workforce Extremely Valuable	Increasing the Black Physician Workforce Valuable	Increasing the Black Physician Workforce Satisfactory	Increasing the Black Physician Workforce Fair	Increasing the Black Physician Workforce Poor

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* 2. QUALITY OF EACH SPEAKER

	Excellent	Very Good	Satisfactory	Fair	Poor
Cedric M. Bright, MD (Moderator)	Cedric M. Bright, MD (Moderator) Excellent	Cedric M. Bright, MD (Moderator) Very Good	Cedric M. Bright, MD (Moderator) Satisfactory	Cedric M. Bright, MD (Moderator) Fair	Cedric M. Bright, MD (Moderator) Poor
Leonard “Len” Marquez	Leonard “Len” Marquez Excellent	Leonard “Len” Marquez Very Good	Leonard “Len” Marquez Satisfactory	Leonard “Len” Marquez Fair	Leonard “Len” Marquez Poor
Marc A. Nivet, EdD, MBA	Marc A. Nivet, EdD, MBA Excellent	Marc A. Nivet, EdD, MBA Very Good	Marc A. Nivet, EdD, MBA Satisfactory	Marc A. Nivet, EdD, MBA Fair	Marc A. Nivet, EdD, MBA Poor
Sheila Pradia-Williams	Sheila Pradia-Williams Excellent	Sheila Pradia-Williams Very Good	Sheila Pradia-Williams Satisfactory	Sheila Pradia-Williams Fair	Sheila Pradia-Williams Poor

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* 3. PRACTICE ENHANCEMENT

	5 - Strongly Agree	4 - Agree	3 - Not Certain	2 - Disagree	1 - Strongly Disagree
This activity will help me improve my professional effectiveness.	This activity will help me improve my professional effectiveness. 5 - Strongly Agree	This activity will help me improve my professional effectiveness. 4 - Agree	This activity will help me improve my professional effectiveness. 3 - Not Certain	This activity will help me improve my professional effectiveness. 2 - Disagree	This activity will help me improve my professional effectiveness. 1 - Strongly Disagree
I will apply the knowledge/skills I learned.	I will apply the knowledge/skills I learned. 5 - Strongly Agree	I will apply the knowledge/skills I learned. 4 - Agree	I will apply the knowledge/skills I learned. 3 - Not Certain	I will apply the knowledge/skills I learned. 2 - Disagree	I will apply the knowledge/skills I learned. 1 - Strongly Disagree

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* 4. INTENDED CHANGES TO PRACTICE

	100%	75%	50%	25%	0%
What degree of confidence do you have that you will employ these strategies in your practice?	What degree of confidence do you have that you will employ these strategies in your practice? 100%	What degree of confidence do you have that you will employ these strategies in your practice? 75%	What degree of confidence do you have that you will employ these strategies in your practice? 50%	What degree of confidence do you have that you will employ these strategies in your practice? 25%	What degree of confidence do you have that you will employ these strategies in your practice? 0%

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* 5. Based upon the information you received from this activity, please list at least two PRACTICE STRATEGIES that you will enhance or implement.

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* 6. Please identify what barriers may exist which you feel would prevent employment of these strategies.

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* 7. QUALITY OF THE ACTIVITY

	5 - Strongly Agree	4 - Agree	3 - Not Certain	2 - Disagree	1 - Strongly Disagree
This activity fulfilled my educational needs.	This activity fulfilled my educational needs. 5 - Strongly Agree	This activity fulfilled my educational needs. 4 - Agree	This activity fulfilled my educational needs. 3 - Not Certain	This activity fulfilled my educational needs. 2 - Disagree	This activity fulfilled my educational needs. 1 - Strongly Disagree
The activity content was effective in helping me achieve my learning objectives.	The activity content was effective in helping me achieve my learning objectives. 5 - Strongly Agree	The activity content was effective in helping me achieve my learning objectives. 4 - Agree	The activity content was effective in helping me achieve my learning objectives. 3 - Not Certain	The activity content was effective in helping me achieve my learning objectives. 2 - Disagree	The activity content was effective in helping me achieve my learning objectives. 1 - Strongly Disagree
The format of the activity was effective in helping me achieve my learning objectives.	The format of the activity was effective in helping me achieve my learning objectives. 5 - Strongly Agree	The format of the activity was effective in helping me achieve my learning objectives. 4 - Agree	The format of the activity was effective in helping me achieve my learning objectives. 3 - Not Certain	The format of the activity was effective in helping me achieve my learning objectives. 2 - Disagree	The format of the activity was effective in helping me achieve my learning objectives. 1 - Strongly Disagree

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* 8. Additional Comments