AIAMC National Initiative VIII  Survey

1.Overall, this program was:

Poor

Below Average

Average

Above Average

Excellent

Have the following objectives been met?

2.Articulate the moral determinants of health

No

Partially

Yes

No

Partially

Yes

3.Identify appropriate sources of measurable data

No

Partially

Yes

No

Partially

Yes

4.Apply learnings to complete their team’s Project Management Plan

No

Partially

Yes

No

Partially

Yes

5.If any of the above objectives were not met, please explain.

KEYNOTE SPEAKER
Please rate Keynote speaker on the following:

6.Cited up to date research

7.Inspired me to learn more

8.Engaging: should be invited back

9.Comment on Keynote Speaker

10. Were you informed whether speakers had any potential conflict of interest (either verbally, in the syllabus, and/or via slide?

No

Yes

No

Yes

11.The teaching and learning methods were effective for the subject matter and incorporated active learning.

12.The information presented was pertinent to my professional needs/scope of practice.

13.My administrative approach and/or practice outcomes will be improved.

14.What is your level of commitment to making the changes stated above?

Do not expect to change practice

Not very committed

Somewhat committed

Very committed

Do not expect to change practice

Not very committed

Somewhat committed

Very committed

15.Do you anticipate barriers in implementing the information gained from this activity?

No

Yes

No

Yes

Please rate the projected impact of this CME activity on your competence, performance and/or patient outcomes.

16.This activity will increase my competence

No

Somewhat

Yes

No

Somewhat

Yes

17.This activity will improve my performance

No

Somewhat

Yes

No

Somewhat

Yes

18.This activity will improve my patient outcomes

No

Somewhat

Yes

No

Somewhat

Yes

19.Was a commercial product, device, or service promoted during this activity?

No

Yes

No

Yes

20.Suggestions for improving this conference so that it will be more effective.

21.Have you participated/attended prior NATIONAL INITIATIVE MEETINGS?

0 prior attendance (1st National Initiative meeting)

1 prior

2 prior

3 or more prior

22.Have you participated/attended OTHER prior AIAMC activities (annual meetings, webinars, etc..)?

0 prior attendance (1st Program)

1 prior

2 prior

3 or more prior

23.NI VIII Meeting One was a valuable use of my time.

24.As a result of this activity, rate your ability to address specific accrediting requirements (e.g., ACGME, ACCME, JC)?

None

Low

Moderate

High

None

Low

Moderate

High

25.Describe a topic/area/idea that emerged during this activity that you plan to address in your organization(s)

26.I plan to collaborate with other entities within our system on this topic/area/idea.

No, Not at this point

Yes, Under Discussion

Yes, In the works

Yes, Definitely

No, Not at this point

Yes, Under Discussion

Yes, In the works

Yes, Definitely

27.Do you plan to share the meeting materials with a colleague from another program/office in your organization or outside your organization? (Check all that apply)

Yes, from within my organization

Yes, from outside my organization

No

If no, why not?

28.Demographics: I am a

Resident/Fellow

Faculty

Medical Education Leader (VP, DIO, Director, Manager, Coordinator, etc.)

Interprofessional NI-VIII Team Member (e.g., Diversity Officer, Community Health, QI, Data Analyst)

Other (please enter title)