*1.Are you a:(Required.)

Physician

Non-physician

Other Advanced Practice (PA, CRNA, NP, etc.)

2.Do you agree this activity met the objectives outlined?

All the objectives were met.

One or two of the objective were met.

None of the objectives were met.

3.The quality of the educational process (method of presentation and information provided) was satisfactory and appropriate:

Strongly agree

Agree

Disagree

Strongly Disagree

4.This educational acitivity has enhanced my professional effectiveness to treat patients:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

5.This educational activity will result in a change in my practice behavior:

Strongly Agree

Agree

Disagree

Strongly Disagree

Not Applicable

6.Please describe any changes you plan to make: 

7.This information was presented without promotional or commercial bias: 

Strongly Agree

Agree

Disagree

Strongly Disagree

8.Do you feel this educational activity could improve your (check all that apply):

Competence

Performance

Patient Outcomes

Please explain how this activity could impact your Competence/Performance/Patient Outcomes:

9.Which of the following competency areas do you feel have been improved by this activity, if any?

Patient Care

Medical Knowledge

Practice-Based Learning and Improvement

Interpersonal and Communication Skills

Professionalism

Systems-Based Practice (healthcare system as a whole and resources it provides for care)

10.Are there any educational topics needed you have identified that would assist the medical profession to provide better patient care?