2023 QME Course (Thursday) Thursday, May 18 Program Evaluation and Record of Attendance To receive verification of your attendance and CME hours, COMPLETE this evaluation form. Question Title * 1. Address Name Email Address Question Title * 2. Accuracy Can Be Crucial In Evaluation Reports andForms Poor Fair Satisfactory Good Excellent Ramon Jimenez, M.D. Ramon Jimenez, M.D. Poor Ramon Jimenez, M.D. Fair Ramon Jimenez, M.D. Satisfactory Ramon Jimenez, M.D. Good Ramon Jimenez, M.D. Excellent Question Title * 3. Utilization of Grip Testing for Impairment Poor Fair Satisfactory Good Excellent Michael Klassen, M.D. Michael Klassen, M.D. Poor Michael Klassen, M.D. Fair Michael Klassen, M.D. Satisfactory Michael Klassen, M.D. Good Michael Klassen, M.D. Excellent Question Title * 4. Managing the "Autopilot Mind" for Optimal Health Poor Fair Satisfactory Good Excellent David Ring, M.D. David Ring, M.D. Poor David Ring, M.D. Fair David Ring, M.D. Satisfactory David Ring, M.D. Good David Ring, M.D. Excellent Question Title * 5. DWC Initiatives Affecting QMEs & AMEs Poor Fair Satisfactory Good Excellent Raymond Meister, M.D. Raymond Meister, M.D. Poor Raymond Meister, M.D. Fair Raymond Meister, M.D. Satisfactory Raymond Meister, M.D. Good Raymond Meister, M.D. Excellent Ted Richards, JD Ted Richards, JD Poor Ted Richards, JD Fair Ted Richards, JD Satisfactory Ted Richards, JD Good Ted Richards, JD Excellent Nicole Richardson, JD Nicole Richardson, JD Poor Nicole Richardson, JD Fair Nicole Richardson, JD Satisfactory Nicole Richardson, JD Good Nicole Richardson, JD Excellent Question Title * 6. Applying the Kite Decision - Here's How to Do It! Poor Fair Satisfactory Good Excellent Dirk Stemerman, JD Dirk Stemerman, JD Poor Dirk Stemerman, JD Fair Dirk Stemerman, JD Satisfactory Dirk Stemerman, JD Good Dirk Stemerman, JD Excellent Martin Guzman, JD Martin Guzman, JD Poor Martin Guzman, JD Fair Martin Guzman, JD Satisfactory Martin Guzman, JD Good Martin Guzman, JD Excellent Question Title * 7. Simplexam - Being More Efficient in Generating Your Reports Poor Fair Satisfactory Good Excellent Brock Curry. Simplexam Brock Curry. Simplexam Poor Brock Curry. Simplexam Fair Brock Curry. Simplexam Satisfactory Brock Curry. Simplexam Good Brock Curry. Simplexam Excellent Question Title * 8. Apportionment Pearls to Improve your Opinions and the Ratability of your Reports Poor Fair Satisfactory Good Excellent Raymond Correio, formerDWC Judge Raymond Correio, formerDWC Judge Poor Raymond Correio, formerDWC Judge Fair Raymond Correio, formerDWC Judge Satisfactory Raymond Correio, formerDWC Judge Good Raymond Correio, formerDWC Judge Excellent Question Title * 9. Objectifying Pain in Disability Evaluations Poor Fair Satisfactory Good Excellent David Ring, M.D. David Ring, M.D. Poor David Ring, M.D. Fair David Ring, M.D. Satisfactory David Ring, M.D. Good David Ring, M.D. Excellent Question Title * 10. How to do Effective Telehealth in MusculoskeletalEvaluations Poor Fair Satisfactory Good Excellent David Eisenhauer, DO David Eisenhauer, DO Poor David Eisenhauer, DO Fair David Eisenhauer, DO Satisfactory David Eisenhauer, DO Good David Eisenhauer, DO Excellent Educational Merit Question Title * 11. To what extent will you be able to apply the information from this meeting in your practice? I will be able to all of the new information in my practice. I will be able to use about 25% of the new information in my practice. I will be able to use about 50% of the new information in my practice. I will be able to use more than 50% of the new information in my practice. I will not be able to use the new information in my practice - not relevant to my sub-specialty practice. Question Title * 12. What will you do to implement the changes in your practices? Question Title * 13. This session increased my confidence in the management of my patients/practice or in performing the procedure(s) discussed: Yes No Question Title * 14. What barriers do you see to implementing changes that you learned about during the presentations today: Done