Post Training Evaluation

Please take a few moments to evaluation this training.  Your input will help inform future sessions. 
IMPORTANT!!
Once you complete the post-training evaluation and click FINISHED and you will be redirected to a webpage to print or save your continuing education certificate.
If you have difficulties completing this survey, contact Amy Wales at amy.wales@miccsi.org.

Demographics

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* 1. Personal Information

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* 2. Please choose your organization from the choices below:

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* 3. Please choose your role:

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* 4. After attending this session, please indicate your confidence in having a serious illness conversation.

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* 5. On a scale of 1-5, how would you rate this training overall? (Scale: 1=very dissatifed & 5=very satisfied)

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* 6. What did you like most about this activity?

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* 7. What did you like least about this activity?

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* 8. Do you have specific suggestions as to how this learning activity might be improved?

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* 9. Did you feel the content was:

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* 10. Did the presentations and materials meet the following objective:

The participant will be able to state two differences between a serious illness conversation and an advance directive?

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* 11. Please provide your impressions about the presentations by rating each category on a scale of 1-5 where:
  1. VERY POOR
  2. POOR
  3. AVERAGE
  4. GOOD
  5. EXCELLENT
  6. N/A

  KNOWLEDGE OF PRESENTER OVERALL RATING OF TOPIC/PRESENTATION THIS TOPIC WAS RELEVANT TO MY ROLE
PRESENTER 1: Mary Beth Billie, NSP, RN-BC, CCM
PRESENTER 2: Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP

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* 12. After attending this session, do you intend to change your practice behavior?

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* 13. After attending this session, I have the ability to apply the skills learned in my role.

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* 14. What new abilities/strategies have you gained from this training?

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* 15. Was the information/material presented in this learning activity free from commercial bias?

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* 16. If you answered no to the above question, please explain.

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* 17. Additional Comments:

T