2017 Annual Meeting- QME Course 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. How Workers' Compensation MPN Physicians are Rated/Selected Poor Fair Satisfactory Good Excellent Kent Spafford, Harbor Health Kent Spafford, Harbor Health Poor Kent Spafford, Harbor Health Fair Kent Spafford, Harbor Health Satisfactory Kent Spafford, Harbor Health Good Kent Spafford, Harbor Health Excellent Lisa Forsythe, Coventry Health Lisa Forsythe, Coventry Health Poor Lisa Forsythe, Coventry Health Fair Lisa Forsythe, Coventry Health Satisfactory Lisa Forsythe, Coventry Health Good Lisa Forsythe, Coventry Health Excellent Question Title * 3. Priorities of DWC in 2017 Poor Fair Satisfactory Good Excellent Ray Meister, M.D. MPH Ray Meister, M.D. MPH Poor Ray Meister, M.D. MPH Fair Ray Meister, M.D. MPH Satisfactory Ray Meister, M.D. MPH Good Ray Meister, M.D. MPH Excellent George Parisotto George Parisotto Poor George Parisotto Fair George Parisotto Satisfactory George Parisotto Good George Parisotto Excellent Question Title * 4. Using IT in Your Office to Improve Efficiency Poor Fair Satisfactory Good Excellent Leslie Kim, M.D. Leslie Kim, M.D. Poor Leslie Kim, M.D. Fair Leslie Kim, M.D. Satisfactory Leslie Kim, M.D. Good Leslie Kim, M.D. Excellent Question Title * 5. How to Stay Out of Trouble and Keep Your QME Certification! Poor Fair Satisfactory Good Excellent Judge Colleen Casey Judge Colleen Casey Poor Judge Colleen Casey Fair Judge Colleen Casey Satisfactory Judge Colleen Casey Good Judge Colleen Casey Excellent Traci W. Hinden, Esq. Traci W. Hinden, Esq. Poor Traci W. Hinden, Esq. Fair Traci W. Hinden, Esq. Satisfactory Traci W. Hinden, Esq. Good Traci W. Hinden, Esq. Excellent Judge Myrle Petty (WCALJ) Judge Myrle Petty (WCALJ) Poor Judge Myrle Petty (WCALJ) Fair Judge Myrle Petty (WCALJ) Satisfactory Judge Myrle Petty (WCALJ) Good Judge Myrle Petty (WCALJ) Excellent Question Title * 6. Evidence Based Digital Rehabilitation and Recovery Solutions for Your Patients Poor Fair Satisfactory Good Excellent Michael Oberlander, M.D. Trainer Rx Michael Oberlander, M.D. Trainer Rx Poor Michael Oberlander, M.D. Trainer Rx Fair Michael Oberlander, M.D. Trainer Rx Satisfactory Michael Oberlander, M.D. Trainer Rx Good Michael Oberlander, M.D. Trainer Rx Excellent Question Title * 7. Apportioning to Comorbidities – Spine, Upper & Lower Extremities Poor Fair Satisfactory Good Excellent Mark Melhorn, M.D Mark Melhorn, M.D Poor Mark Melhorn, M.D Fair Mark Melhorn, M.D Satisfactory Mark Melhorn, M.D Good Mark Melhorn, M.D Excellent Question Title * 8. Improving Outcomes - Earlier Return to Work or How & Why Return to Work Affects My Practice Poor Fair Satisfactory Good Excellent Mark Melhorn, M.D Mark Melhorn, M.D Poor Mark Melhorn, M.D Fair Mark Melhorn, M.D Satisfactory Mark Melhorn, M.D Good Mark Melhorn, M.D Excellent Question Title * 9. Apportionment/Causation - Evaluating Tough Cases - Learn from the Judge and Expert AMEs/QMEs Poor Fair Satisfactory Good Excellent Peter Mandell, M.D. Peter Mandell, M.D. Poor Peter Mandell, M.D. Fair Peter Mandell, M.D. Satisfactory Peter Mandell, M.D. Good Peter Mandell, M.D. Excellent Judge Colleen Casey Judge Colleen Casey Poor Judge Colleen Casey Fair Judge Colleen Casey Satisfactory Judge Colleen Casey Good Judge Colleen Casey Excellent Steven Isono, M.D. Steven Isono, M.D. Poor Steven Isono, M.D. Fair Steven Isono, M.D. Satisfactory Steven Isono, M.D. Good Steven Isono, M.D. Excellent Richard Braun, M.D. Richard Braun, M.D. Poor Richard Braun, M.D. Fair Richard Braun, M.D. Satisfactory Richard Braun, M.D. Good Richard Braun, M.D. Excellent Robert Bruckman, M.D. Robert Bruckman, M.D. Poor Robert Bruckman, M.D. Fair Robert Bruckman, M.D. Satisfactory Robert Bruckman, M.D. Good Robert Bruckman, M.D. Excellent Question Title * 10. m Current Changes in Workers’ Compensation Affecting Your Practice Poor Fair Satisfactory Good Excellent Lesley Anderson, M.D. Lesley Anderson, M.D. Poor Lesley Anderson, M.D. Fair Lesley Anderson, M.D. Satisfactory Lesley Anderson, M.D. Good Lesley Anderson, M.D. Excellent Steven Feinberg, M.D., MPH Steven Feinberg, M.D., MPH Poor Steven Feinberg, M.D., MPH Fair Steven Feinberg, M.D., MPH Satisfactory Steven Feinberg, M.D., MPH Good Steven Feinberg, M.D., MPH Excellent Suzanne Honor-Vangerov, CPC Suzanne Honor-Vangerov, CPC Poor Suzanne Honor-Vangerov, CPC Fair Suzanne Honor-Vangerov, CPC Satisfactory Suzanne Honor-Vangerov, CPC Good Suzanne Honor-Vangerov, CPC Excellent Educational Merit Question Title * 11. Please rate the extent of your knowledge of the subject matter covered before and after this meeting; No knowledge Fair Satisfactory Good Expert Before the meeting Before the meeting No knowledge Before the meeting Fair Before the meeting Satisfactory Before the meeting Good Before the meeting Expert After the meeting After the meeting No knowledge After the meeting Fair After the meeting Satisfactory After the meeting Good After the meeting Expert To what extent do you think you will be able to apply the information from this meeting in your practice? To what extent do you think you will be able to apply the information from this meeting in your practice? No knowledge To what extent do you think you will be able to apply the information from this meeting in your practice? Fair To what extent do you think you will be able to apply the information from this meeting in your practice? Satisfactory To what extent do you think you will be able to apply the information from this meeting in your practice? Good To what extent do you think you will be able to apply the information from this meeting in your practice? Expert Question Title * 12. Cultural Competency: Strongly Disagree Disagree Neutral Agree Strongly Agree Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Strongly Disagree Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Disagree Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Neutral Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Agree Issues in cultural and linguistic competency (e.g. differences in prevalence, diagnosis, treatment in diverse population; linguistic skills; pertinent cultural data) were adequately addressed in this activity: Strongly Agree Question Title * 13. Resources on cultural and linguistic competency have been included in the meeting presentations and materials. How can we further meet your educational needs in this area? Question Title * 14. What barriers do you see to implementing changes that you learned about during the presentations today: Done