CAP Grand Rounds 2024-2025

Child Psychiatry Grand Rounds Evaluation

IMPORTANT: YOU MUST FILL OUT THE EVALUATION TO TRACK ATTENDANCE AND TO RECEIVE CME CREDIT. Evaluation of this program is required.

Talk Title: "Pain Science: A Biopsychosocial Model of Treatment & Practice.”

Speaker: Rachel Zoffness, PhD,

Assistant Clinical Professor, University of California San Francisco School of Medicine

Date: Nov 1, 2024

For Grand Rounds to be eligible for CME credit we need to evaluate how the presentations impact your medical practice.

Please refer to the following objectives while completing this evaluation

Participants will be able to:

1. Describe the biopsychosocial model of pain.

2. Examine how to explain pain to youth and caregivers using neuroscience and metaphor while minimizing stigma.

3. Use the youth-appropriate “pain recipe” concept to identify biological, psychological, and sociological ingredients contributing to pediatric chronic pain.

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* 1. Attendee name:

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* 2. Please provide email unless you are in Seattle Children's Psych Dept (optional)

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* 3. Do you want your email address:

Added to our Grand Rounds Distribution list (only check box if you don't receive our emails)

Added to our Online Evaluation Reminder Distribution list

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* 4. Professional Relevance – This information will affect my practice in the following ways:

How I medically treat my patients

How I relate to & communicate with my patients/families

How I educate my patients/families

Other (please specify)

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* 5. Please rate the presenter(s) and topic(s) using this scale

	1-Poor	2-Fair	3-Good	4-Excellent	5-Outstanding
Relevance	Relevance 1-Poor	Relevance 2-Fair	Relevance 3-Good	Relevance 4-Excellent	Relevance 5-Outstanding
Visuals	Visuals 1-Poor	Visuals 2-Fair	Visuals 3-Good	Visuals 4-Excellent	Visuals 5-Outstanding
Content Meets Objectives	Content Meets Objectives 1-Poor	Content Meets Objectives 2-Fair	Content Meets Objectives 3-Good	Content Meets Objectives 4-Excellent	Content Meets Objectives 5-Outstanding
Effectiveness of Speaker	Effectiveness of Speaker 1-Poor	Effectiveness of Speaker 2-Fair	Effectiveness of Speaker 3-Good	Effectiveness of Speaker 4-Excellent	Effectiveness of Speaker 5-Outstanding

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* 6. Please mark one response for each statement

	Strongly Disagree	Disagree	Agree	Strongly Agree
The description of the program fit the materials presented	The description of the program fit the materials presented Strongly Disagree	The description of the program fit the materials presented Disagree	The description of the program fit the materials presented Agree	The description of the program fit the materials presented Strongly Agree
Speaker’s disclosure was provided	Speaker’s disclosure was provided Strongly Disagree	Speaker’s disclosure was provided Disagree	Speaker’s disclosure was provided Agree	Speaker’s disclosure was provided Strongly Agree
The objectives meet my educational needs	The objectives meet my educational needs Strongly Disagree	The objectives meet my educational needs Disagree	The objectives meet my educational needs Agree	The objectives meet my educational needs Strongly Agree
There was enough opportunity for questions and discussion	There was enough opportunity for questions and discussion Strongly Disagree	There was enough opportunity for questions and discussion Disagree	There was enough opportunity for questions and discussion Agree	There was enough opportunity for questions and discussion Strongly Agree

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* 7. What elements of this course will you use to change your practice?

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* 8. How will you implement those changes?

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* 9. How will you monitor and evaluate your implementation?

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* 10. Do you foresee any barriers to implementing a change in practice?

	None/minimal	Sizeable	Insurmountable
Insurance Reimbursement	Insurance Reimbursement None/minimal	Insurance Reimbursement Sizeable	Insurance Reimbursement Insurmountable
Cost Effectiveness	Cost Effectiveness None/minimal	Cost Effectiveness Sizeable	Cost Effectiveness Insurmountable
Time Management	Time Management None/minimal	Time Management Sizeable	Time Management Insurmountable
Administrative Support	Administrative Support None/minimal	Administrative Support Sizeable	Administrative Support Insurmountable
Patient Compliance	Patient Compliance None/minimal	Patient Compliance Sizeable	Patient Compliance Insurmountable

Other (please specify)

Question Title

* 1. Attendee name:

Question Title

* 2. Please provide email unless you are in Seattle Children's Psych Dept (optional)

Question Title

* 3. Do you want your email address:

Question Title

* 4. Professional Relevance – This information will affect my practice in the following ways:

Question Title

* 5. Please rate the presenter(s) and topic(s) using this scale

Question Title

* 6. Please mark one response for each statement

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* 7. What elements of this course will you use to change your practice?

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* 8. How will you implement those changes?

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* 9. How will you monitor and evaluate your implementation?

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* 10. Do you foresee any barriers to implementing a change in practice?

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* 11. What suggestions do you have for future programs in terms of topics and/or experience?