Cancer Screening in Elderhood Survey

For each statement provided below, please circle the number on the 1 to 5 scale that best reflects your opinions about today’s conference. Using the scale: 1= Strongly Disagree 2= Disagree 3= Somewhat Agree 4= Agree 5= Strongly Agree

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* I feel that as a result of this activity I will be better able to:

	Strongly Disagree 1	Diagree 2	Somewhat Agree 3	Agree 4	Strongly Agree 5
Define the importance of cancer screening in older adults	Define the importance of cancer screening in older adults Strongly Disagree 1	Define the importance of cancer screening in older adults Diagree 2	Define the importance of cancer screening in older adults Somewhat Agree 3	Define the importance of cancer screening in older adults Agree 4	Define the importance of cancer screening in older adults Strongly Agree 5
Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention	Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention Strongly Disagree 1	Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention Diagree 2	Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention Somewhat Agree 3	Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention Agree 4	Define the importance of assessing the overall health of older adults putting into consideration life expectancy, mortality and frailty when deciding to recommend an intervention Strongly Agree 5
Recognize current guidelines and recommendations available for cancer screening in older adults	Recognize current guidelines and recommendations available for cancer screening in older adults Strongly Disagree 1	Recognize current guidelines and recommendations available for cancer screening in older adults Diagree 2	Recognize current guidelines and recommendations available for cancer screening in older adults Somewhat Agree 3	Recognize current guidelines and recommendations available for cancer screening in older adults Agree 4	Recognize current guidelines and recommendations available for cancer screening in older adults Strongly Agree 5
Describe the importance of shared decision making when recommended an intervention.	Describe the importance of shared decision making when recommended an intervention. Strongly Disagree 1	Describe the importance of shared decision making when recommended an intervention. Diagree 2	Describe the importance of shared decision making when recommended an intervention. Somewhat Agree 3	Describe the importance of shared decision making when recommended an intervention. Agree 4	Describe the importance of shared decision making when recommended an intervention. Strongly Agree 5

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* For each statement provided below, please check the number on the 1 to 5 scale that best reflects your opinions about today’s session.

	Strongly Disagree 1	Diagree 2	Somewhat Agree 3	Agree 4	Strongly Agree 5
There was enough time to cover the topic	There was enough time to cover the topic Strongly Disagree 1	There was enough time to cover the topic Diagree 2	There was enough time to cover the topic Somewhat Agree 3	There was enough time to cover the topic Agree 4	There was enough time to cover the topic Strongly Agree 5
I would recommend this session to my peers	I would recommend this session to my peers Strongly Disagree 1	I would recommend this session to my peers Diagree 2	I would recommend this session to my peers Somewhat Agree 3	I would recommend this session to my peers Agree 4	I would recommend this session to my peers Strongly Agree 5
The information was applicable to my daily activities	The information was applicable to my daily activities Strongly Disagree 1	The information was applicable to my daily activities Diagree 2	The information was applicable to my daily activities Somewhat Agree 3	The information was applicable to my daily activities Agree 4	The information was applicable to my daily activities Strongly Agree 5

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* What were the major strengths of today’s session?

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* Describe any perceived commercial bias.

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* Was today’s topic one that you would have identified as important to you?

Yes

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* Amount of time I spent at this activity:

15 minutes

30 minutes

45 minutes

60 minutes

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* Please share any additional comments and suggestions. Your feedback is extremely valuable to us.

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* Please indicate what type of certificate you are requesting:

CME (1.0 AMA PRA Category 1 Credit)

Nursing CEU

Certificate of Attendance

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* Please list your information below so we may send you a Certificate:

Name and Credentials

Company

State

Email Address