2016 Selby Spine

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* 1. Check appropriate title.

MD/DO

ARNP/RN/NP

PT/DPT

AT/OT

Other (please specify)

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* 2. Please rate your overall satisfaction with the organization of this meeting.

Excellent

Good

Average

Fair

Poor

Other (please specify)

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* 3. The ACCME defines commercial bias as presentations giving an unbalanced view of therapeutic options by promoting a specific proprietary business interest of a commercial interest.

Was this CME course free of commercial bias?

Yes

If no, please explain

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* 4. Did the faculty disclose significant relationships with commercial support?
(One or more of these methods: Syllabus / Opening Remarks / Verbally / On Slides)

Yes

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* 5. Please rate the quality of the meeting facilities.

Excellent

Good

Average

Fair

Poor

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* 6. How well were the Selby Spine course objectives met?

Upon completion of the course participants should be able to:

	Significantly Met	Somewhat Met	Not Met
Evaluate and discuss treatment options for complex and challenging deformity cases	Evaluate and discuss treatment options for complex and challenging deformity cases Significantly Met	Evaluate and discuss treatment options for complex and challenging deformity cases Somewhat Met	Evaluate and discuss treatment options for complex and challenging deformity cases Not Met
Assess the current trends in imaging and emerging technologies	Assess the current trends in imaging and emerging technologies Significantly Met	Assess the current trends in imaging and emerging technologies Somewhat Met	Assess the current trends in imaging and emerging technologies Not Met
Compare evidence of cervical spine care options	Compare evidence of cervical spine care options Significantly Met	Compare evidence of cervical spine care options Somewhat Met	Compare evidence of cervical spine care options Not Met
Assess the general healthcare marketplace and legal landscape as it relates to spine surgery.	Assess the general healthcare marketplace and legal landscape as it relates to spine surgery. Significantly Met	Assess the general healthcare marketplace and legal landscape as it relates to spine surgery. Somewhat Met	Assess the general healthcare marketplace and legal landscape as it relates to spine surgery. Not Met

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* 7. Did you meet your personal goal/objective for what you intended to get out of this course?

Significantly Met

Somewhat Met

Not Met

We encourage you to expand on your answer below:

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* 8. Do you intend to integrate what you learned at this conference into your current practice?

This activity validated my current practice; no changes will be made.

Create/revise protcols, policies and/or procedures.

Change the management and/or treatment of my patients.

Other, please specify

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* 9. Please rate the relevance of this program to your scope of practice:

Very Relevant

Relevant

Somewhat Relevant

Not Very Relevant

Irrelevant

Please explain:

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* 10. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION I: Future of Healthcare

	Excellent	Very Good	Good	Fair	Poor
Richard Fessler, MD, PhD - Update on legislative changes to Obamacare	Richard Fessler, MD, PhD - Update on legislative changes to Obamacare Excellent	Richard Fessler, MD, PhD - Update on legislative changes to Obamacare Very Good	Richard Fessler, MD, PhD - Update on legislative changes to Obamacare Good	Richard Fessler, MD, PhD - Update on legislative changes to Obamacare Fair	Richard Fessler, MD, PhD - Update on legislative changes to Obamacare Poor
Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You	Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You Excellent	Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You Very Good	Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You Good	Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You Fair	Jeff Dunkel - Surgeons in the Crosshairs: How Current and Near Future Data Allows Payers & Patients to Evaluate You Poor
Eric Muehlbauer, MD - Recent Changes at NASS	Eric Muehlbauer, MD - Recent Changes at NASS Excellent	Eric Muehlbauer, MD - Recent Changes at NASS Very Good	Eric Muehlbauer, MD - Recent Changes at NASS Good	Eric Muehlbauer, MD - Recent Changes at NASS Fair	Eric Muehlbauer, MD - Recent Changes at NASS Poor
Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare	Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare Excellent	Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare Very Good	Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare Good	Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare Fair	Jill Serbousek - Reality of Insurance Status for Those Changes From Private Insurance to Obamacare Poor

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* 11. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION II: Cervical Spine

	Excellent	Very Good	Good	Fair	Poor
Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion	Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion Excellent	Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion Very Good	Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion Good	Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion Fair	Thomas Gilbert, MD - Radiologic Assessment of Spine Fusion Poor
Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF	Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF Excellent	Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF Very Good	Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF Good	Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF Fair	Peter Ullrich, MD - Zero Profile Cages Have Replaced Plating for ACDF Poor
Tim Adamson, MD - Cervical Plating Remains the Standard of Care	Tim Adamson, MD - Cervical Plating Remains the Standard of Care Excellent	Tim Adamson, MD - Cervical Plating Remains the Standard of Care Very Good	Tim Adamson, MD - Cervical Plating Remains the Standard of Care Good	Tim Adamson, MD - Cervical Plating Remains the Standard of Care Fair	Tim Adamson, MD - Cervical Plating Remains the Standard of Care Poor
Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases	Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases Excellent	Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases Very Good	Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases Good	Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases Fair	Faheem Sandhu, MD - Prosthetic Discs Should Replace Fusion in Most Cases Poor
Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery	Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery Excellent	Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery Very Good	Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery Good	Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery Fair	Sigurd Berven, MD, PhD, FRCSC, FACS - Cervical Balance Should Be Considered in all Cervical Surgery Poor
Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery	Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery Excellent	Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery Very Good	Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery Good	Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery Fair	Pierce Nunley, MD - Cervical Balance is Irrelevant in Most Cervical Surgery Poor

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* 12. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION III: Emerging Technologies

	Excellent	Very Good	Good	Fair	Poor
Robert Henderson - Techniques of Dural Repair	Robert Henderson - Techniques of Dural Repair Excellent	Robert Henderson - Techniques of Dural Repair Very Good	Robert Henderson - Techniques of Dural Repair Good	Robert Henderson - Techniques of Dural Repair Fair	Robert Henderson - Techniques of Dural Repair Poor
Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies	Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies Excellent	Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies Very Good	Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies Good	Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies Fair	Jean Jacques Abitbol, MD, FRCSC - Hemostatic Technologies Poor
Paul Slosar, MD - Surfacing Technologies	Paul Slosar, MD - Surfacing Technologies Excellent	Paul Slosar, MD - Surfacing Technologies Very Good	Paul Slosar, MD - Surfacing Technologies Good	Paul Slosar, MD - Surfacing Technologies Fair	Paul Slosar, MD - Surfacing Technologies Poor
Ken Gall, PhD - Porous Peek Technologies	Ken Gall, PhD - Porous Peek Technologies Excellent	Ken Gall, PhD - Porous Peek Technologies Very Good	Ken Gall, PhD - Porous Peek Technologies Good	Ken Gall, PhD - Porous Peek Technologies Fair	Ken Gall, PhD - Porous Peek Technologies Poor
Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity	Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity Excellent	Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity Very Good	Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity Good	Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity Fair	Neel Anand, MD - MIS Techniques for Sagittal Plan Correction in Adult Degenerative Deformity Poor

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* 13. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION IV: Deformity

	Excellent	Very Good	Good	Fair	Poor
John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One	John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One Excellent	John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One Very Good	John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One Good	John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One Fair	John Small, MD - Grade II/III Spondylolisthesis is a DEFORMITY Case and Should be Treated as One Poor
Ira Fedder, MD - No It Isn't	Ira Fedder, MD - No It Isn't Excellent	Ira Fedder, MD - No It Isn't Very Good	Ira Fedder, MD - No It Isn't Good	Ira Fedder, MD - No It Isn't Fair	Ira Fedder, MD - No It Isn't Poor
Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance	Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance Excellent	Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance Very Good	Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance Good	Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance Fair	Sigurd Berven, MD, PhD, PRCSC, FACS - Sagittal Balance Poor
Richard Fessler, MD - MIS will Replace Most Open Surgery	Richard Fessler, MD - MIS will Replace Most Open Surgery Excellent	Richard Fessler, MD - MIS will Replace Most Open Surgery Very Good	Richard Fessler, MD - MIS will Replace Most Open Surgery Good	Richard Fessler, MD - MIS will Replace Most Open Surgery Fair	Richard Fessler, MD - MIS will Replace Most Open Surgery Poor
Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It	Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It Excellent	Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It Very Good	Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It Good	Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It Fair	Pierce Nunley, MD - MIS Is a Passing Fad and Its Limitations Will Kill It Poor
Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid?	Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid? Excellent	Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid? Very Good	Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid? Good	Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid? Fair	Farhan Siddiqi, MD - Is PSO Necessary or Too Morbid? Poor

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* 14. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION V: Best Paper Review/ My Worst Complications

	Excellent	Very Good	Good	Fair	Poor
Marc Weinstein, MD - Best 5 Paper Review	Marc Weinstein, MD - Best 5 Paper Review Excellent	Marc Weinstein, MD - Best 5 Paper Review Very Good	Marc Weinstein, MD - Best 5 Paper Review Good	Marc Weinstein, MD - Best 5 Paper Review Fair	Marc Weinstein, MD - Best 5 Paper Review Poor

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* 15. Based on your CME needs, please give suggestions for future program topics/formats.

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* 16. What barriers do you foresee that may hinder your implementation of changes learned at this activity? What educational strategies could help to overcome these barriers?

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* 17. What do you see as your BIGGEST challenge in improving patient safety, patient care and/or patient outcomes? What educational strategies could help to overcome this challenge?

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* 18. How did you hear about this CME Program?

Direct Mail

Eblast

Phone Call

Course Catalog

Orthopedics Today/Orthopedics Ad

Social Media (Facebook/Twitter)

Referral (Please list below)

Other (please specify)

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* 19. Please provide your contact information.

Full Name:

Degree:

Email Address:

Phone Number:

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* 20. The Foundation for Orthopaedic Research and Education (FORE) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

FORE designates this live activity for a maximum of 15.75 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Please attest to the total number of credit hours (minimum .25- maximum 15.75) that you spent in this CME
activity:

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* 1. Check appropriate title.

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* 2. Please rate your overall satisfaction with the organization of this meeting.

Question Title

* 3. The ACCME defines commercial bias as presentations giving an unbalanced view of therapeutic options by promoting a specific proprietary business interest of a commercial interest. Was this CME course free of commercial bias?

Question Title

* 4. Did the faculty disclose significant relationships with commercial support? (One or more of these methods: Syllabus / Opening Remarks / Verbally / On Slides)

Question Title

* 5. Please rate the quality of the meeting facilities.

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* 6. How well were the Selby Spine course objectives met?Upon completion of the course participants should be able to:

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* 7. Did you meet your personal goal/objective for what you intended to get out of this course?

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* 8. Do you intend to integrate what you learned at this conference into your current practice?

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* 9. Please rate the relevance of this program to your scope of practice:

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* 10. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakersSESSION I: Future of Healthcare

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* 11. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakersSESSION II: Cervical Spine

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* 12. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakersSESSION III: Emerging Technologies

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* 13. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakersSESSION IV: Deformity

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* 14. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakersSESSION V: Best Paper Review/ My Worst Complications

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* 15. Based on your CME needs, please give suggestions for future program topics/formats.

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* 16. What barriers do you foresee that may hinder your implementation of changes learned at this activity? What educational strategies could help to overcome these barriers?

Question Title

* 17. What do you see as your BIGGEST challenge in improving patient safety, patient care and/or patient outcomes? What educational strategies could help to overcome this challenge?

Question Title

* 18. How did you hear about this CME Program?

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* 19. Please provide your contact information.

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* 3. The ACCME defines commercial bias as presentations giving an unbalanced view of therapeutic options by promoting a specific proprietary business interest of a commercial interest.

Was this CME course free of commercial bias?

* 4. Did the faculty disclose significant relationships with commercial support?
(One or more of these methods: Syllabus / Opening Remarks / Verbally / On Slides)

* 6. How well were the Selby Spine course objectives met?

Upon completion of the course participants should be able to:

* 10. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION I: Future of Healthcare

* 11. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION II: Cervical Spine

* 12. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION III: Emerging Technologies

* 13. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION IV: Deformity

* 14. Please rate the OVERALL EFFECTIVENESS of each of our Selby Spine speakers
SESSION V: Best Paper Review/ My Worst Complications