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NASPGHAN 2016 WCPGHN Nutrition Symposium
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How would you like your name to appear on your certificate?



How many credit hours did you complete?
Agreement
By completing this form, you attest that you have attended the number of hours you have indicated above.
Please rate the following:
The program was relevant to my work. 
Content matched stated objectives. 
Usefulness of handouts/AV.
Quality of facilities were conducive to learning.
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names? 
If you answered any of the above questions with 'Fair', 'Poor', 'Discharge' or 'Strongly Disagree' please explain in detail (e.g. session title, speaker name, and situation)
Objective 1: To understand treatments/management for motility disorders and be able to successfully intervene with pediatric patients
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice. 
By meeting the above my professional performance will improve because I should be able to implement the new strategies. 
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies. 
Objective 2: To understand and be able to utilize current practice principles in caring for patients on parenteral nutrition
By meeting the above my professional performance will improve because I should be able to implement the new strategies. 
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies. 
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice. 
Objective 3: To understand important nutrition intervention for food allergic patients and those with celiac disease
By meeting the above my professional performance will improve because I should be able to implement the new strategies. 
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies. 
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice. 
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice or activities?
Was the educational content scientifically sound?
Was the mode of education effective for learning? 
If you answered "No" to any of the above questions, please explain:
Did you perceive any product/service/company/commercial bias in any educational session you attended or materials you received? 
If you answered "Yes" to any of the above questions, please explain:
Were you solicited by sales personnel in an educational room while you attended this educational activity?
If you answered "Yes" to any of the above questions, please explain:
How much did you learn as a result of this education program?
Please answer the following:
What specfically did you learn during this activity that you intend to integrate into your practice?
What questions have arisen in your pratice for which you need answers/strategies that you can implement?
What patients/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
Do you believe this activity was appropriate for the scope of your professional practice or activities?
What problems are your patients/clients communicating to you that need attention or fllow-up?
Was the mode of education effective for learning? 
If you answered "Yes" to any of the above questions, please explain:
If you answered "Yes" to any of the above questions, please explain:
Are you interested in basic, intermediate or advanced level trainings? 
What barriers might you have that would interfere with implementation of new information learned from this training? 
How can this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?
How did you hear about the conference?
Are the topics relevant to your practice? Why or why not?
What topics or speakers would you like to see in the future? 
Was there a good balance among speakers with some RD and non-RD speakers?
Would you consider joining the leadership of such an Organization?
Would you be interested in helping plan next year's symposium? 
Are you predominantly a pediatric dietitian?
If no, please explain:
If yes, do you have a subspecialty that you work in? 
Additional comments:
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