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FOU-32 Professionals Weekend - October 29, 2011
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
Please rate the following:
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question.
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of handouts/AV.

Quality of facilities.

If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain in detail (e.g. session title, speaker name, situation):

Please answer the following:
Do you believe this activity was appropriate for the scope of your professional activities?
Was the educational content scientifically sound?
Was the mode of education effective to learning?
If you answered "No" to any of the above questions, please explain.
How much did you learn as a result of this educational program?
Having completed the activity, please rate how well are you able to meet each of the following objectives

Explain how the autonomic nervous system is involved in trauma and addiction

List examples of emotional regulation techniques

Describe how somatic interventions connect to traditional addiction treatment models

Diagnose addictive disorders in patients who suffer from chronic pain

Discuss treatment of addictive disorders in patients who suffer from chronic pain

Describe the role of mental health professionals in the treatment of patients with chronic pain disorders

Evaluate their ethical practice

Compare thoughtful attitudes developed by "master therapists"

Analyze ethics as a process and not merely a destination

Write down their own philosophy of ethics

What specifically did you learn during this activity that you intend to integrate into your practice?

What do you "need" to learn (versus "want" to learn) that should be addressed in future meetings that will result in improved competence, performance and/or patient outcomes in your practice?

Are you interested in basic, intermediate or advanced level trainings?
What barriers might you have that would interfere with implementation of new information from this training?
How could this training be improved to impact your competence or performance in practice?
Additional comments:
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