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VA - 2012 Brief Interventions for Hazardous Drinking in Patients with Hepatitis C (Seattle)
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
Please rate the following:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of handouts/AV.
Quality of facilities.
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain:
Objective 1: Describe the Stages of Change Model
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 2: Identify a patient's stage of change and what interventions and goals are appropriate for that stage.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 3: Describe the components of a standard Brief Alcohol Intervention (BAI) Toolkit, containing clinical resources for addressing hazardous alcohol use in patients with hepatitis C.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 4: Describe the spirit and five basic principles of Motivational Interviewing (MI).
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 5: Demonstrate the micro-skills of MI (open-ended questions, affirmations, reflective listening, and summaries).
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 6: Appraise "change talk" from patients in a clinical setting.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 7: Integrate MI skills into brief feedback-based interventions
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 8: Identify resistant behavior by using reflective or strategic interventions.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
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 the above question, please explain:

Were you solicited by sales personnel in an educational room while you attended this educational activity?

If you answered 'Yes' to the above question, please explain:
How much did you learn as a result of this education program?
What specifically did you learn during this activity that you intend to integrate into your practice?
What did you learn during this activity that you intend to integrate into your practice?
What questions have arisen in your practice for which you need answers/strategies that you can implement?
What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?

What problems are your patients/clients communicating to you that need attention or follow-up?

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 can this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?

Information on the program's logistical (date, location, time) arrangements were delivered in a timely fashion.
The logistical information on the program was complete.

Overall, the program was worthwhile.

The program compared favorably with other continuing education/employee development activities I have attended.

I would recommend this program to a friend or co-worker.

I had to get travel orders to attend the program because it was outside my commuting area.
Timeliness of information.
Appropriate depth of materials.
Pace of session.
Length of session.
Effective use of time.
Quality of handout materials.
Opportunity to ask questions.
Teaching/instructional quality.
Helpfulness of standarized patient feedback.
Please use this space for any additional comments about the use of standarized patients and the role-play exercises.
Please rate John Baer on the following points:
Timeliness of information
Appropriate depth of materials
Pace of session
Length of session
Effective use of time
Quality of handout materials
Opportunity to ask questions
Teaching quality
Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Christopher Dunn on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Peter Hauser on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Michael Chang on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Erick Dieperink on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Bret Fuller on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Additional comments:
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