How would you like your name to appear on your certificate?

Profession

How many credit hours did you complete?

Credit Hours (maximum: 1.0)

Agreement

By completing this form, you attest that you have attended the number of hours you have indicated above.

I agree

Please rate your satisfaction with the content and quality of the program.

Was the educational content scientifically sound?

Yes

No

If no, please explain...

Did you perceive any commercial bias or influence in the educational content?

Yes

No

If yes, what...

Did this program improve your Skill or Strategy in your role or contribution as a member of the healthcare team?

Yes

No

If no, why not?

Do you believe your participation in this activity will positively impact your healthcare team?

Yes

No

If yes, how?

If no, why not?

What did you learn that will help you in your practice?

Were the following objectives met?

Learn how to navigate national organizations and local institutions when developing a training programs.

Yes

No

I don't know

Were the following objectives met?

Identify and leverage institutional priorities when planning and developing clinical programs.

Yes

No

I don't know

Were the following objectives met?

Learn how to capitalize on interdisciplinary teams to facilitate patient centered care.

Yes

No

I don't know

The program was up-to-date and relevant to my professional practiceÂ

What questions are you having in your practice that you would like to see addressed in an educational activity?

Questions, concerns and accommodations were addressed efficiently and in a timely manner

Additional comments