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NASPGHAN - THERAPEUTIC PEDIATRIC ENDOSCOPY HANDS ON COURSE 2012
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
Please rate the following using a scale of 1 to 10 where 1=Poor and 10=Excellent:
Overall quality of the meeting
How well were the educational objectives met?
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 a score of less than 5, please explain:
Please andwer the following questions:
Was the educational content free from commercial bias?
If you answered no the the above question, please explain:
Objective 1: Explain basic principles and practice of therapeutic endoscopy in children.
By meeting the above objective my professional knowdedge has increased.
By meeting the above objective my professional competence will increase.
By meeting the above objective my performance in my professional practice will change.
Objective 2: Identify and properly use endoscopic therapeutic equipment key to each procedure.
By meeting the above objective my professional knowdedge has increased.
By meeting the above objective my professional competence will increase.
By meeting the above objective my performance in my professional practice will change.
Objective 3: Employ basic skills to perform effective and safe therapeutic pediatric endoscopy.
By meeting the above objective my professional knowdedge has increased.
By meeting the above objective my professional competence will increase.
By meeting the above objective my performance in my professional practice will change.
Please rate the following using a scale of 1 to 10 where 1=Not At All and 10=Very Much So
How much did you enjoy hands on training?
How effective was hands on training as an educational approach?
How useful will hands on training be to you as a pediatric GI?
How would you compare hands on training to more traditional didactic approaches?
Hands on training was more enjoyable
Hands on training was more effective
Hands on training was more useful
Please answer the following questions:
Do you believe this activity was appropriate for the scope of your professional activities?
Do you believe this activity will result in your ability to improve your practice?
Was the mode of hands on education effective for learning?
If faculty spoke to you about off-label or investigational uses of a product, was that information disclosed to you?
If you answered "No" to any of the above questions, please explain:
Were you solicited by sales personnel in an educational room (other areas do not matter) while you attended this educational activity?
If you answered ‘Yes' to the above question, please explain in detail (e.g. who, when, where):

Which of the following best describes your current position?

If you answered "Other" to the above question, please specify:

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

List any perceived practice "gaps" you would like future trainings focused on:

What barriers might you have that would interfere with implementation of new information learned from this training?
How can this training be improved to better impact your competence or practice?

Please list any educational needs you would like to see addressed in future programs:

Additional comments:
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