Logo1
WC - Shared Decision Making 2012
Mr pencil

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



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 in detail (e.g. session title, speaker name, situation):
Objective 1: List the benefits of Shared Decision Making
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 objective 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: Explain how to build and maintain an infrastructure to successfully adopt Shared Decision Making
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 objective 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 3: Identify critical communication skills required to assess patients’ values and enhance the patient centered choice
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 objective 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 4: Evaluate the effectiveness and create a portfolio of Decision Aids based on informing options, probability of outcomes and clarifying personal values
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 objective 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 5: Describe how you would work to empower patients to be informed, active, and a collaborative contributor to their care
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 objective 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 6: Cite strategies for managing the cultural shift in the physician’s office and effect on work flow when Shared Decision Making is implemented
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 performance will improve because I should be able to implement the new strategies.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Objective 7: Discuss practical and concrete strategies to put into operation when you get back to the office
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 performance will improve because I should be able to implement the new 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 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 detail the situation below (e.g. session title, speaker name):
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):
How much did you learn as a result of this educational program?
What specifically 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 learned from this training?
How could this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?
Additional comments:
Mr question