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ACPA - TLC Learning Center Group 4: The Physician Advisor Role
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How would you like your name to appear on your certificate?



What activities did you attend at the event?
Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
Please rate the following:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of handouts/AV/technology.
Quality of facilities/facility accomodations or website/accessibility if online.
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):
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did this program improve your Skill or Strategy in your role or contribution as a member of the healthcare team?
Please explain how, or why not?
Please answer the following:
Was the educational content scientifically sound?
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
Was the mode of education effective to learning?
If you answered "No" to any of the above questions, please explain.
Did you perceive any commercial bias or influence in the educational content?
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 area (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):
Do you believe your participation in this activity will positively impact your healthcare team?
Why or why not?
What questions are you having in your practice that you would like to see addressed in an educational activity?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training (the overall meeting) be improved to better impact knowledge, strategies/skills, performance and/or patient outcomes?

Additional comments:

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