ACMS - 2013 Mohs College Annual Meeting
How would you like your name to appear on your certificate?
Profession
Select Your Profession
Other
Physician
Next
Agreement
By completing this form, you attest that you have attended the activity in its entirety.
I agree
Previous
Next
Please rate the following:
The program was relevant to my work.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Content matched stated objectives.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Usefulness of handouts/AV.
Excellent
Very Good
Good
Fair
Poor
Quality of facilities.
Excellent
Very Good
Good
Fair
Poor
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?
Excellent
Very Good
Good
Fair
Poor
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain:
Previous
Next
Objective 1: Identify strategies to address critical anatomic landmarks and structures that impact tumor excision and the functional and cosmetic reconstruction of the genitalia and perineum.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Objective 2: Identify critical anatomic landmarks and structures that impact tumor excision
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Objective 3: Differentiate benign mimickers of skin cancer from their malignant counterparts on frozen sections.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Objective 4: Explain the outcomes of patients undergoing cutaneous surgery who have had medically necessary anticoagulant and antiplatelet medications stopped.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Objective 5: Describe how to incorporate the new staging system into patient counseling and therapy.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Objective 6: Describe how to utilize the appropriate choice and timing of prophylactic antibiotics.
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice?
Yes
No
NA
Was the educational content scientifically sound?
Yes
No
NA
Was the educational content free from commercial bias?
Yes
No
Was the mode of education effective for learning?
Yes
No
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
Yes
No
NA
If you answered 'No' to any of the above questions, please explain:
Were you solicited by sales personnel in an educational room while you attended this educational activity?
Yes
No
NA
If you answered 'Yes' to the above question, please explain:
Previous
Next
What did you learn during this activity that you intend to integrate into your practice?
Previous
Next
What questions have arisen in your practice for which you need answers/strategies that you can implement?
Previous
Next
What patient problems or patient challenges do you feel you are not able to address appropriately or to your satisfaction?
Previous
Next
What problems are your patients communicating to you that need attention or follow-up?
Previous
Next
Are you interested in basic, intermediate or advanced level trainings?
Basic
Intermediate
Advanced
Previous
Next
What barriers might you have that would interfere with implementation of new information from this training?
Previous
Next
How could
this
training be improved to impact your competence or performance in practice?
Previous
Next
Additional comments regarding the speaker or session:
Previous
Next
New Important Information That Should be Presented to Improve My KNOWLEDGE(basic knowledge about the disease/topic): (Check all that apply)
Melanoma
Basic Science
Immunotherapies
Chemotherapy
SLNB
Excisions/Margins
Merkel Cell
Basic Science
SLNB
Multidisciplinary
Radiation Therapy
Basal Cell
Basic Science
New Gene/Immunotherapies
High Risk Tumors
Squamous Cell
Basic Science
New Chemotherapies approaches
Multidisciplinary– SLNB ; Radiation Therapy
Approach to Large/Recurrent Tumors
Other Tumors
DFSP
Sebaceous Carcinoma
Eccrine Carcinoma
Extramammary Paget's Disease
Dermatopathology (Diagnosis, Stains, Artifacts, Mimickers
Surgery
Flaps
Grafts
Xenografts and tissue substrates
Complications
Technology
New Sutures
New Closure Devices
PDT
XRT
Lab
Surviving Inspection
Immunostaining
Healthcare Reform and Government Regulatory Issues
Billing and Coding Compliance
RAC Audits
Payment Models and ACO – Integration of Dermatology and Mohs Surgery
Information Technology and Practice Administration
EHR Update
Meaningful Use Update / Audits
IT Pearls
Program Directors (past, present and future)
How to write or maintain a PIF
Preparing for a site visit
Surviving a site visit
Previous
Next
New Important Information That Should be Presented to Improve My PRACTICE (assist with direct patient care): (Check all that apply)
Melanoma
Basic Science
Immunotherapies
Chemotherapy
SLNB
Excisions/Margins
Merkel Cell
Basic Science
SLNB
Multidisciplinary
Radiation Therapy
Basal Cell
Basic Science
New Gene/Immunotherapies
High Risk Tumors
Squamous Cell
Basic Science
New Chemotherapies approaches
Multidisciplinary– SLNB ; Radiation Therapy
Approach to Large/Recurrent Tumors
Other Tumors
DFSP
Sebaceous Carcinoma
Eccrine Carcinoma
Extramammary Paget's Disease
Dermatopathology (Diagnosis, Stains, Artifacts, Mimickers
Surgery
Flaps
Grafts
Xenografts and tissue substrates
Complications
Technology
New Sutures
New Closure Devices
PDT
XRT
Lab
Surviving Inspection
Immunostaining
Healthcare Reform and Government Regulatory Issues
Billing and Coding Compliance
RAC Audits
Payment Models and ACO – Integration of Dermatology and Mohs Surgery
Information Technology and Practice Administration
EHR Update
Meaningful Use Update / Audits
IT Pearls
Program Directors (past, present and future)
How to write or maintain a PIF
Preparing for a site visit
Surviving a site visit
Previous
Next
Other new information that should be including in upcoming meetings:
Previous