SDBP 2008 Hypnosis Workshop
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Profession
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Physician
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Psychologist
Social Worker
MFT
Nursing
Child Life
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What activities did you attend at the event?
Hypnosis Workshop
-- Select an Activity --
Hypnosis Workshop - Introductory
Hypnosis Workshop - Intermediate
Hypnosis Workshop - Advanced
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Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
I agree
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Please rate the following:
Overall quality of the meeting.
Excellent
Very Good
Good
Fair
Poor
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
Comfort of rooms.
Excellent
Very Good
Good
Fair
Poor
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The speakers; Erickson, Gold, Hall, Kaiser, Kohen, Olness, Reaney and Warnke, were well organized.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The speakers; Erickson, Gold, Hall, Kaiser, Kohen, Olness, Reaney and Warnke, were well organized.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The speakers; Erickson, Gold, Hall, Kaiser, Kohen, Olness, Reaney and Warnke, were well organized.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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Please answer the following:
The educational sessions gave a balanced view of therapeutic options, including the use of generic names.
Yes
No
N/A
The activity was appropriate for the scope of your professional activities.
Yes
No
N/A
This activity will result in your ability to improve your practice.
Yes
No
N/A
The educational content was scientifically sound.
Yes
No
N/A
The educational content was free from commercial bias.
Yes
No
N/A
If, during the educational session, faculty spoke about off-label uses or an investigational use for a product, was that information disclosed to the audience?
Yes
No
N/A
The mode of education effective to learning?
Yes
No
N/A
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
N/A
If you answered "Yes" to the above question, please explain:
Please rate the speakers' didatic presentations.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Please rate the speakers' didatic presentations.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Please rate the speakers' didatic presentations.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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What did you learn during this activity that you intend to integrate into your practice?
Please rate the speakers' small group sessions.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Please rate the speakers' small group sessions.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Please rate the speakers' small group sessions.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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List any perceived practice "gaps" which you would like addressed in future trainings.
Please use this space to give us additional comments about the presenters.
Please use this space to give us additional comments about the presenters.
Please use this space to give us additional comments about the presenters.
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Are you interested in basic, intermediate or advanced level trainings?
Basic
Intermediate
Advanced
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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What barriers might you have that would interfere with implementation of new information learned from this training?
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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How can this training be improved to impact your competence or practice?
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective has increased my professional knowledge.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will increase my professional competence.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
The above objective will result in changes to performance in my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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How did you hear about the Conference? (Mark all that apply)
Mail
Email
Employer
Co-Worker
Word of Mouth
Voice Message
Website
Health Care Provider
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Would you attend this meeting again? If not, why?
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Would you recommend this meeting to others in the field of pediatrics?
Yes
No
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Check selections that best describe you:
Specialty:
Developmental Behavioral Pediatrics
Neurodevelopmental Disabilities
General Pediatrics
Psychiatry
Psychologist
Other
Trainee:
Yes
No
Affiliation:
Academic
Government Employee/Military/Public Health
Hospital Based Practice
Private Solo
Private Group, Single Specialty
Private Group, Multi Specialty
Other
Degree:
MD
MD/PhD
PsyD
MA/MS/MSW
Other
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