MOFAS - Family Matters: Strategies for Successful Outcomes
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
I agree
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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
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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):
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Objective 1: Discuss the importance of recognizing strengths in individuals with an FASD and their families
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
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Objective 2: Describe why families of individuals with an FASD often become more isolated
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
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Objective 3: Identify ways that families of individuals with an FASD can increase their social supports
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
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Please answer the following:
Do you believe this activity was appropriate for the scope of your professional activities?
Yes
No
NA
Was the mode of education effective for learning?
Yes
No
If you answered 'No' to either of the above questions, please explain:
How much did you learn as a result of this educational program?
Great deal
Quite a bit
Some
Very little
Nothing
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What specifically did you learn during this activity that you intend to integrate into your practice?
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What questions have arisen in your practice for which you need answers/strategies that you can implement?
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What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
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What problems are your patients/clients communicating to you that need attention or follow-up?
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Are you interested in basic, intermediate or advanced level trainings?
Basic
Intermediate
Advanced
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What barriers might you have that would interfere with implementation of new information learned from this training?
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How could
this
training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?
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Additional comments:
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