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ACMS - 2014 Mohs College Annual Meeting
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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:
Objective 1: Identify the standard of care for high risk cutaneous tumors as well as multidisciplinary approaches to treatment and prognostic characteristics of the tumor;
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: Describe a path towards career goals and aspirations applicable to private and academic practice, for the more recent Fellowship trained Mohs surgeon;
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: Describe the correct way to bill for Mohs surgery, reconstruction, and other dermatologic surgery procedures in clinical situations;
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: Identify legal and therapeutic applications of laser technology in the field of cutaneous oncology
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: Apply new practice management pearls to your practice.
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.
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice?
Was the educational content scientifically sound?
Was the educational content free from commercial bias?
Was the mode of education effective for learning?
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
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?
If you answered 'Yes' to the above question, please explain:
What 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 problems or patient challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients 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 from this training?
How could this training be improved to impact your competence or performance in practice?
Additional comments regarding the speaker or session:
New Important Information That Should be Presented to Improve My KNOWLEDGE(basic knowledge about the disease/topic): (Check all that apply)
Melanoma
Merkel Cell
Basal Cell
Squamous Cell
Other Tumors
Reconstructive Surgery
Technology
Lab
Healthcare Reform and Government Regulatory Issues
Information Technology and Practice Administration
Program Directors (past, present and future)
Dermatopathology
New Important Information That Should be Presented to Improve My PRACTICE (assist with direct patient care): (Check all that apply)
Melanoma
Merkel Cell
Basal Cell
Squamous Cell
Other Tumors
Reconstructive Surgery
Technology
Lab
Healthcare Reform and Government Regulatory Issues
Information Technology and Practice Administration
Program Directors (past, present and future)
Dermatopathology 
Other new information that should be including in upcoming meetings:
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