Logo1
WELL - Modern Wound Care Management
Mr pencil

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 speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
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 in detail (e.g. session title, speaker name, situtation):
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:
Having completed the activity, please rate your ability to meet each of the following objectives:
Describe the emotional and physical challenges of being a patient with diabete
Determine implications for caring for a patient with foot ulcers
Discuss statistics of the scope of the number of people with chronic wounds in the US
Evaluate the breakdown of wounds and the impact of wounds on national health care
Compute how an increase in wounds will occur with an aging population and describe its implications on national healthcare.
Calculate how there will be an increase in wounds in the population with the increase in obeses population and describe its implications on national healthcare.
Evaluate the historical context of wound care in the United States and the science behind it
Measure the current gaps in wound care from a historical perspective and where it is necessary to research ways to improve wound care options.
Critique different research techniques that would effect the standard of care for chronic wounds
Evaluate how the process of research initiatives becomes translated into the standard of modern wound care for chronic wounds
Recognize basic principals of medical care as applied to complex wound care
Determine pitfalls in operationalizing successful wound care.
How well were objectives met
Discuss rare causes of chronic wounds
Determine how inflammation plays a role in chronic wounds
Discuss opportunities in philanthropy and volunteering to improve care of chronic wounds.
List opportunities for growth in philanthropy and volunteering to improve wound care.
Recognize opportunities for advanced education in wound care
Discuss gaps and inconsistencies in education in wound care.
Recognize the role of nutrition in healing chronic wounds.
Discuss the mechanisms of malnutrition and its contribution to chronic wounds
Discuss the options of care of a patient with a rare and uncommon cause of wound.
Specify medical endovascular and surgical options of care for a paitent with a rare and uncommon cause for his/her wound.
How well were objectives met
How well were objectives met
Discuss mechanisms on a large and small scale that lead to a venous stasis ulcer
Determine measures to prevent venous stasis ulcer using pathophysiology knowledge.
Identify techniques that will allow for optimal evaluation of lower extremity venous wound
Discuss and demonstrate options for diagnostic testing of lower extremity venous wounds.
Discuss the different types of compression and physiology.
Specifiy practice patterns of prescribing compression to the appropriate type patient.
Discuss specific medical modalities that are available to heal chronic wounds.
Discuss clinic flow modalities to improve wound care.
Utilize endovascular and open surgery to heal wounds for venous leg ulcers.
Interpret proper time frames of using endovascular therapies to heal venous leg ulcers
Discuss options of care of a patient with a challenging venous ulcer.
Specifiy medical endovascular and surgical options for a patient presenting with a difficult to heal venous ulcer.
Discuss options of care of a patient with a challenging venous ulcer
Specifiy medical endovascular and surgical options for a patient presenting with a difficult to heal venous ulcer
How well were objectives met
Discuss compression therapy as an option of care of a patient with a challenging venous ulcer.
Demonstrate compression therapy as a method of treatment for patients
Discuss total contact casting and off-loading as an option of care of a patient with a challenging venous ulcer.
Demonstrate total contact casting as a method of treatment for patients.
Review the gaps in a typical evaluation of a diabetic foot ulcer.
Determine outcomes related to optimal diabetic foot ulcer evaluation
Propose modern soft tissue and orthopedic techniques to treat diabetic foot wounds
Name pitfalls in suboptimal acute diabetic foot wound management
Measure treatment modalities for infections disease therapy in diabetic foot wounds.
Demonstrate a strategy to treat the resistant polymicrobial diabetic foot infection.
Determine effective treatment modalities and timing for off-loading.
Describe proper techniques in total contact casting
Discussions options of care for a patient with a challenging diabetic foot ulce
Specify medical endovascular and surgical options for patients with diabetic foot ulcers
Discussions options of care for a patient with a challenging diabetic foot ulcer
Specify medical endovascular and surgical options for patients with diabetic foot ulcers.
How well were objectives met
Explain therapeutic options regarding skin substitute
Develop Treatment algorithms to properly incorporate skin substitutes and other ancillary treatments
Describe evidence-based protocols for HBO treatment in healing diabetic foot wounds.
Evaluate optimal criteria for patient selection of using HBO treatment to heal diabetic foot wounds.
Describe risk factors that lead to pressure ulcers.
Formulate algorithms of treatment of patients with pressure ulcers
Discuss options of care with patients with challenging diabetic foot ulcers
Specify medical endovascular options and surgical options for treatment with patients with challenging diabetic foot ulcers
Discuss options of care with patients with challenging diabetic foot ulcers
Specify medical endovascular options and surgical options for treatment with patients with challenging diabetic foot ulcers
How well were objectives met
How well were objectives met
Determine techniques that will allow for optimal evaluation of lower extremity arterial ischemia.
Discuss and demonstrate diagnostic testing in patients with LE arterial ischemia wounds
Discuss how chronic wounds can lead to major and minor amputation.
Discuss how to optimize outcomes after major or minor amputation from chronic wounds
Propose the use of endovascular medicine and open surgery to heal the wounds for lower extremity ischemia.
Interpret proper time frames for using endovascular medicine to heal lower extremity arterial wounds
Discuss options of care of a patient with recalcitrant lower extremity ischemic wound
Specify medical endovascular and open surgical options for treatment of patient swith recalcitrant lower extremity ischemic wounds
Discuss options of care of a patient with recalcitrant lower extremity ischemic wound
Specify medical endovascular and open surgical options for treatment of patient swith recalcitrant lower extremity ischemic wounds
How well were objectives met
Discuss the mechanisms of formation of bacteria on chronic wounds.
Determine optimal treatments to eradicate biofilms
Discuss key medications that inhibit wound healing
Discuss those medications specifically designed to enhance wound healing
Discuss key factors that determine why wounds respond to negative pressure wound therapy
Discuss new innovative types of devices for negative wound pressure.
Differentiate strategies that will help grow your market of patients with chronic wounds
Determine how to establish partnerships with hospitals, private wound care companies, and industry to increase market share for your wound care clinic
Discuss pitfalls leading to a dysfunctional wound care team.
Prescribe effective leadership to optimize care in a wound care cente
Objective 1: Utilize comprehensive strategies for maximizing limb salvage in patients with high risk chronic wounds.
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: Discuss current methods of noninvasive diagnosis of patients for arterial and venous insufficiency.
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 options and protocols for effective offloading to reduce pressure on diabetic foot ulcers
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: Implement methods to revascularize limbs with wounds related to peripheral arterial disease.
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: Describe the risks associated with hyperbaric treatment and protocols for prevention of HBO associated complications.
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 activities?
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 product/service/company/commercial bias in any educational session you attended or materials you received?
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 room (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):
How much did you learn as a result of this education program?
What specifically 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/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients/clients 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 learned from this training?

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

Additional comments:

Mr question