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Professional's Weekend - April 4, 2009
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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 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:
Please rate the speaker(s) as a group.  You will have the opportunity to elaborate on an individual speaker in the following question. 
Objective 1: Discuss the diagnosis and treatment of ADD/ADHD in dual diagnosis patients
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
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:
Objective 2: Cite options for treatment of insomnia in dual diagnosis patients
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 3: Explain how to identify depression in addiction
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 4: Explain how to anxiety depression in addiction
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 5: Discuss the importance of treating both the mental illness and the addiction in dual diagnosis patients
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 6: Define Motivational Interviewing
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 7: List early traps to avoid
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 8: State the basic assumptions of Motivational Interviewing
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 9: List the core skills in Motivational Interviewing
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Objective 10: Demonstrate how to measure competence in using Motivational Interviewing
The above objective will increase my professional competence, will result in changes to performance my professional practice, and/or will result in improved patient outcomes as follows:
Please answer the following:

Do you believe this activity was appropriate for the scope of your professional activities?

Was the educational content scientifically sound?
Was the educational content free of commercial bias?
Was the mode of education effective to 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?

My professional competence would be improved if I had training on:

My professional performance would be improved if I had training on:

My patient outcomes would be improved if I had training on:

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 be improved to better impact competence, performance and/or patient outcomes?

Additional comments:

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