QEDU - EVALUATION TEMPLATE
How would you like your name to appear on your certificate?
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
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Please rate the following:
How well did this educational enduring material give a balanced view of therapeutic options, including the use of generic names?
Excellent
Very Good
Good
Fair
Poor
Comments:
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Objective 1: [QUORUM_OBJ1]
How well did we meet this objective?
Highly Effective
Effective
Somewhat Effective
Neutral
Somewhat Ineffective
Ineffective
Highly Ineffective
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Objective 2: [QUORUM_OBJ2]
How well did we meet this objective?
Highly Effective
Effective
Somewhat Effective
Neutral
Somewhat Ineffective
Ineffective
Highly Ineffective
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Objective 3: [QUORUM_OBJ3]
How well did we meet this objective?
Highly Effective
Effective
Somewhat Effective
Neutral
Somewhat Ineffective
Ineffective
Highly Ineffective
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Objective 4: [QUORUM_OBJ4]
How well did we meet this objective?
Highly Effective
Effective
Somewhat Effective
Neutral
Somewhat Ineffective
Ineffective
Highly Ineffective
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Please rate the presenters as a group. You will have the opportunity to elaborate on an individual person in the following question.
Excellent
Very Good
Good
Fair
Poor
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If you have comments regarding an individual person, please use the space below:
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Please answer the following:
Was the educational content scientifically sound?
Yes
No
NA
If you answered 'No' to the above question, please explain:
Did you perceive any product/service/company/commercial bias in this activity?
Yes
No
If you answered "Yes" to the above question, please detail below:
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Please answer the following:
By completing this activity my professional competence will increase because I have acquired new strategies to use in my practice.
Yes
No
If you answered yes to the above question, please explain:
By completing this activity my professional performance will improve because I should be able to implement the new strategies.
Yes
No
If you answered yes to the above question, please explain:
By completing this activity my patient outcomes should improve due to the implementation of newly-learned strategies.
Yes
No
If you answered yes to the above question, please explain:
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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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How could this activity be improved to better impact competence, performance and/or patient/client outcomes?
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Additional comments:
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