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Commission for Case Management Certification Role and Function Survey
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How would you like your name to appear on your certificate?



Agreement
By completing this form, you attest that you have attended the activity in its entirety.
Please rate the following:
The activity was relevant to my work.
Content matched stated objectives.

Ease of use and access.

If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain:

Identify current case management practices in various care settings.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Review and revise the list of the essential activities and knowledge related to work performed by case managers.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Define major content areas (domains of practice) and knowledge needed for competent performance.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Please rate the extent to which you agree with the above statement:

The survey was well executed and straightforward.

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 you answered 'No' to any of the above questions, 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 from this training?
How could this training be improved to impact your competence or performance in practice?
Additional comments:
In order for us to enter your credits to your transcript, plesae enter your CCM ID number:
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