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APPD - 13th Annual Fall Meeting
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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 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: Discuss the process involved in guiding and maintaining a pediatric residency or subspecialty residency program.
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.
Objective 2: List Educational and evaluation tools for the residency program.
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.
Objective 3: Describe how to prepare for regulatory site visits and recruitment seasons.
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.
Objective 4: Discuss professionalism related to directors and resident physicians, including professional development of the individual, their responsibilities and role identity.
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.
Objective 5: Demonstrate uses of new media and technologies to promote creative learning opportunities within the residency program.
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 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?

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:
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