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IHFDA - 2nd Annual IHFDA Conference - Pharmacist
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Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
PHARMACISTS AND PHARMACY TECHNICIANS ONLY -- Please provide the following:
NABP eProfile ID (ePID):
Date of Birth (MM/DD) - Example September 24 would be 0924:
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. 
Objective 1: describe the impact of diversion by healthcare personnel on patient safety and quality of care
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.
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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):
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: understand the tools necessary for implementing a diversion program
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.
Understand the role of IHFDA in providing resources and support to drug diversion investigators and healthcare facilities
Understand the role of IHFDA in providing resources and support to drug diversion investigators and healthcare facilities
Understand the perspective of the patient victim in diversion
Understand how to support patients who have been victims of diversion
Understand the perspective of the patient victim in diversion
Understand the role of prescribing in the opioid epidemic
State ways in which the risks associated with prescrbing can be reduced
Understand the role of prescribing in the opioid epidemic
Understand barriers to implementing a diversion program
State steps to take to implement a diversion program
Understand barriers to implementing a diversion program
Understand benefits and drawbacks of random urine drug screening
State methods required to ensure that random urine drug screening produces an accurate and reliable result
Understand benefits and drawbacks of random urine drug screening
Understand the role of the FDA in the investigation and prosecution of cases involving tampering with medications
Understand the role of the FDA in the investigation and prosecution of cases involving tampering with medications
Understand the risks of failing to report diversion by healthcare personnel and examine the benefits of robust post-case reporting
Understand the risks of failing to report diversion by healthcare personnel and examine the benefits of robust post-case reporting
Understand the role of organized labor in the investigation and response to suspected diversion
Understand the role of organized labor in the investigation and response to suspected diversion
Understnd the role of drug courts in the prosecution and discipline of diverters
Understnd the role of drug courts in the prosecution and discipline of diverters
Describe the role of the DEA in the investigation and prosecution of diversion a a clinic-bsed outpatient pharacy
Describe the role of the DEA in the investigation and prosecution of diversion a a clinic-bsed outpatient pharacy
Examine how a coordinated prescribing practice program can promote the appropriate use of opioids and improve patient outcomes
Examine how a coordinated prescribing practice program can promote the appropriate use of opioids and improve patient outcomes
Understand the role of State Professional Boards in the investigation of deversion and the discipline of healthcare professionals
Understand the role of State Professional Boards in the investigation of deversion and the discipline of healthcare professionals
Examine how diversion occurs, how it impacts the healthcare provider, and how to support a program of ongoing recovery
Examine how diversion occurs, how it impacts the healthcare provider, and how to support a program of ongoing recovery
Examine potential implications of diversion on patients and the community
Examine potential implications of diversion on patients and the community
State effective techniques for interviewing a staff member suspected of diversions
State effective techniques for interviewing a staff member suspected of diversions
Please tell us about any session you found particularly good or bad
Please tell us about any objective you feel we accomplished well or poorly. 
Please tell us about any presenter you found particularly good or bad
Please answer the following:
Was the educational content scientifically sound?
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.
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):
What specifically did you learn during this activity that you intend to integrate into your practice?
What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?

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?

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