How would you like your name to appear on your certificate?

Profession

What activities did you attend at the event?

Wednesday, April 25 - 11:30 am - 1:00 pm

Agreement

By completing this form, you attest that you have participated in all selected activities in thier entirety.

I agree

Please rate the following:

The program was relevant to my work.

Usefulness of handouts/AV.

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):

The instructor was knowledgeable about the content

The instructor presented the subject matter clearly

The instructor was responsive to participants

The instructor used the technology effectively

Having completed the activity, please rate your ability to meet each of the following objectives:

Discuss the value of collaborative care models for psychosocial care in oncology and learn strategies for successful implementation from model programs

Identify the challenges of meeting the needs of the growing population of cancer survivors, emphasizing the importance of adjusted practice models and a multidisciplinary approach to care

Describe conceptual and practical models of resilience and resilience-building in cancer patients, as well as impact of provider burnout on patient outcomes

Review strategies for developing and advocating for expansion of a psycho-oncology program

Please answer the following:

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

Was the educational content scientifically sound?

If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?

Was the mode of education effective to learning?

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):

How much did you learn as a result of this education program?

What specifically did you learn during this activity that you intend to integrate into your practice?

What questions have arisen in your practice for which you need answers/strategies that you can implement?

What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?

What problems are your patients/clients communicating to you that need attention or follow up?

Are you interested in basic, intermediate or advanced level trainings?

Basic

Intermediate

Advanced

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?

Additional comments: