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

Profession

How many credit hours did you complete?

Credit Hours (maximum: 10.0)

Agreement

By completing this form, you attest that you have attended the number of hours you have indicated above.

I agree

Please rate the following:

Content matched stated objectives.

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, situation):

Objective 1: To improve practitioner knowledge and skills related to the nutritional assessment of individuals who are candidates for enteral nutrition

By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.

Objective 2: To engage in a quality improvement project to ensure that all appropriate aspects of nutritional assessments related to enteral nutrition are performed and that best practices are followed re: enteral nutrition management

By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.

This activity met the aforementioned learning objectives

This activity was free from commercial bias

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

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

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 could this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?

Additional comments:

American Board of Pediatrics (ABP): If you are seeking ABP MOC Part 2 credits, answer the following 2 questions. If you do not, your MOC Part 2 hours will not be uploaded. Hours will post to your dash board at the beginning of the following month you complete this activity.

ABP ID

Date of birth (MM/DD)