TOU Behavior Therapy Institute 10.6.18
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
I agree
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Please rate your satisfaction with the content and quality of the program:
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Very Dissatisfied
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Was the educational content scientifically sound?
Yes
No
If no, please explain...
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Did you perceive any commercial bias or influence in the educational content?
Yes
No
If yes, what...
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Did this program improve your competence or performance?
Yes
No
If yes, how...
If no, please explain...
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What did you learn that will help you in your practice?
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Were the following objectives met?
Objective 1: Identify TS and other tic disorders
Yes
No
Not sure
Were the following objectives met?
Objective 2: Administer, score, and interpret TS-specific assessments including the YGTSS, PTQ and PUTS scales
Yes
No
Not sure
Were the following objectives met?
Objective 3:Â Outline the overall structure of CBTI
Yes
No
Not sure
Were the following objectives met?
Objective 4:Â Conduct Functional Assessment
Yes
No
Not sure
Were the following objectives met?
Objective 5:Â Practice Habit Reversal Therapy (HRT)
Yes
No
Not sure
Were the following objectives met?
Objective 6:Â Plan the assessment and treatment strategy
Yes
No
Not sure
Were the following objectives met?
Objective 7:Â Discuss effective ways of seeking reimbursement for CBIT
Yes
No
Not sure
Were the following objectives met?
Objective 8:Â Administer, score, and interpret TS-specific assessments including the YGTSS, PTQ, and PUTS scales
Yes
No
Not sure
Were the following objectives met?
Objective 9: Outline the overall structure of CBIT
Yes
No
Not sure
Were the following objectives met?
Objective 10: State a rationale for Comprehensive Behavioral Intervention for Tics
Yes
No
Not sure
Were the following objectives met?
Objective 11: Create Tic Hierarchy
Yes
No
Not sure
Were the following objectives met?
Objective 12: Create Inconvenience Review
Yes
No
Not sure
Were the following objectives met?
Objective 13: State the rationale for the behavioral program
Yes
No
Not sure
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The program was up-to-date and relevant to my professional practiceÂ
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Additional comments
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Was the location suitable?
Yes
No
The facilities were conducive to learning
Yes
No
Not sure
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Rate the following for all instructors
Instructor was knowledgeable about the content
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor presented the subject matter clearly
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor was responsive
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor used technology, hand outs and other learning aids effectively
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Additional questions about the instructor(s)
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What questions are you having in your practice that you would like to see addressed in an educational activity?
Questions, concerns and accommodations were addressed efficiently and in a timely manner
Additional comments
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