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ACH - Relationship-Centered Communication: Improving Patient and Clinician Experiences
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How would you like your name to appear on your certificate?



What activities did you attend at the event?
Agreement
By completing this form, you attest that you have participated in all selected activities in thier entirety.
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Did you attend the session in its entirety?
Objective 1: Quickly establish rapport at the beginning of the encounter
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.
The teaching methods used were appropriate to the objectives
Objective 2: Consistently elicit a list of ALL of the patients’ concerns at the beginning of the encounter
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.
The teaching methods used were appropriate to the objectives
Objective 3: Negotiate an agenda for the encounter
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.
The teaching methods used were appropriate to the objectives
Objective 4: 4 Ask open ended-questions to explore patients’ perspective throughout the encounter.
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.
The teaching methods used were appropriate to the objectives
Objective 5: Offer opportunities for patients to express emotions
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.
The teaching methods used were appropriate to the objectives
Objective 6: Acknowledge patients’ emotions with empathic responses.
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.
The teaching methods used were appropriate to the objectives
Objective 7: Share information in small “chunks” that patients can easily understand.
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.
The teaching methods used were appropriate to the objectives
Objective 8: Consistently check a patients’ understanding of what was discussed.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
The teaching methods used were appropriate to the objectives
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 professional competence will increase because I have acquired new strategies to use in my practice.
Objective 9:Encourage patients to summarize what was discussed.
The teaching methods used were appropriate to the objectives
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
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.
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):
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 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?

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:

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