HOPE 2019 Transitions of Care Community Coalition
How would you like your name to appear on your certificate?
Profession
Select Your Profession
Addictions & Substance Abuse Counselor
Counselor
Employee Assistance Professionals
Marriage and Family Therapist
Nurse
Other
Physician
Psychologist
Social Worker
Next
Agreement
By completing this form, you attest that you have attended the activity in its entirety.
I agree
Previous
Next
Please rate your satisfaction with the content and quality of the program:
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Very Dissatisfied
Previous
Next
Was the educational content scientifically sound?
Yes
No
If no, please explain...
Previous
Next
Did you perceive any commercial bias or influence in the educational content?
Yes
No
If yes, what...
Previous
Next
Did this program improve your competence or performance?
Yes
No
If yes, how...
If no, please explain...
Previous
Next
What did you learn that will help you in your practice?
The program was up-to-date and relevant to my professional practiceÂ
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Were the following objectives met?
Describe cancer basics and the care of the immunocompromised patient
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Understand the transplant related complication of acute and chronic graft versus host disease (aGvHD, cGvHD)
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Describe the shift to oral chemotherapy from clinic to home
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Discuss the needs of LGBTQ cancer patients and accessibility to healthcare resources
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Discuss wound care and the considerations for various patient settings
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Discuss the needs of geriatric cancer patients
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Discuss the needs of geriatric cancer patients and accessibility to healthcare resources
Yes
No
I don't know
Previous
Next
Were the following objectives met?
Discuss mental health of cancer patients during active treatment, survivorship and end-of-life care
Yes
No
I don't know
Previous
Next
The facilities were conducive to learning
Yes
No
Not sure
Previous
Next
Was the location suitable?
Yes
No
Previous
Next
Additional questions about the instructor(s)
Previous
Next
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
Previous
Next
Rate the following for all instructors
Instructor presented the subject matter clearly
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Rate the following for all instructors
Instructor was responsiveÂ
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Rate the following for all instructors
Instructor was knowledgeable about the content
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Were questions, concerns and accommodations were addressed efficiently and in a timely manner?
Previous
Next
What questions are you having in your practice that you would like to see addressed in an educational activity?
Previous
Next
Additional comments, questions or concerns
Previous
