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VA - Booster for Brief Interventions for Hazardous Drinking in Patients with Hepatitis C - Chicago
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
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:
Objective 1: List the challenges to the everyday practice of providing MI.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Objective 2: Describe ways to overcome the challenges.
The above objective will increase my professional competence.
The above objective will result in changes to performance in my professional practice.
The above objective will result in improved patient outcomes.
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice?
Was the educational content scientifically sound?
Was the educational content free from commercial bias?
Was the mode of education effective for learning?
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
If you answered 'No' to any of the above questions, please explain:
Were you solicited by sales personnel in an educational room while you attended this educational activity?
If you answered 'Yes' to the above question, please explain:
What did you learn during this activity that you intend to integrate into your practice?

My professional competence would be improved if I had training on:

My professional performance would be improved if I had training on:

My patient outcomes would be improved if I had training on:

Are you interested in basic, intermediate or advanced level trainings?
What barriers might you have that would interfere with implementation of new information from this training?
How could this training be improved to impact your competence or performance in practice?
Information on the program's logistical (date, location, time) arrangements were delivered in a timely fashion.
The logistical information on the program was complete.

Overall, the program was worthwhile.

The program compared favorably with other continuing education/employee development activities I have attended.

I would recommend this program to a friend or co-worker.

I had to get travel orders to attend the program because it was outside my commuting area.
Timeliness of information.
Appropriate depth of materials.
Pace of session.
Length of session.
Effective use of time.
Quality of handout materials.
Opportunity to ask questions.
Teaching/instructional quality.
Helpfulness of standarized patient feedback.
Please use this space for any additional comments about the use of standarized patients and the role-play exercises.
Please rate John Baer on the following points:
Timeliness of information
Appropriate depth of materials
Pace of session
Length of session
Effective use of time
Quality of handout materials
Opportunity to ask questions
Teaching quality
Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Please rate Christopher Dunn on the following points:
Timeliness of information

Appropriate depth of materials

Pace of session

Length of session

Effective use of time

Quality of handout materials

Opportunity to ask questions

Teaching quality

Was the presentation evidence-based and did it conform to generally accepted standards of research design, data collection and analysis?
Other comments about this speaker.
Additional comments:
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