Participant Assessment and Program Evaluation First Name Last Name Email* Enter the certification organization(s) for which you are seeking credits: How would you rate this educational activity overall? *Worst1234Best How would you rate the applicability of this program to your educational needs?*Worst1234Best How would you rate the effectiveness of teaching and learning methods used for this program?*Worst1234BestPlease rate the projected impact of this activity on your competence, performance, and patient/client outcomes: This activity increased my competence (i.e., ability to apply knowledge, skills and judgment).*Strongly AgreeAgreeDisagreeStrongly Disagree This activity will improve my performance.*Strongly AgreeAgreeDisagreeStrongly Disagree This activity will improve my patient/client outcomes.*Strongly AgreeAgreeDisagreeStrongly DisagreeDid you consider the program: -to be practically useful?*YesNoPartially -to be comprehensive?*YesNoPartially -to be appropriate in length?*YesNoPartially -to achieve the learning objectives stated in promotional materials?*YesNoPartially How will you change your practice/training as a result of this activity? What barriers, besides time and/or money, do you anticipate encountering as you make changes in your practice/training? What percentage of information presented in this program will be of use to you?* Do you feel that the information presented was based on the best available evidence? If no, please explain: *YesNo Label Did you feel that there was commercial bias or influence in this activity? If yes, please explain:*YesNo Label(1)Please rate the following components of this program: The program met my expectations. *Strongly AgreeAgreeDisagreeStrongly Disagree The teaching and learning methods used were appropriate.*Strongly AgreeAgreeDisagreeStrongly Disagree The quality of materials and program design met my expectations.*Strongly AgreeAgreeDisagreeStrongly Disagree The information received was useful and beneficial.*Strongly AgreeAgreeDisagreeStrongly Disagree What did you like the most about this program? What did you like the least about this program? Identify topics you would like to have presented at future meetings/programs. General Comments: May we have permission to use your comments in future publicity about this program? (No personally Identifiable Information (PII) will be shown. only your first name and certification organization will be displayed) *YesNoSubmitReset
