Clone of Clone of CCO Evaluation

Learning Objectives

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Learning Objective 1	Learning Objective 1 - Strongly Agree	Learning Objective 1 - Agree	Learning Objective 1 - Neutral	Learning Objective 1 - Disagree	Learning Objective 1 - Strongly Disagree
Learning Objective 2	Learning Objective 2 - Strongly Agree	Learning Objective 2 - Agree	Learning Objective 2 - Neutral	Learning Objective 2 - Disagree	Learning Objective 2 - Strongly Disagree
Learning Objective 3	Learning Objective 3 - Strongly Agree	Learning Objective 3 - Agree	Learning Objective 3 - Neutral	Learning Objective 3 - Disagree	Learning Objective 3 - Strongly Disagree
Learning Objective 4	Learning Objective 4 - Strongly Agree	Learning Objective 4 - Agree	Learning Objective 4 - Neutral	Learning Objective 4 - Disagree	Learning Objective 4 - Strongly Disagree
Learning Objective 5	Learning Objective 5 - Strongly Agree	Learning Objective 5 - Agree	Learning Objective 5 - Neutral	Learning Objective 5 - Disagree	Learning Objective 5 - Strongly Disagree

Speaker Effective in Presenting the Material

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Speaker 1	Speaker 1 - Strongly Agree	Speaker 1 - Agree	Speaker 1 - Neutral	Speaker 1 - Disagree	Speaker 1 - Strongly Disagree
Speaker 2	Speaker 2 - Strongly Agree	Speaker 2 - Agree	Speaker 2 - Neutral	Speaker 2 - Disagree	Speaker 2 - Strongly Disagree
Speaker 3	Speaker 3 - Strongly Agree	Speaker 3 - Agree	Speaker 3 - Neutral	Speaker 3 - Disagree	Speaker 3 - Strongly Disagree

Speaker Avoided Commercial Bias or Influence

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Speaker 1	Speaker 1 - Strongly Agree	Speaker 1 - Agree	Speaker 1 - Neutral	Speaker 1 - Disagree	Speaker 1 - Strongly Disagree
Speaker 2	Speaker 2 - Strongly Agree	Speaker 2 - Agree	Speaker 2 - Neutral	Speaker 2 - Disagree	Speaker 2 - Strongly Disagree
Speaker 3	Speaker 3 - Strongly Agree	Speaker 3 - Agree	Speaker 3 - Neutral	Speaker 3 - Disagree	Speaker 3 - Strongly Disagree

Please rate your level of agreement with the following:

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The content was evidence based	The content was evidence based - Strongly Agree	The content was evidence based - Agree	The content was evidence based - Neutral	The content was evidence based - Disagree	The content was evidence based - Strongly Disagree
The educational material provided useful information for my practice	The educational material provided useful information for my practice - Strongly Agree	The educational material provided useful information for my practice - Agree	The educational material provided useful information for my practice - Neutral	The educational material provided useful information for my practice - Disagree	The educational material provided useful information for my practice - Strongly Disagree
The activity enhanced my current knowledge base	The activity enhanced my current knowledge base - Strongly Agree	The activity enhanced my current knowledge base - Agree	The activity enhanced my current knowledge base - Neutral	The activity enhanced my current knowledge base - Disagree	The activity enhanced my current knowledge base - Strongly Disagree
The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session)	The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session) - Strongly Agree	The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session) - Agree	The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session) - Neutral	The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session) - Disagree	The activity provided appropriate and effective opportunities for active learning (eg, case studies, discussion, question and answer session) - Strongly Disagree
The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity)	The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity) - Strongly Agree	The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity) - Agree	The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity) - Neutral	The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity) - Disagree	The opportunities provided to assess my own learning were appropriate (eg, questions before, during, or after the activity) - Strongly Disagree

The content presented:

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Enhanced my current knowledge base	Enhanced my current knowledge base - Strongly Agree	Enhanced my current knowledge base - Agree	Enhanced my current knowledge base - Neutral	Enhanced my current knowledge base - Disagree	Enhanced my current knowledge base - Strongly Disagree
Addressed my most pressing questions	Addressed my most pressing questions - Strongly Agree	Addressed my most pressing questions - Agree	Addressed my most pressing questions - Neutral	Addressed my most pressing questions - Disagree	Addressed my most pressing questions - Strongly Disagree
Promoted improvements or quality in healthcare	Promoted improvements or quality in healthcare - Strongly Agree	Promoted improvements or quality in healthcare - Agree	Promoted improvements or quality in healthcare - Neutral	Promoted improvements or quality in healthcare - Disagree	Promoted improvements or quality in healthcare - Strongly Disagree
Was scientifically rigorous and evidence based	Was scientifically rigorous and evidence based - Strongly Agree	Was scientifically rigorous and evidence based - Agree	Was scientifically rigorous and evidence based - Neutral	Was scientifically rigorous and evidence based - Disagree	Was scientifically rigorous and evidence based - Strongly Disagree
Avoided commercial bias or influence	Avoided commercial bias or influence - Strongly Agree	Avoided commercial bias or influence - Agree	Avoided commercial bias or influence - Neutral	Avoided commercial bias or influence - Disagree	Avoided commercial bias or influence - Strongly Disagree

Based on your participation in this activity, do you intend to change your practice behavior?

My current practice has been reinforced by the information presented

I need more information before I will change my practice

I plan to implement changes in my practice based on the information presented

Thinking about how your participation in this activity will influence your patient care, how many of your patients are likely to benefit? (eg, 250)

If you plan to change your practice behavior, what types of changes do you plan to implement?

Apply latest guidelines

Change in pharmaceutical therapy

Change in non-pharmaceutical therapy

Incorporate XXXXXXXXXXXXXXXXXX in my practice

Choice of treatment/management approach

Change in current practice for referral

Change in differential diagnosis

Other, please specify:

If you plan to change your practice behavior, what types of changes do you plan to implement? Other, please specify:

How confident are you that you will be able to make your intended changes?

Very confident

Somewhat Confident

Unsure

Not very confident

Which of the following do you anticipate will be the primary barrier to implement these changes?

Formulary restrictions

Time constraints

Healthcare system constraints

Patient adherence/compliance

Insurance/financial issues

Lack of multidisciplinary support

Treatment-related adverse events

Other, please specify:

Which of the following do you anticipate will be the primary barrier to implement these changes? Other, please specify:

Please list any clinical issues/problems within your scope of practice you would like to see addressed in future educational activities:

I do not wish to participate in a follow-up survey for this activity to help determine its effectiveness and guide the type of education Annenberg provides in the future

I do not wish to participate

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Clone of Clone of CCO Evaluation