Please rate the effectiveness of the faculty *

	High	Above Average	Average	Below Average	Low
Bradley Monk, MD, DFACOG, GACS	Bradley Monk, MD, DFACOG, GACS - High	Bradley Monk, MD, DFACOG, GACS - Above Average	Bradley Monk, MD, DFACOG, GACS - Average	Bradley Monk, MD, DFACOG, GACS - Below Average	Bradley Monk, MD, DFACOG, GACS - Low
Paula Anastasia, RN, MN, AOCN	Paula Anastasia, RN, MN, AOCN - High	Paula Anastasia, RN, MN, AOCN - Above Average	Paula Anastasia, RN, MN, AOCN - Average	Paula Anastasia, RN, MN, AOCN - Below Average	Paula Anastasia, RN, MN, AOCN - Low

As a result of participating in this activity, I am better able to *

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Describe scientific updates and key practice changes in the management of gynecologic cancer	Describe scientific updates and key practice changes in the management of gynecologic cancer - Strongly Agree	Describe scientific updates and key practice changes in the management of gynecologic cancer - Agree	Describe scientific updates and key practice changes in the management of gynecologic cancer - Neutral	Describe scientific updates and key practice changes in the management of gynecologic cancer - Disagree	Describe scientific updates and key practice changes in the management of gynecologic cancer - Strongly Disagree
Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology	Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology - Strongly Agree	Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology - Agree	Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology - Neutral	Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology - Disagree	Identify the common disease symptoms and/or side effects encountered in the management of gynecologic cancer and detail the best management strategies utilized by advanced practitioners in oncology - Strongly Disagree
Discuss the role of genetic testing in gynecologic malignancies	Discuss the role of genetic testing in gynecologic malignancies - Strongly Agree	Discuss the role of genetic testing in gynecologic malignancies - Agree	Discuss the role of genetic testing in gynecologic malignancies - Neutral	Discuss the role of genetic testing in gynecologic malignancies - Disagree	Discuss the role of genetic testing in gynecologic malignancies - Strongly Disagree
Identify management strategies for sexual dysfunction secondary to gynecologic cancer	Identify management strategies for sexual dysfunction secondary to gynecologic cancer - Strongly Agree	Identify management strategies for sexual dysfunction secondary to gynecologic cancer - Agree	Identify management strategies for sexual dysfunction secondary to gynecologic cancer - Neutral	Identify management strategies for sexual dysfunction secondary to gynecologic cancer - Disagree	Identify management strategies for sexual dysfunction secondary to gynecologic cancer - Strongly Disagree
Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers	Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers - Strongly Agree	Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers - Agree	Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers - Neutral	Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers - Disagree	Describe collaboration between various members of the healthcare team (including but not limited to physician, advanced practitioner, and pharmacist) in the treatment of gynecologic cancers - Strongly Disagree

Please rate your level of agreement with the following statements *

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
This activity met my educational needs, expectations, and objectives	This activity met my educational needs, expectations, and objectives - Strongly Agree	This activity met my educational needs, expectations, and objectives - Agree	This activity met my educational needs, expectations, and objectives - Neutral	This activity met my educational needs, expectations, and objectives - Disagree	This activity met my educational needs, expectations, and objectives - Strongly Disagree
This activity was relevant to my practice	This activity was relevant to my practice - Strongly Agree	This activity was relevant to my practice - Agree	This activity was relevant to my practice - Neutral	This activity was relevant to my practice - Disagree	This activity was relevant to my practice - Strongly Disagree
I feel confident treating patients in my practice based on this activity	I feel confident treating patients in my practice based on this activity - Strongly Agree	I feel confident treating patients in my practice based on this activity - Agree	I feel confident treating patients in my practice based on this activity - Neutral	I feel confident treating patients in my practice based on this activity - Disagree	I feel confident treating patients in my practice based on this activity - Strongly Disagree
This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months	This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months - Strongly Agree	This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months - Agree	This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months - Neutral	This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months - Disagree	This activity rates highly in comparison with other CE/CME activities in which I have participated in the last 12 months - Strongly Disagree
The presentation was scientifically sound and free of commercial bias or influence	The presentation was scientifically sound and free of commercial bias or influence - Strongly Agree	The presentation was scientifically sound and free of commercial bias or influence - Agree	The presentation was scientifically sound and free of commercial bias or influence - Neutral	The presentation was scientifically sound and free of commercial bias or influence - Disagree	The presentation was scientifically sound and free of commercial bias or influence - Strongly Disagree

If you thought the presentations were commercially biased, please explain

For you, was the educational level of this activity *

Too basic

Appropriate

Too advanced

Of all of the patients that you see per month, how many are likely to be impacted by the information that you acquired in this CE/CME activity? (example: 50) *

Based upon your participation in this activity, choose the statements that apply *

I plan to implement new strategies/ skills/ information

I gained new strategies/ skills/ information that I can apply to my area of practice

I need more information before I can implement new strategies/ skills/ information

My current practice is consistent with the information presented

This topic is not within my scope of practice

I do not agree with the information presented

What, if any, additional changes do you plan to implement into your practice?

My confidence level in being able to implement these changes is *

Very confident

Somewhat confident

Uncertain

Little confidence

No confidence

Not Applicable

If you consider a change in practice, please check any barriers to overcome before initiating that change *

Organizational constraints

Formulary issues

Patient reluctance to change

Patient nonadherence

Insufficient time

Financial/Insurance

Do not know enough about the recommendations to change yet

What still remains unanswered for you?

Additional comments

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