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Your feedback will betaken into consideration when planning CME events in the future. Please return your completed evaluation form to the registration desk as you leave.  \nLearning Objectives – The following learning objectives were met. Please circle your response  \n\n| 5-Strongly Agree | 4 – Agree | 3 – Somewhat Agree | 2-Disagree | 1-Strongly Disagree |\n| --- | --- | --- | --- | --- |\n| \u003CInsert Objectives Here> |  |  |  |  |\n|  |  |  |  | 5 4 3 2 1 |\n|  |  |  |  | 5 4 3 2 1 |\n|  |  |  |  | 5 4 3 2 1 |\n|  |  |  |  | 5 4 3 2 1 |\n\nPlease rate the content and quality of the speaker’s presentation. Please circle your response.  \n\n| 5-Excellent | 4 – Above Average | 3-Average | 2-Fair | 1-Poor |\n| --- | --- | --- | --- | --- |\n| \u003CInsert Topic Here> |  |  | CONTENT | SPEAKER |\n|  |  |  |  |  |\n|  |  |  | 5 4 3 2 1 | 5 4 3 2 1 |\n\nWere the speaker’s commercial relationships and types of relationships disclosed to the audience (either by announcement, distribution, slide or listed in the front of the syllabus) prior to the beginning of the activity? Alternatively, if the speaker(s) had no relationships to disclose was the audience informed prior to the activity?  \nYes □ No □  \nIf a conflict of interest was identified, was the method of resolution disclosed to the audience?  \nYes □ No □  \nCME activities are required to be evidence based and bias free. Do you feel the presentation was balanced and free from commercial bias? Yes □ No □  \nIf no, please explain;  \n\n|  |\n| --- |\n|  |\n\nContinued on Opposite Side 􀃆  \nWill information obtained from this activity alter your practice/procedure? Yes □ No □ Somewhat □  \nWill you develop mechanisms to influence behavior changes in your patients? If yes, please explain Print clearly:  \nList two things you will do differently in your practice as a result of this activity.  \nIs there a performance or quality gap that can be addressed for you in a future program?  \nWhat additional topics would you like us to cover in future programs?  \nList one new fact or concept learned from this activity.  \nPlease rate the audiovisuals.  \nPlease rate the facility.  \nExcellent □  \nExcellent □  \nSatisfactory □  \nSatisfactory □  \nPoor □  \nPoor □  \nHow did you find out about this program?  \nComments:  \n\n|  |\n| --- |\n|  |\n\nThank you.  \nRev. May 2013","cbCaihTo0pxNfki6","https://ap.wps.com/l/cbCaihTo0pxNfki6","pdf",242530,"English","# Learning Objectives\n# Content and Speaker Presentation Rating\n# Disclosures and Bias Questions\n# Impact on Practice and Behavior Change\n# Future Program Needs\n# Ratings for Audiovisuals and Facility\n# How You Found Out About the Program\n# Comments","[{\"question\":\"该评估表主要用于收集哪些类型的反馈？\",\"answer\":\"用于收集对学习目标达成情况、讲者演示内容与讲者表现的评分，以及关于商业关系披露、利益冲突处理与偏倚的态度反馈。\"},{\"question\":\"是否要求评估讲者的商业关系披露与偏倚情况？\",\"answer\":\"是的。表格会询问讲者商业关系是否在活动开始前向听众披露、若发现利益冲突是否披露解决方法，以及参与者是否认为演示平衡且不受商业偏倚影响。\"},{\"question\":\"表格还会评估哪些改进或后续需求？\",\"answer\":\"会询问活动信息是否会改变实践/流程、是否会制定影响患者行为的机制、希望未来项目覆盖的主题、以及需要解决的绩效或质量差距等内容。\"}]","EVALUATION TEMPLATE - Evaluation Form for CME Program Activities - Feedback Survey | PDF",1789842579]