Blank Survey CME COURSE EVALUATION MASTER Thank you for attending a course accredited by Boston Children’s Hospital, we hope you enjoyed it. All evaluation results are anonymous, and will help provide guidance and feedback to improve future educational offerings from Boston Children’s Hospital. Please complete the evaluation below in order to receive your certificate. The following questions are asked regarding the overall course, and content presented. Please answer accordingly: 1. Please identify your profession type(Required) Physician (MD/DO) Nurse Pharmacist Physician Assistant Psychologist Social Worker Optometrist Dentist Athletic Trainer Physical Therapist Dietitian Other Please specify 2. Overall course rating:(Required) Excellent Very Good Neutral Fair Poor 3. How would you rate your overall satisfaction with this course?(Required) Completely Satisfied Mostly Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Mostly Dissatisfied Completely Dissatisfied 4. Will you make clinical, teaching, research or administrative changes as a result of engaging in this course?(Required) Yes, please specify No What changes will you make?5. If you will not make changes as a result of taking this course, why not? Current practice is satisfactory I disagreed with the recommendations made Lack of time Lack of resources Lack of support for change by administration Costs Patient barriers Other (please specify) Why will you not make changes?6. Were all of the identified course objectives met? (list below)(Required) Yes No, please specify Which objectives were not met? Please indicate if you agree or disagree with the following statements: 7. The educational activity helped to address, overcome, or remove barriers to change in my personal practice.Strongly AgreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly Disagree8. This course improved my ability to work efficiently with healthcare team members who do not share my same title or professional training.Strongly agreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly Disagree9. This course improved my ability to communicate efficiently with healthcare team members who do not share my same title or professional training.Strongly agreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly DisagreePlease respond to the following questions regarding the overall presentations, and provide specific feedback where you feel appropriate and necessary. 10. The format and educational methodologies engaged me in learning and were appropriate for the objectives and desired results.(Required)Strongly AgreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly Disagree11. The course content was appropriate for the length of the presentations.Strongly agreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly Disagree12. The content of the presentation was organized and clear to understand.Strongly agreeAgreeSomewhat AgreeNeutralSomewhat DisagreeDisagreeStrongly disagree13. Would you be interested in attending another presentation by this speaker? Yes No Why would you not be interested in other presentations by this speaker?14. Please include any presentation or speaker specific feedback related to this course here:15. Please include any overall course feedback related to this course here:16. Do you have suggestions for future educational courses?17. How did you hear about the course? Social Media Email Word of Mouth Past Attendee Direct Mail (brochure save the date, etc.) PhoneThis field is for validation purposes and should be left unchanged.