Example Evaluation

1 Start 2 Complete

Geisinger CE Program Evaluation

Completion of the activity evaluation is required for crediting and to obtain your certificate (if applicable).

Thank you for your feedback and participation as a life-long learner.

Overall Evaluation *

	Excellent	Very Good	Good	Fair	Poor
The content of this educational activity met my expectations.	The content of this educational activity met my expectations. - Excellent	The content of this educational activity met my expectations. - Very Good	The content of this educational activity met my expectations. - Good	The content of this educational activity met my expectations. - Fair	The content of this educational activity met my expectations. - Poor
Format enhanced achievement of program objectives.	Format enhanced achievement of program objectives. - Excellent	Format enhanced achievement of program objectives. - Very Good	Format enhanced achievement of program objectives. - Good	Format enhanced achievement of program objectives. - Fair	Format enhanced achievement of program objectives. - Poor
Level of material was appropriate for me.	Level of material was appropriate for me. - Excellent	Level of material was appropriate for me. - Very Good	Level of material was appropriate for me. - Good	Level of material was appropriate for me. - Fair	Level of material was appropriate for me. - Poor
There was adequate educational interactivity.	There was adequate educational interactivity. - Excellent	There was adequate educational interactivity. - Very Good	There was adequate educational interactivity. - Good	There was adequate educational interactivity. - Fair	There was adequate educational interactivity. - Poor
Information presented will be useful in my practice.	Information presented will be useful in my practice. - Excellent	Information presented will be useful in my practice. - Very Good	Information presented will be useful in my practice. - Good	Information presented will be useful in my practice. - Fair	Information presented will be useful in my practice. - Poor
Resources provided were useful.	Resources provided were useful. - Excellent	Resources provided were useful. - Very Good	Resources provided were useful. - Good	Resources provided were useful. - Fair	Resources provided were useful. - Poor
Change in my knowledge as a result of this program.	Change in my knowledge as a result of this program. - Excellent	Change in my knowledge as a result of this program. - Very Good	Change in my knowledge as a result of this program. - Good	Change in my knowledge as a result of this program. - Fair	Change in my knowledge as a result of this program. - Poor
Site was conducive to learning.	Site was conducive to learning. - Excellent	Site was conducive to learning. - Very Good	Site was conducive to learning. - Good	Site was conducive to learning. - Fair	Site was conducive to learning. - Poor

The content presented was fair, balanced, and free of commercial bias. *

Agree

Disagree

Please provide details

Include the speaker's name/topic and explain the concern.

Presentation 1 - Navigating the Complexities of Chronic Pain Management: A Multidisciplinary Approach - Dr. Samantha Greer, MD, MPH, Pain Medicine Specialist

Presentation 1 - Attendance

Did not attend

Speaker Evaluation

Please rate the speaker.

	Excellent	Very Good	Good	Fair	Poor
Amount and depth of material	Amount and depth of material - Excellent	Amount and depth of material - Very Good	Amount and depth of material - Good	Amount and depth of material - Fair	Amount and depth of material - Poor
Relevance of topic	Relevance of topic - Excellent	Relevance of topic - Very Good	Relevance of topic - Good	Relevance of topic - Fair	Relevance of topic - Poor
Organization and effectiveness of delivery	Organization and effectiveness of delivery - Excellent	Organization and effectiveness of delivery - Very Good	Organization and effectiveness of delivery - Good	Organization and effectiveness of delivery - Fair	Organization and effectiveness of delivery - Poor

Constructive Comments for Speaker(s)

Presentation 2 - Advancing Telemedicine in Rural Healthcare: Overcoming Barriers to Access - Dr. Marcus Li, DO, MBA, Telemedicine Expert

Presentation 2 - Attendance

Did not attend

Speaker Evaluation

Please rate the speaker.

	Excellent	Very Good	Good	Fair	Poor
Amount and depth of material	Amount and depth of material - Excellent	Amount and depth of material - Very Good	Amount and depth of material - Good	Amount and depth of material - Fair	Amount and depth of material - Poor
Relevance of topic	Relevance of topic - Excellent	Relevance of topic - Very Good	Relevance of topic - Good	Relevance of topic - Fair	Relevance of topic - Poor
Organization and effectiveness of delivery	Organization and effectiveness of delivery - Excellent	Organization and effectiveness of delivery - Very Good	Organization and effectiveness of delivery - Good	Organization and effectiveness of delivery - Fair	Organization and effectiveness of delivery - Poor

Constructive Comments for Speaker(s)

Objectives

Please rate the degree to which the objective(s) were met.

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes.	Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes. - Strongly Agree	Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes. - Agree	Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes. - Neutral	Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes. - Disagree	Identify the key components of a multidisciplinary approach to chronic pain management and how they improve patient outcomes. - Strongly Disagree
Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations.	Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations. - Strongly Agree	Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations. - Agree	Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations. - Neutral	Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations. - Disagree	Evaluate various pharmacological and non-pharmacological treatment options for chronic pain and their effectiveness in different patient populations. - Strongly Disagree
Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings.	Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings. - Strongly Agree	Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings. - Agree	Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings. - Neutral	Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings. - Disagree	Examine the current challenges and barriers to implementing telemedicine in rural healthcare settings. - Strongly Disagree
Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations.	Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations. - Strongly Agree	Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations. - Agree	Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations. - Neutral	Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations. - Disagree	Analyze the impact of telemedicine on patient access to care and health outcomes in underserved populations. - Strongly Disagree

What changes will you incorporate into your practice as a result of the knowledge acquired during this activity? *

Please check all that apply.

Change my screening/prevention practice

Incorporate different diagnostic strategies into patient evaluation

Use alternative communication methodologies with patients and families

Modify treatment plans

Other, please specify:

What changes will you incorporate into your practice as a result of the knowledge acquired during this activity? Other, please specify:

How will your participation in this activity help improve the effectiveness of your healthcare team?

The best way to improve this activity is:

Suggestions for future topics:

Additional comments

ADA Request

Did you make a request for any Americans with Disabilities Act (ADA) accommodations?

Yes

Please provide details about whether or not you were satisifed with how CE handled your request.

Leave this field blank

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