1 Start 2 Complete Was disclosure of faculty relationships with commercial entities made to the audience prior to the start of the activity? * Yes No I was not there prior to the start of the activity Activity met the stated purpose/objective(s)? * Yes No Was there any evidence of bias in the activity/session? * Yes No If yes, please specify * Would you recommend this activity to your peers? * Definitely recommend Likely to recommend Unlikely to recommend Definitely NOT recommend Rate each speaker/author/moderator on their ability to deliver clear and actionable education * ExcellentAbove AverageAverageBelow AveragePoor Speaker Speaker - Excellent Speaker - Above Average Speaker - Average Speaker - Below Average Speaker - Poor Speaker Speaker - Excellent Speaker - Above Average Speaker - Average Speaker - Below Average Speaker - Poor Speaker Speaker - Excellent Speaker - Above Average Speaker - Average Speaker - Below Average Speaker - Poor Performance Improvement As a part of the accreditation process, we will follow up with a sample of participants 3-6 months after the activity and will cite responses to the following questions. Do you wish MOC credit? * Yes No If yes you must add a reflective statement To earn ABIM MOC points you MUST make a reflect statement by answering this question: Briefly describe what you have learned AND indicate a commitment to change or maintain an element of practice Do you wish Nursing CE? * Yes No Provide 3 examples of how you will implement changes in your practice * Briefly describe what you have learned AND indicate a commitment to change or maintain an element of practice * Additional Comments or other topics that would help you improve your performance. Leave this field blank
