Title/topic of session Presenter Date of session * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 This educational activity met its stated objectives: Yes No This educational series was relevant to my clinical practice/training level: Strongly Agree Agree Neither Agree Nor Disagree Disagree Strongly Disagree Explain: What did you learn about the topic area discussed in this session? Rate the presentation: Poor Fair Good Excellent Content (what was said) Content (what was said) - Poor Content (what was said) - Fair Content (what was said) - Good Content (what was said) - Excellent Delivery (how it was said) Delivery (how it was said) - Poor Delivery (how it was said) - Fair Delivery (how it was said) - Good Delivery (how it was said) - Excellent Please offer feedback to the presenter(s): This educational session contributed to my professional effectiveness related to: Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree Working with an interprofessional team Working with an interprofessional team - Strongly Agree Working with an interprofessional team - Agree Working with an interprofessional team - Neither Agree nor Disagree Working with an interprofessional team - Disagree Working with an interprofessional team - Strongly Disagree Engaging in effective interprofessional communication Engaging in effective interprofessional communication - Strongly Agree Engaging in effective interprofessional communication - Agree Engaging in effective interprofessional communication - Neither Agree nor Disagree Engaging in effective interprofessional communication - Disagree Engaging in effective interprofessional communication - Strongly Disagree Defining the roles/responsibilities of my team members Defining the roles/responsibilities of my team members - Strongly Agree Defining the roles/responsibilities of my team members - Agree Defining the roles/responsibilities of my team members - Neither Agree nor Disagree Defining the roles/responsibilities of my team members - Disagree Defining the roles/responsibilities of my team members - Strongly Disagree Applying values/ethics to interprofessional practice Applying values/ethics to interprofessional practice - Strongly Agree Applying values/ethics to interprofessional practice - Agree Applying values/ethics to interprofessional practice - Neither Agree nor Disagree Applying values/ethics to interprofessional practice - Disagree Applying values/ethics to interprofessional practice - Strongly Disagree What specific changes will you make in your clinical practice as a result of your participation in this session? List them below. Explain how you will share the information provided during the session with your interprofessional team in order to develop a plan to improve patient care: What barriers do you anticipate in the implementation of best practice related to the presented topic? How will you address these barriers? Commercial bias is defined as a personal judgment in favor of a specific proprietary business interest of an entity that produces, markets, sells, or distributes healthcare goods or services consumed by, or used on, patients. It is important that CE activities accredited by the University of Wisconsin - Madison Interprofessional Continuing Education Partnership be free of commercial bias. If you perceived the presence of commercial bias in the educational content or actions of any speaker and/or planner please tell us here: List challenges, problem areas, new treatments, guidelines, drugs, etc. in your practice in which you could benefit from further education: Leave this field blank
