MAPHTC: H1N1 Disease and Vaccine in Maryland Update Part 2 What Healthcare Providers Need to Know
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1. Course Evaluation
1
. If you watched with a group, how many others were watching with you?
If you watched with a group, how many others were watching with you?
2
. Did the content of the training address the stated objectives
Did the content of the training address the stated objectives
Completely
Partially
Not at all
Comments
3
. What additional information would you like to see covered in our next training
What additional information would you like to see covered in our next training
More in depth information on workshop topic(s)
More opportunity to practice/role play
Additional topic(s) covered
4
. Please rate the presenter using the following scale
Below Average
Average
Good
Excellent
Frances B. Phillips, RN, MHA,
Please rate the presenter using the following scale Frances B. Phillips, RN, MHA, Below Average
Average
Good
Excellent
David Blythe, MD, MPH
David Blythe, MD, MPH Below Average
Average
Good
Excellent
Greg Reed, MPA
Greg Reed, MPA Below Average
Average
Good
Excellent
Aaron Milstone, MD, MHS
Aaron Milstone, MD, MHS Below Average
Average
Good
Excellent
5
. On a scale of 1 -5 (1=Strongly disagree; 5= Strongly agree) please rate the following
Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
The information I gained is (or will be) useful to me
On a scale of 1 -5 (1=Strongly disagree; 5= Strongly agree) please rate the following The information I gained is (or will be) useful to me Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
The information I gained was new to me
The information I gained was new to me Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
The instructional methods/tools were effective
The instructional methods/tools were effective Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
I had sufficient opportunity to ask questions
I had sufficient opportunity to ask questions Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
This conference provided an opportunity for me to network with people that I usually do not have a chance to meet
This conference provided an opportunity for me to network with people that I usually do not have a chance to meet Strongly disagree
Disagree
Neutral
Agree
Strongly Agree
6
. How did you find out about this training (please check all that apply)
How did you find out about this training (please check all that apply)
Email
Coworker/colleague
Supervisor recommended
Other
7
. Where would you like to participate in future trainings (please check all that apply)
Where would you like to participate in future trainings (please check all that apply)
Worksite
Offsite
At this site
Other
8
. Please tell us which is the MOST desirable way for you to receive future trainings (please check all that apply)
Please tell us which is the MOST desirable way for you to receive future trainings (please check all that apply)
Distance learning
Web cast
Vidoconference
Teleconference
Face to Face workshop format
Videotape
Audiotape
CD ROM
Other
9
. What additional topics would you like for future training?
What additional topics would you like for future training?
10
. Would you recommend this conference to your colleagues
Would you recommend this conference to your colleagues
Yes
No
Please explain
11
. What degree of confidence do you have that you will apply your "new" learning in the work you do?
What degree of confidence do you have that you will apply your "new" learning in the work you do?
100%
75%
50%
25%
0%
12
. Please list TWO ways that you will use the information from this conference to enhance the work that you do
Please list TWO ways that you will use the information from this conference to enhance the work that you do
1.
2.
13
. Please make any additional comments or suggestions
Please make any additional comments or suggestions
14
. The following questions are part of our reporting requirements to our federal funders, the Health Resources and Services Administration (HRSA) and the Center for Disease Control (CDC). You cooperation will greatly assist us in continuing to offer trainings that meet your needs
In which of the following disciplines do you practice? (please Check all that apply)
The following questions are part of our reporting requirements to our federal funders, the Health Resources and Services Administration (HRSA) and the Center for Disease Control (CDC). You cooperation will greatly assist us in continuing to offer trainings that meet your needs In which of the following disciplines do you practice? (please Check all that apply)
Community Health Worker
Dentist
Environmental Health
Emergency/Bioterrorism Prep
Epidemiologist
Health Administrator
Health Promotion/Education
HIS/Biostat
Lab Sciences
Mental Health & Substance Abuse
Nurse
Nutrition
Physician
Public Health Law
Public Health Policy
Social Work
Vet
Other
15
. What type of organization do you work for?
What type of organization do you work for?
City Health Department
County Health Department
Public Health Community based organization (CBO)
State Health Department
Other
16
. What is your gender and age?
What is your gender and age?
Male - Under 20
Male - 20 - 29
Male - 30 - 39
Male - 40 - 49
Male - 50 - 59
Male - 60 or Older
Female - Under 20
Female - 20 - 29
Female - 30 - 39
Female - 40 - 49
Female - 50 - 59
Female - 60 or Older
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