CE Needs Assessment Survey

5. Of the following topics, please rank each column with regard to your knowledge base of the topic (1= not knowledgeable; 3= proficient) and how relevant you feel it is to your practice (1= not important; 3= very important).

	Knowledge Base	Relevant to your practice
Administrative/Management	Of the following topics, please rank each column with regard to your knowledge base of the topic (1= not knowledgeable; 3= proficient) and how relevant you feel it is to your practice (1= not important; 3= very important). Administrative/Management Knowledge Base	Relevant to your practice
Cardiovascular/Hypertension	Cardiovascular/Hypertension Knowledge Base	Relevant to your practice
Endocrine/Reproductive (i.e.Thyroid, BPH, ED, Infertility)	Endocrine/Reproductive (i.e.Thyroid, BPH, ED, Infertility) Knowledge Base	Relevant to your practice
Gastrointestinal	Gastrointestinal Knowledge Base	Relevant to your practice
Geriatrics	Geriatrics Knowledge Base	Relevant to your practice
Infectious Disease	Infectious Disease Knowledge Base	Relevant to your practice
Colds, Flu, HIV/AIDS	Colds, Flu, HIV/AIDS Knowledge Base	Relevant to your practice
Oncology	Oncology Knowledge Base	Relevant to your practice
Pulmonary, Allergies, Asthma	Pulmonary, Allergies, Asthma Knowledge Base	Relevant to your practice
Nutrition	Nutrition Knowledge Base	Relevant to your practice
Dermatology	Dermatology Knowledge Base	Relevant to your practice
Law	Law Knowledge Base	Relevant to your practice
Pediatrics	Pediatrics Knowledge Base	Relevant to your practice
Rheumatology/Arthritis	Rheumatology/Arthritis Knowledge Base	Relevant to your practice
Neurology/Psychiatry	Neurology/Psychiatry Knowledge Base	Relevant to your practice
Renal/Dialysis	Renal/Dialysis Knowledge Base	Relevant to your practice
Compounding, 797, JCAHO	Compounding, 797, JCAHO Knowledge Base	Relevant to your practice
Drug Literature	Drug Literature Knowledge Base	Relevant to your practice
Diabetes	Diabetes Knowledge Base	Relevant to your practice
Pain Management	Pain Management Knowledge Base	Relevant to your practice
Consultation/Motivational Interviewing	Consultation/Motivational Interviewing Knowledge Base	Relevant to your practice
MTM/Drug Utilization Review	MTM/Drug Utilization Review Knowledge Base	Relevant to your practice
Opthalmic/Otic	Opthalmic/Otic Knowledge Base	Relevant to your practice
OTC/Herbals	OTC/Herbals Knowledge Base	Relevant to your practice
Immunizations/Vaccinations	Immunizations/Vaccinations Knowledge Base	Relevant to your practice
Long-Term Care	Long-Term Care Knowledge Base	Relevant to your practice
Women’s Health	Women’s Health Knowledge Base	Relevant to your practice
New Drugs	New Drugs Knowledge Base	Relevant to your practice
Pharmacogenomics	Pharmacogenomics Knowledge Base	Relevant to your practice
Pharmacokinetics	Pharmacokinetics Knowledge Base	Relevant to your practice
Preceptor Training	Preceptor Training Knowledge Base	Relevant to your practice
Smoking Cessation	Smoking Cessation Knowledge Base	Relevant to your practice
Stroke	Stroke Knowledge Base	Relevant to your practice
Self Monitoring Devices	Self Monitoring Devices Knowledge Base	Relevant to your practice
HIPAA	HIPAA Knowledge Base	Relevant to your practice

What is your primary license? Pharmacist	Technician	Other
Other (please specify)

What is your preferred method of Continuing Education Delivery? Homestudy-Paper(journals, newsletters, multi-theme, etc.)	Live- Seminars (location:______________________________)	Internet
Other (please specify)

How important is having more certificate programs offered to you by the continuing education department? Very important	Neutral	Not important
Other (please specify)

1. Default Section

1. What is your primary license?

2. What is your preferred method of Continuing Education Delivery?

3. When choosing continuing education offerings, which of the following are MOST important to you?

4. How important is having more certificate programs offered to you by the continuing education department?

5. Of the following topics, please rank each column with regard to your knowledge base of the topic (1= not knowledgeable; 3= proficient) and how relevant you feel it is to your practice (1= not important; 3= very important).