Breaking the Silence pi-4853

Post Event Survey

We hope you found this education session both interesting and informative. We would like to hear from you and appreciate you taking the time to answer these survey questions.

Question Title

* 1. What date did you attend this activity?

Date / Time

Date

Question Title

* 2. Were you advised of the following disclosures?

	Yes	No
Criteria for Successful Completion in Order to be Awarded Contact Hours/Requirements for successful completion	Criteria for Successful Completion in Order to be Awarded Contact Hours/Requirements for successful completion Yes	Criteria for Successful Completion in Order to be Awarded Contact Hours/Requirements for successful completion No
Presence or Absence of Relevant Financial Relationships	Presence or Absence of Relevant Financial Relationships Yes	Presence or Absence of Relevant Financial Relationships No

Question Title

* 3. How might the format of this activity be improved?

Format was appropriate; no changes needed

Include more case-based presentations

Increase interactivity with attendees

Schedule more time for Q & A

Other (please specify)

Question Title

* 4. Share the projected impact of this activity on the following:

	YES	NO
This activity increased my knowledge of proper suicide risk assessment.	This activity increased my knowledge of proper suicide risk assessment. YES	This activity increased my knowledge of proper suicide risk assessment. NO
This activity increased my knowledge of how to document a suicide risk assessment.	This activity increased my knowledge of how to document a suicide risk assessment. YES	This activity increased my knowledge of how to document a suicide risk assessment. NO
This activity improved my knowledge of the correct procedure when suicidal ideation is identified.	This activity improved my knowledge of the correct procedure when suicidal ideation is identified. YES	This activity improved my knowledge of the correct procedure when suicidal ideation is identified. NO
I am more confident in my ability to correctly assess a patient for suicide.	I am more confident in my ability to correctly assess a patient for suicide. YES	I am more confident in my ability to correctly assess a patient for suicide. NO
I am more confident in my ability to assist a patient when suicidal ideation is identified.	I am more confident in my ability to assist a patient when suicidal ideation is identified. YES	I am more confident in my ability to assist a patient when suicidal ideation is identified. NO

Question Title

* 5. What is your level of satisfaction with this activity?

0 - Not at all satisfied

10 - Very satisfied

Clear

i We adjusted the number you entered based on the slider’s scale.

Breaking the Silence pi-4853

Post Event Survey

Question Title

* 1. What date did you attend this activity?

Question Title

* 2. Were you advised of the following disclosures?

Question Title

* 3. How might the format of this activity be improved?

Question Title

* 4. Share the projected impact of this activity on the following:

Question Title

* 5. What is your level of satisfaction with this activity?

Question Title

* 6. Additional comments/feedback: