Safe Prescribing of Opioids: Zero Unintentional Deaths Survey

The planning and execution of useful and educationally sound activities are guided in large part by input from participants. To assist us in evaluating the effectiveness of this activity and to make recommendations for future educational offerings, please take a few moments to complete this evaluation form. Your response will help ensure that future programs are informative and meet the educational needs of all participants.

* Required

	5 Strongly Agree	4	3	2	1 Strongly Disagree
Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths	Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 5 Strongly Agree	Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 4	Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 3	Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 2	Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 1 Strongly Disagree
Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids	Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 5 Strongly Agree	Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 4	Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 3	Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 2	Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 1 Strongly Disagree
Identify tools to help integrate these practices into your clinical care of patients	Identify tools to help integrate these practices into your clinical care of patients 5 Strongly Agree	Identify tools to help integrate these practices into your clinical care of patients 4	Identify tools to help integrate these practices into your clinical care of patients 3	Identify tools to help integrate these practices into your clinical care of patients 2	Identify tools to help integrate these practices into your clinical care of patients 1 Strongly Disagree
Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice	Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 5 Strongly Agree	Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 4	Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 3	Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 2	Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 1 Strongly Disagree

5 Strongly Agree

1 Strongly Disagree

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 5 Strongly Agree

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 4

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 3

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 2

Describe the prevalence and demographics of overdose deaths from prescription opioids in the United States, together with the major risk factors for unintentional overdose deaths 1 Strongly Disagree

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 5 Strongly Agree

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 4

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 3

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 2

Employ “Six practices for safe opioid prescribing” while treating chronic pain to minimize the risk of overdose deaths from prescription opioids 1 Strongly Disagree

Identify tools to help integrate these practices into your clinical care of patients

Identify tools to help integrate these practices into your clinical care of patients 5 Strongly Agree

Identify tools to help integrate these practices into your clinical care of patients 4

Identify tools to help integrate these practices into your clinical care of patients 3

Identify tools to help integrate these practices into your clinical care of patients 2

Identify tools to help integrate these practices into your clinical care of patients 1 Strongly Disagree

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 5 Strongly Agree

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 4

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 3

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 2

Integrate “Clinical Guidelines on Prescribing Opioids for Treatment of Pain” into your practice 1 Strongly Disagree

	5 Strongly Agree	4	3	2	1 Strongly Disagree
The information presented increased my awareness/understanding of the subject.	The information presented increased my awareness/understanding of the subject. 5 Strongly Agree	The information presented increased my awareness/understanding of the subject. 4	The information presented increased my awareness/understanding of the subject. 3	The information presented increased my awareness/understanding of the subject. 2	The information presented increased my awareness/understanding of the subject. 1 Strongly Disagree
The information presented will help me improve patient care.	The information presented will help me improve patient care. 5 Strongly Agree	The information presented will help me improve patient care. 4	The information presented will help me improve patient care. 3	The information presented will help me improve patient care. 2	The information presented will help me improve patient care. 1 Strongly Disagree
The program was educationally sound and scientifically balanced.	The program was educationally sound and scientifically balanced. 5 Strongly Agree	The program was educationally sound and scientifically balanced. 4	The program was educationally sound and scientifically balanced. 3	The program was educationally sound and scientifically balanced. 2	The program was educationally sound and scientifically balanced. 1 Strongly Disagree
The active learning strategies (questions, discussions, etc) were appropriate and effective.	The active learning strategies (questions, discussions, etc) were appropriate and effective. 5 Strongly Agree	The active learning strategies (questions, discussions, etc) were appropriate and effective. 4	The active learning strategies (questions, discussions, etc) were appropriate and effective. 3	The active learning strategies (questions, discussions, etc) were appropriate and effective. 2	The active learning strategies (questions, discussions, etc) were appropriate and effective. 1 Strongly Disagree
The program avoided commercial bias or influence.	The program avoided commercial bias or influence. 5 Strongly Agree	The program avoided commercial bias or influence. 4	The program avoided commercial bias or influence. 3	The program avoided commercial bias or influence. 2	The program avoided commercial bias or influence. 1 Strongly Disagree
I would recommend this program to my colleagues.	I would recommend this program to my colleagues. 5 Strongly Agree	I would recommend this program to my colleagues. 4	I would recommend this program to my colleagues. 3	I would recommend this program to my colleagues. 2	I would recommend this program to my colleagues. 1 Strongly Disagree

5 Strongly Agree

1 Strongly Disagree

The information presented increased my awareness/understanding of the subject.

The information presented increased my awareness/understanding of the subject. 5 Strongly Agree

The information presented increased my awareness/understanding of the subject. 4

The information presented increased my awareness/understanding of the subject. 3

The information presented increased my awareness/understanding of the subject. 2

The information presented increased my awareness/understanding of the subject. 1 Strongly Disagree

The information presented will help me improve patient care.

The information presented will help me improve patient care. 5 Strongly Agree

The information presented will help me improve patient care. 4

The information presented will help me improve patient care. 3

The information presented will help me improve patient care. 2

The information presented will help me improve patient care. 1 Strongly Disagree

The program was educationally sound and scientifically balanced.

The program was educationally sound and scientifically balanced. 5 Strongly Agree

The program was educationally sound and scientifically balanced. 4

The program was educationally sound and scientifically balanced. 3

The program was educationally sound and scientifically balanced. 2

The program was educationally sound and scientifically balanced. 1 Strongly Disagree

The active learning strategies (questions, discussions, etc) were appropriate and effective.

The active learning strategies (questions, discussions, etc) were appropriate and effective. 5 Strongly Agree

The active learning strategies (questions, discussions, etc) were appropriate and effective. 4

The active learning strategies (questions, discussions, etc) were appropriate and effective. 3

The active learning strategies (questions, discussions, etc) were appropriate and effective. 2

The active learning strategies (questions, discussions, etc) were appropriate and effective. 1 Strongly Disagree

The program avoided commercial bias or influence.

The program avoided commercial bias or influence. 5 Strongly Agree

The program avoided commercial bias or influence. 4

The program avoided commercial bias or influence. 3

The program avoided commercial bias or influence. 2

The program avoided commercial bias or influence. 1 Strongly Disagree

I would recommend this program to my colleagues.

I would recommend this program to my colleagues. 5 Strongly Agree

I would recommend this program to my colleagues. 4

I would recommend this program to my colleagues. 3

I would recommend this program to my colleagues. 2

I would recommend this program to my colleagues. 1 Strongly Disagree

	5 Strongly Agree	4	3	2	1 Strongly Disagree
Dr Webster demonstrated current knowledge of the topic.	Dr Webster demonstrated current knowledge of the topic. 5 Strongly Agree	Dr Webster demonstrated current knowledge of the topic. 4	Dr Webster demonstrated current knowledge of the topic. 3	Dr Webster demonstrated current knowledge of the topic. 2	Dr Webster demonstrated current knowledge of the topic. 1 Strongly Disagree
Dr Webster was organized in his presentation.	Dr Webster was organized in his presentation. 5 Strongly Agree	Dr Webster was organized in his presentation. 4	Dr Webster was organized in his presentation. 3	Dr Webster was organized in his presentation. 2	Dr Webster was organized in his presentation. 1 Strongly Disagree
Dr Webster was an effective presenter.	Dr Webster was an effective presenter. 5 Strongly Agree	Dr Webster was an effective presenter. 4	Dr Webster was an effective presenter. 3	Dr Webster was an effective presenter. 2	Dr Webster was an effective presenter. 1 Strongly Disagree

5 Strongly Agree

1 Strongly Disagree

Dr Webster demonstrated current knowledge of the topic.

Dr Webster demonstrated current knowledge of the topic. 5 Strongly Agree

Dr Webster demonstrated current knowledge of the topic. 4

Dr Webster demonstrated current knowledge of the topic. 3

Dr Webster demonstrated current knowledge of the topic. 2

Dr Webster demonstrated current knowledge of the topic. 1 Strongly Disagree

Dr Webster was organized in his presentation.

Dr Webster was organized in his presentation. 5 Strongly Agree

Dr Webster was organized in his presentation. 4

Dr Webster was organized in his presentation. 3

Dr Webster was organized in his presentation. 2

Dr Webster was organized in his presentation. 1 Strongly Disagree

Dr Webster was an effective presenter.

Dr Webster was an effective presenter. 5 Strongly Agree

Dr Webster was an effective presenter. 4

Dr Webster was an effective presenter. 3

Dr Webster was an effective presenter. 2

Dr Webster was an effective presenter. 1 Strongly Disagree

Safe Prescribing of Opioids: Zero Unintentional Deaths

1. Evaluation

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* 1. Having completed this activity, are you better able to:

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* 2. Overall Evaluation

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* 3. Was faculty disclosure information available at this activity?

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* 4. Were you advised of off-label/unapproved uses of products or devices?

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* 5. Speaker Evaluation