CSIM Evaluation Form
Your feedback is invaluable and will help us improve the meeting and plan future educational activities.


Thursday, October 11, 2018
W05. Beyond These Walls: Reaching Remote and Rural Populations with High-Quality GIM Care – Dr. Amy Hendricks

To thank you for completing these evaluation forms, we will hold a daily draw for a $25 Tim Hortons gift card. If you wish to enter, please indicate your name and email address. Winners will be announced on-site at the meeting and on social media.

Participation is optional; if you do not wish to participate, leave the following two fields blank.

One entry per session evaluated. Contact information will only be used for draw purposes. Survey responses are anonymous.

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* 1. Your Name

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* 2. Your Email Address



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* 3. Please rate this session as follows

  Poor Fair Satisfactory Good Excellent
Scientific content of this presentation
Usefulness/practicality of this presentation
Adequate time for questions/discussion
Speaker effectiveness

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* 4. Session objectives were met

  Not at all Partially Mostly Completely
Provide high-quality, non-face-to-face care for individuals living far from the usual practice setting.
Challenge the assumption of specialty care relying on patient travel and propose less costly alternatives.
Develop an efficient, rewarding model for a geographically distributed practice designed to meet the needs of patients and other care providers.

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* 5. Which CanMEDS roles do you feel were addressed during this educational activity?

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* 6. Outcomes: As a result of attending this session, are you planning to

  Yes No Maybe
Discuss the session with your colleagues
Pursue additional learning activities
Complete a Personal Learning Project (PLP)

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* 7. What new information did you learn from this session?

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* 8. What changes will you make as a result?

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* 9. As part of its continuing professional development efforts, the CSIM would like to follow up with you in three months regarding potential impact this session had on your practice.

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* 10. If you clicked "yes" above, please indicate your name and email address below:

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* 11. Bias and Balance

  Yes No Unsure
The content of this presentation was scientifically valid and balanced
This session WAS FREE from indicators of undue industry bias
This session WAS FREE from indicators of undue personal/other bias

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* 12. General Comments

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* 13. Topic suggestions for future conferences (please be as specific as possible)

An evaluation form for general conference feedback is available on the CSIM website and will also be emailed to you after the conference.

Thank you for your feedback.

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