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Evaluation for Geriatric Grand Rounds held on October 4, 2017

You must fill out an attendance & evaluation form in order to receive continuing education. Please note that it can take 6-8 weeks to receive your certificate.

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* 1. Last Name: (Required)

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* 2. First Name; Degree: (required for certificate)

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* 3. Please check your health care discipline.

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* 4. Email Address: (required for certificate)

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* 5. Phone number (including area code) Required

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* 6. what is the name of your organization? Please do not abbreviate.

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* 7. What is the city and zip code where your organization is located?

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* 8. What is the name of the county where the site is located? (required)

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* 9. Please indicate how well the speaker(s) met each of the stated learning outcomes?

  Strongly Agree Agree Undecided Disagree Strongly Disagree
Define the terms decision-making capacity and competency
Identify warning signs that a person's decision-making capacity may be impaired
List items that need to be documented to support an assessment of decision-making capacity

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* 10. This section addresses the appropriateness and design of the course content.

  Strongly Agree Agree Undecided Disagree Strongly Disagree
a. The content was clearly organized.
b. The content had a good blend of theoretical and practical information.

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* 11. Presenter Effectiveness: This section rates the effectiveness of the presenter: Mark Ensberg, MD, Associate Professor of Geriatrics, Michigan State University, Department of Family Medicine, effectively.

  Strongly Agree Agree Undecided Disagree Strongly Disagree
a. The presenter was knowledgeable.
b. The presenter was well prepared
c. The presenter answered questions adequately/clearly.

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* 12. Instructional Strategies/Materials/Facilities: This section evaluates the delivery of content/materials used and appropriateness of activity site.

  Strongly Agree Agree Undecided Disagree Strongly Disagree
a. The activities and examples provided an opportunity to see how content is related to my job.
b. The educational activity site/room was appropriate.

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* 13. Transfer Expectation: This section evaluates how you plan to apply the content to your job.

  Strongly Agree Agree Undecided Disagree Strongly Disagree
a. I will be able to transfer this content to my work environment.

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* 14. Overall satisfaction

  Strongly Agree Agree Undecided Disagree Strongly Disagree
Overall, I am satisfied with this educational activity

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* 15. What patient issues, problems, or challenges do you feel that you're not able to address appropriately to your satisfaction? (This will help us in designing future program offerings and required by continuing education accreditation).

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* 16. What educational sessions would you like offered? (This will help us in designing future program offerings.)

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* 17. Comments

Thank you for participating in the Geriatric Grand Rounds Program on October 4, 2017 and completing the evaluation for this program. If you have any questions, please contact Victoria at (517) 355-8250.
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