1. Evaluation for Oral Health Grand Rounds held on September 15, 2017

 
100% of survey complete.

You must fill out an attendance and evaluation form in order to receive continuing education. Your forms will be delayed otherwise and you will not receive a certificate.

Also, please make sure that you are using the same email as on your attendance record. Thank you for your cooperation!.

* 1. Last Name: (Required)

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

* 3. Please check your health care discipline.

* 4. Email Address: (required for certificate)

* 5. Phone number (including area code) Required

* 6. What is the name of your organization (please do not abbreviate)?

* 7. What is your organization's street address?

* 8. What city is your organization located in?

* 9. Please list the county where your organization is?

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

  Strongly Agree Agree Undecided Disagree Strongly Disagree
Learn indications for transoral robotic surgery
Learn risk factors for developing oropharyngeal cancers
Be familiar with the role of free tissue transfer in head and neck cancer surgery

* 11. 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.

* 12. Presenter Effectiveness: This section rates the effectiveness of the presenter: Tamer Ghamen, MD, Henry Ford Medical Group, 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.

* 13. Presenter Effectiveness: This section rates the effectiveness of the presenter: Steven Chang, MD, Henry Ford Health System, 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.

* 14. 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.

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

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

* 16. Was this presentation free of commercial bias?

* 17. Overall satisfaction

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

* 18. 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). How would addressing this topic help you in your profession?

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

* 20. Additional Comments

Thank you for participating in the Oral Health Grand Rounds program on September 15,  2017 and completing the evaluation for this program.

If you have any questions please contact Victoria at victoria.lantzy@hc.msu.edu or (517)355-8250.

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