Family Focus: Evaluation Form

The following instructions are for General Practitioners wishing to use this training resource to accrue Continuing Professional Development (CPD) points.

Completion of this activity will attract 40 Category 1 points with the RACGP QI&CPD program in the 2014-2016 triennium. To claim CPD points from the RACGP (or ACRRM) please complete each of the below.

We greatly appreciate your honest feedback and your time.

The COPMI national initiative

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* 1. What is your full name?

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* 2. What is your QA & CPD number (required for RACGP accreditation)

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* 3. What is your ACCRM number? (If you are claiming Professional Development Points through the AustralianCollege of Rural and Remote Medicine - ACRRM).

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* 4. What is the name of your primary place of work? (In case we need to contact you)

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* 5. What is your email address? (So that we can contact you to confirm your CPD point allocation)

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* 6. To receive CPD points: First, complete the online survey.

Yes - survey complete

No - I have not completed this survey

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* 7. Choose to complete one of the following activities:

1. Watch the Family Focus DVD. You can view the DVD footage online or order a copy from the COPMI website.

2. Read advice and guidelines for GPs working with parents with a mental illness at the COPMI website.

I have watched Family Focus DVD footage

I have read advice and guidelines for GPs at the COPMI website

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* 8. Please rate to what degree the learning objectives of the program were met. Did this resource assist you to:

	Not met	Partially met	Entirely met
Describe how parental depression or anxiety may impact on children, parents and families.	Describe how parental depression or anxiety may impact on children, parents and families. Not met	Describe how parental depression or anxiety may impact on children, parents and families. Partially met	Describe how parental depression or anxiety may impact on children, parents and families. Entirely met
Identify strategies to prevent mental illness and promote mental health in children of parents with depression and/or anxiety	Identify strategies to prevent mental illness and promote mental health in children of parents with depression and/or anxiety Not met	Identify strategies to prevent mental illness and promote mental health in children of parents with depression and/or anxiety Partially met	Identify strategies to prevent mental illness and promote mental health in children of parents with depression and/or anxiety Entirely met
Be able to apply the Family Focus preventive intervention with target families.	Be able to apply the Family Focus preventive intervention with target families. Not met	Be able to apply the Family Focus preventive intervention with target families. Partially met	Be able to apply the Family Focus preventive intervention with target families. Entirely met

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* 9. Please rate the below:

	Not met	Partially met	Entirely met
To what degree were your learning needs were met?	To what degree were your learning needs were met? Not met	To what degree were your learning needs were met? Partially met	To what degree were your learning needs were met? Entirely met
To what degree is this activity relevant to your practice?	To what degree is this activity relevant to your practice? Not met	To what degree is this activity relevant to your practice? Partially met	To what degree is this activity relevant to your practice? Entirely met

Question Title

* 1. What is your full name?

Question Title

* 2. What is your QA & CPD number (required for RACGP accreditation)

Question Title

* 3. What is your ACCRM number? (If you are claiming Professional Development Points through the AustralianCollege of Rural and Remote Medicine - ACRRM).

Question Title

* 4. What is the name of your primary place of work? (In case we need to contact you)

Question Title

* 5. What is your email address? (So that we can contact you to confirm your CPD point allocation)

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* 6. To receive CPD points: First, complete the online survey.

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* 7. Choose to complete one of the following activities: 1. Watch the Family Focus DVD. You can view the DVD footage online or order a copy from the COPMI website. 2. Read advice and guidelines for GPs working with parents with a mental illness at the COPMI website.

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* 8. Please rate to what degree the learning objectives of the program were met. Did this resource assist you to:

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* 9. Please rate the below:

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* 10. Do you have any other comments regarding the course?

* 7. Choose to complete one of the following activities:

1. Watch the Family Focus DVD. You can view the DVD footage online or order a copy from the COPMI website.

2. Read advice and guidelines for GPs working with parents with a mental illness at the COPMI website.