Developmental Screening Learning Collaborative Kickoff 2018

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* 1. Overall, how would you rate this educational activity?

Excellent

Very Good

Good

Fair

Poor

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* 2. Overall, how would you rate the speaker’s competence and expertise? Anna Smith & Christy Cronheim (ITP)

Excellent

Very Good

Good

Fair

Poor

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* 3. Overall, how would you rate the speaker’s competence and expertise? J.T. Leavell, MD

Excellent

Very Good

Good

Fair

Poor

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* 4. Overall, how would you rate the speaker’s competence and expertise? Nicole Van Borkulo (QI Expert)

Excellent

Very Good

Good

Fair

Poor

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* 5. Overall, how would you rate the speaker’s competence and expertise? Tom Patterson, MD

Excellent

Very Good

Good

Fair

Poor

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* 6. Do you feel each of the following objectives was met?*

Identify and utilize validated screening tools, screen early and screen often, document and interpret screening results

Screen for appropriate development at all of the recommended American Academy of Pediatric Bright Futures Periodicity Schedule

Cite appropriate resources for children with diagnosed or suspected developmental delays (Please add additional rows for additional objectives)

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* 7. On which of the following areas of your practice do you feel this activity will have a projected impact?* (Check all that apply)

Knowledge

Competence

Performance

Patient Outcomes

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* 8. Which of the following competency areas do you feel were addressed by this activity?* (Check all that apply)

Patient care or patient-centered care

Medical knowledge

Practice-based learning & improvement

Interpersonal & communication skills

Professionalism

System-based practice

Interdisciplinary teams

Employ evidence-based practice

Quality improvement

Utilize informatics

None of the above

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* 9. Do you feel the activity was evidence-based, balanced and free of commercial bias or influence?*

Yes

If No, please explain:

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* 10. As a result of participating in this activity, how will you change your practice?* (Check all that apply)

This activity validated my current practice; no changes will be made

Create/revise protocols, policies, and/or procedures

Change the management and/or treatment of my patients

Other (please specify)

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* 11. Did the activity have practical application for your professional needs?

Yes

Retired

If No, and actively practicing, please explain:

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* 12. Did you have an opportunity to discuss practice-relevant questions with speakers and have your questions answered?

Yes

If No, please explain:

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* 13. Please indicate your profession:

MD/DO

PharmD/RPh

Other (please specify)