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* 1. Date of Session

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* 2. What is your profession?

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* 3. Please indicate how this activity helps to meet and fulfill the mission of continuing professional education. Check all that apply

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* 4. The educational activity was:

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Un-biased, free from commercial influence
Balanced and evidence-based
Effective in changing provider skills, strategies, or performance

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* 5. Faculty Rating

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* 6. As a result of participating in this activity, I am better able to integrate a team-based approach to caring for our patients.

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* 7. An example of what I or our team will change is:

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* 8. What was done well with this activity?

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* 9. What needs to improve?

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* 10. Your information

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