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1. First Name

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2. Last Name

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3. Email

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4. The professional practice gap (educational needs) identified for this activity matches my current professional needs.

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5. This CME activity promotes practical changes or strategies that will enhance my professional practice and competence.

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6. This activity addresses areas of content that are relevant and have a direct impact on my professional practice or competence.

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7. Based on the stated desired learning outcomes (ideal competence) designed for this activity, my professional practice is in need of improvement(s).

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8. It is clear to me what the desired learning outcomes (educational objectives) are for this activity.

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