CME On Demand Evaluation/Attestation Form

Aspirus Wausau Hospital is accredited by the Wisconsin Medical Society to provide continuing medical education programs. In order to continue offering CME, we are required to document outcomes and barriers to change to fulfill the requirements of our accreditation. Your feedback is very important; please know that no attendee names are included on the summary sent to the speaker(s) or the committee reviewing the summary.  Thank you.

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* 1. Speaker (Paul DeChant, MD, MBA) - Presentation Skills

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* 2. Speaker (Paul DeChant, MD, MBA) - Content

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* 3. Speaker (Paul DeChant, MD, MBA) - Objectivity (no commercial support and/or pharmaceutical bias)

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* 4. Speaker (Paul DeChant, MD, MBA) - Time allowed

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* 5. OBJECTIVES: Was learning objective #1 met? Provide a brief overview of the causes, manifestations, and implications of physician burnout, including why burnout has gotten worse in the past 10 years

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* 6. OBJECTIVES: Was learning objective #2 met? Learn a comprehensive approach to improving the clinical workplace to reduce the risk of burnout

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* 7. OBJECTIVES: Was learning objective #3 met? Identify specific actions physician and non-physician leaders can take to support front line physicians and staff workers

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* 8. Did the presentation reinforce your current practice?

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* 9. Will the information alter your practice performance?

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* 10. If the information will alter your practice performance, do you believe it will produce a change in your diagnostic methods?

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* 11. If the information will alter your practice performance, do you believe it will produce a change in your treatments?

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* 12. If the information will alter your practice performance, do you believe it will produce a change in your general patient care?

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* 13. As a result of this program, what will you change when you go back to work? What will you share with your team?

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* 14. What barriers do you anticipate in incorporating what you learned in your work (check all that apply)?

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* 15. Attestation:

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* 16. This evaluation also serves as your sign-in form for viewing the presentation online. Please type your first and last name.

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* 18. Please enter your email address.

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* 19. Please enter the name of your Aspirus Hospital or Clinic, or address if you do not work at Aspirus

Thank you!  A certificate of attendance will be provided to you within 24 hours.

Statement of Accreditation: Aspirus Wausau Hospital is accredited by the Wisconsin Medical Society to provide continuing medical education for physicians.

Credit Designation Statement: Aspirus Wausau Hospital designates this live educational activity for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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