Thrombosis Canada Needs Assessment

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* 1. Most of the patients with Thrombosis that I see have problems in the following areas, so I would be interested in CPD on these topics:

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* 2. List the two diagnoses/clinical problems in Thrombosis that you most frequently encounter:

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* 3. What skills or procedures related to Thrombosis would you benefit from learning or reviewing?

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* 4. What practice gaps in Thrombosis, if any, have you observed among healthcare providers? (A practice gap is the difference between actual and ideal performance.) Professional practice gaps are measured in terms of:

Knowledge: being aware of what to do.

Competence: being able to apply knowledge, skills, and judgment in practice‐ knowing how to do something.

Performance: having the ability to implement the strategy or skill‐what one actually does.

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* 5. What gaps in Thrombosis do you believe are directly affecting your practice? Please check off any or all of the following:

Basic Knowledge

Technical Skill (ability to execute)

Outcomes/Results

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* 6. Which of the following subject areas in Thrombosis would this gap apply to? (Please check off all that apply):

Diagnosis of DVT/PE

Management of DVT/PE

Cancer-associated Thrombosis

Thrombosis in Women

Thrombosis management in the Emergency Department

Thrombosis management in special populations (Obesity, Thrombophilia, etc)

Anticoagulants and other medications

Anticoagulants and bleeding

Periprocedural management of anticoagulation

Anticoagulation and renal failure

Other (please specify)

Thrombosis Canada Needs Assessment

Question Title

* 1. Most of the patients with Thrombosis that I see have problems in the following areas, so I would be interested in CPD on these topics:

Question Title

* 2. List the two diagnoses/clinical problems in Thrombosis that you most frequently encounter:

Question Title

* 3. What skills or procedures related to Thrombosis would you benefit from learning or reviewing?

Question Title

* 4. What practice gaps in Thrombosis, if any, have you observed among healthcare providers? (A practice gap is the difference between actual and ideal performance.) Professional practice gaps are measured in terms of:

Question Title

* 5. What gaps in Thrombosis do you believe are directly affecting your practice? Please check off any or all of the following:

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* 6. Which of the following subject areas in Thrombosis would this gap apply to? (Please check off all that apply):

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* 7. Where do you go to get information about Thrombosis (website(s), publication, colleague, etc.). Please list all sources.

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* 8. Have you ever used the Thrombosis Canada website or App?

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* 9. Additional comments

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* 10. Name (Optional for discount to conference)

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* 11. E-mail address (Optional for discount to conference)