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Spring CME Conference on Adolescent Health Evaluation Survey

Adolescent Health CME Evaluation Survey

Please complete this evaluation survey in order to receive a CME or CE credit certificate. Make sure to answer all of the questions for each presentation you attended. If you did not attend a particular presentation, please skip that question. Thank you!

1.Full Name
(Please make sure to type it as you want it to appear on your certificate)(Required.)
2.AAP ID#
(If you are not an AAP member, write N/A)(Required.)
3.Type of practice or license(Required.)
4.Email address (Required.)
5.This virtual format educational program met my expectations for improving my knowledge of the topics presented.(Required.)
6.Risk Taking in Adolescence | Bonnie Halpern-Felsher, PhD, FSAHM
Excellent
Above Average
Average
Below Average
Poor
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
7.Adolescent Mental Health | Shashank Joshi, MD, FAAP, DFAACAP
Excellent
Above Average
Average
Below Average
Poor
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
8.Adolescent Media Use and Abuse | Shafia Zaloom
Excellent
Above Average
Average
Below Average
Poor
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
9.Small Group Discussion:
Motivational Interviewing | Seth Ammerman, MD, FAAP
Excellent
Above average
Average
Below Average
Poor
N/A (Did not attend this session)
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
10.Small Group Discussion:
In- & Out-Patient Substance Abuse Counseling & Treatment | Steven Peterson, LCSW, CADCIII
Excellent
Above average
Average
Below Average
Poor
N/A (Did not attend this session)
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
11.Small Group Discussion:
Hands on Learning About PEARLS Screening and ACEs in Teens with Role Play and Discussions | Miriam Rhew, MD, MPH, FAAP & Deirdre Bernard-Pearl, MD, FAAP
Excellent
Above average
Average
Below Average
Poor
N/A (Did not attend this session)
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
12.Small Group Discussion:
Physician Wellness and Self-Care | Hailey Nelson, MD, FAAP, IBCLC
Excellent
Above average
Average
Below Average
Poor
N/A (Did not attend this session)
Topic knowledge
Ability to communicate
Clarity of materials
Relevance to my practice
Questions 13-22 about program evaluation and outcome are required for our accreditation documentation, so please be sure to complete this section of the survey. Thank you!
13.How well did the Adolescent Health CME Conference meet your educational expectations?(Required.)
Exceeded Expectations
Met Expectations
Did NOT Meet Expectations
14.Were the learning objectives of this CME activity achieved?(Required.)
15.Based on what you learned in this activity, do you plan to change:
(a) The strategies you implement in practice?(Required.)
16.Based on what you learned in this activity, do you plan to change:
(b) What you do in practice?(Required.)
17.If YES to either of the above questions, please identify any changes in practice that you plan to make:
18.If NO and you do not plan to make changes in practice, other than lack of time and resources, why not? (select all that apply)
19.On a scale of 1 to 7, what was the return on your investment of time/effort for participating in this activity?(Required.)
1 (High Return)
2
3
4 (Medium Return)
5
6
7 (Low Return)
20.Do you feel a commercial product, device, or service was inappropriately promoted in the educational content?(Required.)
21.Are you a member of NAPNAP (National Association of Pediatric Nurse Practitioners)?(Required.)
22.How would you rate your overall satisfaction with this CME activity?(Required.)
Very Satisfied
Satisfied
Not Satisfied
23.Would you recommend this activity to a colleague based on its impact on your practice/patient care?
24.On a scale of 1 to 7, what is the likelihood that what you learned in this activity will result in improvement
in your patients’ health status?
Highly Likely
Highly Unlikely
25.Will you use the information you learned in this activity to enhance any of the following:
26.Which lecture did you find the most valuable?
27.Which small group discussion did you find the most valuable?
28.Do you have any other comments?
Thank you for completing the Program and Speaker Evaluation. Once your response has been registered you will receive your CME or CE certificate via the email address supplied on this survey.

For questions, please contact info@aapca1.org or call 916-274-4173.
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