Managing Conflict Between Patients, Families and Providers

Program Evaluation

We appreciate your participation in our continuing education activity. Your responses will allow us to improve our program offerings and services. Thank you for your time.

SECTION 1
Please use the scale below to rate the questions:
1= Not at all confident
2= Somewhat confident
3= Mostly confident
4= Fully confident

Question Title

* 1. Evaluation of Training
Using the rating key, how confident were you BEFORE in your ability to:

	1	2	3	4
Recognize that in life threatening situations anger is a common response	Recognize that in life threatening situations anger is a common response 1	Recognize that in life threatening situations anger is a common response 2	Recognize that in life threatening situations anger is a common response 3	Recognize that in life threatening situations anger is a common response 4
Describe communication techniques for defusing anger	Describe communication techniques for defusing anger 1	Describe communication techniques for defusing anger 2	Describe communication techniques for defusing anger 3	Describe communication techniques for defusing anger 4
Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 1	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 2	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 3	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 4

Question Title

* 2. Evaluation of Training
Using the rating key, how confident are you AFTER in your ability to:

	1	2	3	4
Recognize that in life threatening situations anger is a common response	Recognize that in life threatening situations anger is a common response 1	Recognize that in life threatening situations anger is a common response 2	Recognize that in life threatening situations anger is a common response 3	Recognize that in life threatening situations anger is a common response 4
Describe communication techniques for defusing anger	Describe communication techniques for defusing anger 1	Describe communication techniques for defusing anger 2	Describe communication techniques for defusing anger 3	Describe communication techniques for defusing anger 4
Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 1	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 2	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 3	Apply recommended skills to deal with conflict and guide patients families and other clinicians through difficult decisions 4

Question Title

* 3. Evaluation of Presenter
To what extent did the presenter accomplish the following:

	1	2	3	4
a. Presented information clearly	a. Presented information clearly 1	a. Presented information clearly 2	a. Presented information clearly 3	a. Presented information clearly 4
b. Knowledge of Subject	b. Knowledge of Subject 1	b. Knowledge of Subject 2	b. Knowledge of Subject 3	b. Knowledge of Subject 4
c. Quality of Material	c. Quality of Material 1	c. Quality of Material 2	c. Quality of Material 3	c. Quality of Material 4
d. Practical applicability or relevance of topic	d. Practical applicability or relevance of topic 1	d. Practical applicability or relevance of topic 2	d. Practical applicability or relevance of topic 3	d. Practical applicability or relevance of topic 4

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* 4. What was the most significant thing(s) you learned today?

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* 5. Do you intend to implement at least one practice improvement learned as a result of this learning activity?

Yes

N/A

If yes, please describe:

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* 6. What could we do to improve this training session? Please feel free to share any additional comments and suggestions. Your feedback is extremely valuable to us.

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* 7. Are you interested in receiving continuing education credits?

Yes

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* 8. If yes, what type of continuing education credit are you interested in?

Continuing Nursing Education (CEU)

Social Work

Medicine (CME)

Certificate of Attendance

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* 9. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Roger Williams Medical Center and the Rhode Island Geriatric Education Center. Roger Williams Medical Center is accredited by the Rhode Island Medical Society to provide continuing medical education for physicians.

Roger Williams Medical Center designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Please claim credit based on the time you spent in this activity.

I claim _____credit(s).

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* 10. Please enter your information (below) so we may send you a certificate

Full Name and Credentials

Preferred Email address

Organization

State

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* 1. Evaluation of TrainingUsing the rating key, how confident were you BEFORE in your ability to:

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* 2. Evaluation of TrainingUsing the rating key, how confident are you AFTER in your ability to:

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* 3. Evaluation of PresenterTo what extent did the presenter accomplish the following:

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* 4. What was the most significant thing(s) you learned today?

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* 5. Do you intend to implement at least one practice improvement learned as a result of this learning activity?

Question Title

* 6. What could we do to improve this training session? Please feel free to share any additional comments and suggestions. Your feedback is extremely valuable to us.

Question Title

* 7. Are you interested in receiving continuing education credits?

Question Title

* 8. If yes, what type of continuing education credit are you interested in?

Question Title

Question Title

* 10. Please enter your information (below) so we may send you a certificate

* 1. Evaluation of Training
Using the rating key, how confident were you BEFORE in your ability to:

* 2. Evaluation of Training
Using the rating key, how confident are you AFTER in your ability to:

* 3. Evaluation of Presenter
To what extent did the presenter accomplish the following: