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Age-Friendly Care:  4M Training for Community Health Wokers

Program Evaluation

Please take a few moments to answer the following questions, which will be used to assist us in meeting your educational needs. Your feedback will be kept private and confidential and only aggregate data will be shared. On behalf of the RI Geriatric Education Center, we thank you!
What was the purpose for your participation in this activity?(Required.)
What is your primary professional discipline? (Required.)
Please list any degree(s) and professional license / certificates you hold:
PROGRAM SATISFACTION:
How satisfied with the activity were you overall?(Required.)
1 
Extremely Dissatisfied

2
3
Neutral
4
5
Extremely Satisfied
Satisfaction Rating
EVALUATION OF TRAINING:
Please use the scale below to rate the efficacy of the learning objectives, the presenters, and the instructional format:
        1=Totally ineffective    2=Somewhat ineffective     3=Somewhat effective    4=Effective    5=Highly effective
How effective was the activity in meeting the stated learning objectives?   
     Upon completion of this activity, participants will be able to:
(Required.)
1
Totally Ineffective
2
3
4
5
Highly Effective
Describe the 4M model of Age-Friendly Care.
Identify and define assessment methods to align with the 4M model of care in the areas of What Matters, Medication, Mobility and Mentation.
Discuss strategies to apply the 4Ms in practice.
Rate the effectiveness of the presenter. 
 Consider presentation style, knowledge of subject, quality of material, and practical applicability or relevance of topic in your assessment. (Required.)
1
Totally Ineffective
2
3
4
5
Highly Effective
Lidia Vognar, MD, MHS, MHA, CMD
What was the most significant thing(s) you learned as a result of participating in this activity?(Required.)
In your work with older adults, do you intent to implement at least one practice improvement learned as a result of this activity?(Required.)
RETROSPECTIVE ASSESSMENT:
Please indicate your perceived level of knowledge for each items listed below 1.) BEFORE completing the activity, and 2.) AFTER completing the activity. Rating Scale: 0% to 100% (no knowledge at all ... to most knowledge possible)(Required.)
BEFORE
AFTER
I know about the 4M model of Age-Friendly Care.
I know about assessment methods that align with the 4M model of care in the areas of What Matters, Medication, Mobility and Mentation.
I know about strategies to apply the 4Ms in practice.
Please indicate your perceived level of confidence to apply each of the items listed below 1.) BEFORE completing this activity and 2.) AFTER completing the activity.   Rating Scale: 0% to 100% (no confidence at all... to most confidence possible)(Required.)
BEFORE
AFTER
I am confident I can describe the 4M model of Age-Friendly Care
I am confident I can identify and define assessment methods to align with the 4M model of care in the areas of What Matters, Medication, Mobility and Mentation
I am confident I can discuss strategies to apply the 4Ms in practice.
Please feel free to share any additional comments and suggestions for improvement. Your feedback is extremely valuable to us. 
What topics or issues related to older adult care would you like us to address in future programs?
Please complete the information below so we may send your certificate:
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