Disclosing a Dementia Diagnosis

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!

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* 1. What was the purpose for your participation in this activity?

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* 2. What is your primary professional discipline?

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* 3. Please list all professional license/certificate/degree(s) you hold:

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* 4. How satisfied with the activity were you overall?

Extremely dis-satisfied

Somewhat dis-satisfied

Neither satisfied nor dis-satisfied

Somewhat satisfied

Extremely satisfied

Comment:

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* 5. Was this session free from commercial bias?

Yes

Comment:

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

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* 6. How effective was the activity in meeting the stated learning objectives?
Upon completion of this activity, participants will be able to:

	1 Totally ineffective	2	3	4	5 Highly effective
Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners 1 Totally ineffective	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners 2	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners 3	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners 4	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners 5 Highly effective
Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness 1 Totally ineffective	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness 2	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness 3	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness 4	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness 5 Highly effective
Recognize the importance of involving care partners in delivering a dementia diagnosis	Recognize the importance of involving care partners in delivering a dementia diagnosis 1 Totally ineffective	Recognize the importance of involving care partners in delivering a dementia diagnosis 2	Recognize the importance of involving care partners in delivering a dementia diagnosis 3	Recognize the importance of involving care partners in delivering a dementia diagnosis 4	Recognize the importance of involving care partners in delivering a dementia diagnosis 5 Highly effective
Describe the barriers that may limit care partner understanding of diagnosis	Describe the barriers that may limit care partner understanding of diagnosis 1 Totally ineffective	Describe the barriers that may limit care partner understanding of diagnosis 2	Describe the barriers that may limit care partner understanding of diagnosis 3	Describe the barriers that may limit care partner understanding of diagnosis 4	Describe the barriers that may limit care partner understanding of diagnosis 5 Highly effective
Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease 1 Totally ineffective	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease 2	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease 3	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease 4	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease 5 Highly effective

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* 7. 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.

	1 Totally ineffective	2	3	4	5 Highly effective
John Stoukides MD	John Stoukides MD 1 Totally ineffective	John Stoukides MD 2	John Stoukides MD 3	John Stoukides MD 4	John Stoukides MD 5 Highly effective

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* 8. Rate the effectiveness of teaching strategies:

	1 Totally ineffective	2	3	4	5 Highly effective
Teaching strategies:	Teaching strategies: 1 Totally ineffective	Teaching strategies: 2	Teaching strategies: 3	Teaching strategies: 4	Teaching strategies: 5 Highly effective

Comments:

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* 9. What was the most significant thing(s) you learned as a result of participating in this activity?

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* 10. Identify any specific changes that you plan to implement in your professional practice as a result of information you obtained as an attendee of this CME activity:

None – I did not learn anything that would be helpful

Patient Work-up

Treatment Plans

Patient Education

Change in Practice Procedures/Policy

Other

Please describe:

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* 11. What are the impediments to change or implementation?

Cost

Lack of time to assess/counsel patients

Lack of administrative support/resources

Insurance/reimbursement issues

Patient compliance issues

Lack of consensus of professional guidelines

Other

Please describe:

RETROSPECTIVE ASSESSMENT:

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* 12. 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)

	BEFORE	AFTER
Best practices when communicating a dementia diagnosis to a patient with dementia and care partner	Best practices when communicating a dementia diagnosis to a patient with dementia and care partner BEFORE menu	Best practices when communicating a dementia diagnosis to a patient with dementia and care partner AFTER menu
Challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness	Challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness BEFORE menu	Challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness AFTER menu
Importance of involving care partners in delivering a dementia diagnosis	Importance of involving care partners in delivering a dementia diagnosis BEFORE menu	Importance of involving care partners in delivering a dementia diagnosis AFTER menu
Barriers that may limit care partner understanding of diagnosis	Barriers that may limit care partner understanding of diagnosis BEFORE menu	Barriers that may limit care partner understanding of diagnosis AFTER menu
Importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease	Importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease BEFORE menu	Importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease AFTER menu

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* 13. 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)

	BEFORE	AFTER
Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners BEFORE menu	Identify best practices when communicating a dementia diagnosis to a patient with dementia and care partners AFTER menu
Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness BEFORE menu	Describe challenges of disclosing diagnosis of dementia to a person with dementia and care partners across stages of illness AFTER menu
Recognize the importance of involving care partners in delivering a dementia diagnosis	Recognize the importance of involving care partners in delivering a dementia diagnosis BEFORE menu	Recognize the importance of involving care partners in delivering a dementia diagnosis AFTER menu
Describe the barriers that may limit care partner understanding of diagnosis	Describe the barriers that may limit care partner understanding of diagnosis BEFORE menu	Describe the barriers that may limit care partner understanding of diagnosis AFTER menu
Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease BEFORE menu	Recognize the importance of an accurate and early diagnosis and disclosure in the setting of new disease modifying treatments for Alzheimer’s disease AFTER menu

Disclosing a Dementia Diagnosis

Program Evaluation

Question Title

* 1. What was the purpose for your participation in this activity?

Question Title

* 2. What is your primary professional discipline?

Question Title

* 3. Please list all professional license/certificate/degree(s) you hold:

Question Title

* 4. How satisfied with the activity were you overall?

Question Title

* 5. Was this session free from commercial bias?

Question Title

* 6. How effective was the activity in meeting the stated learning objectives?
Upon completion of this activity, participants will be able to:

Question Title

* 7. 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.

Question Title

* 8. Rate the effectiveness of teaching strategies:

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* 9. What was the most significant thing(s) you learned as a result of participating in this activity?

Question Title

* 10. Identify any specific changes that you plan to implement in your professional practice as a result of information you obtained as an attendee of this CME activity:

Question Title

* 11. What are the impediments to change or implementation?

Question Title

* 12. 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)

Question Title

* 13. 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)

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* 14. Please feel free to share any additional comments and suggestions for improvement. Your feedback is extremely valuable to us.

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* 15. Please indicate your preferred completion certificate:

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* 16. Please complete the information below so we may send your certificate:

Question Title

* 1. What was the purpose for your participation in this activity?

Question Title

* 2. What is your primary professional discipline?

Question Title

* 3. Please list all professional license/certificate/degree(s) you hold:

Question Title

* 4. How satisfied with the activity were you overall?

Question Title

* 5. Was this session free from commercial bias?

Question Title

* 6. How effective was the activity in meeting the stated learning objectives? Upon completion of this activity, participants will be able to:

Question Title

* 7. 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.

Question Title

* 8. Rate the effectiveness of teaching strategies:

Question Title

* 9. What was the most significant thing(s) you learned as a result of participating in this activity?

Question Title

* 10. Identify any specific changes that you plan to implement in your professional practice as a result of information you obtained as an attendee of this CME activity:

Question Title

* 11. What are the impediments to change or implementation?

Question Title

* 12. 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)

Question Title

* 13. 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)

Question Title

* 14. Please feel free to share any additional comments and suggestions for improvement. Your feedback is extremely valuable to us.

Question Title

* 15. Please indicate your preferred completion certificate:

Question Title

* 16. Please complete the information below so we may send your certificate:

* 6. How effective was the activity in meeting the stated learning objectives?
Upon completion of this activity, participants will be able to:

* 7. 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.