Skip to content
Substance Use Disorders in Older Adults
Program Evaluation
We appreciate your participation in our continuing education activity. Your responses to this anonymous survey w
ill allow us to improve our program offerings and services. Thank you for your time.
*
1.
What is your primary professional
discipline
?
(Required.)
Medicine
Rehab Therapy (PT/OT/SLP)
Nursing
Social Work
Pharmacy
Other
*
2.
Please list all professional license/certificate/degree(s) you hold:
(Required.)
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, wouldn't recommend
2 = Somewhat ineffective, at least one serious deficiency
3 = Somewhat effective, acceptable but not outstanding
4 = Effective, meets high standards, would recommend
5 = Highly effective, among the best
*
3.
Rate the relationship between activity content to stated learning objective:
(Required.)
1
2
3
4
5
Discuss prevalence data of substance use disorders and mental health prevalence in older adults, including the growing issue of OUD
1
2
3
4
5
Identify risk factors: signs and symptoms of substance use disorders in older adults
1
2
3
4
5
Discuss methods of patient engagement, screenings, and communication can identify and engage patients to improve outcomes
1
2
3
4
5
*
4.
Rate the effectiveness of the presenter(s)
(Required.)
1
2
3
4
5
a. Presentation Style
1
2
3
4
5
b. Knowledge of Subject
1
2
3
4
5
c. Quality of Material
1
2
3
4
5
d. Practical applicability or relevance of topic
1
2
3
4
5
*
5.
Please rate the effectiveness of teaching strategies:
(Required.)
1
2
3
4
5
Effectiveness of teaching strategies:
1
2
3
4
5
*
6.
What was the most significant thing(s) you learned?
(Required.)
*
7.
In your work with older adults, do you intent to implement at least one practice improvement learned as a result of this activity?
(Required.)
Yes
No
N/A
If yes, please describe:
RETROSPECTIVE ASSESSMENT:
Use the following scale to rate your perceived level of
confidence
in the topics listed below BEFORE the
training
an AFTER the training.
Scale
: 1= not at all confident, 2= somewhat confident, 3= mostly confident 4= fully
confident
*
8.
How confident were/are you in your ability to:
(Required.)
Before
After
a. Discuss prevalence data of substance use disorders and mental health prevalence in older adults, including the growing issue of OUD
1
2
3
4
1
2
3
4
b. Identify risk factors: signs and symptoms of substance use disorders in older adults
1
2
3
4
1
2
3
4
c. Discuss methods of patient engagement, screenings, and communication can identify and engage patients to improve outcomes
1
2
3
4
1
2
3
4
9.
Please feel free to share any additional comments and suggestions. Your feedback is extremely valuable to us.
10.
If you would like a Certificate of Completion please complete the information below:
Name and Title
Email address
Organization
State/Province
