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American Burn Association
2013 Partnership Conference
EvaluationForm

Thank you for your attendance at the 2013 Partnership Conference. Please take a moment to complete the questionnaire. Your input will help improve future conferences.

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* Please indicate your discipline:

BSN

CCRN

CCRP

FACS

FCCM

FNP-BC

MBA

MSN

PA-C

PhD

Other (please specify)

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* Are you an ABA member?

Yes

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* How many years have you been a member?

I'm a new member

1 - 2 years

2 - 5 years

5 - 7 years

7 - 10 years

10 -15 years

15 - 20 years

20 or more years

I'm not a member

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* Tuesday Morning Sessions: Please read each statement and select the response that best reflects your opinion:

	Excellent	Very Good	Good	Fair	Poor
Injury Prevention	Injury Prevention Excellent	Injury Prevention Very Good	Injury Prevention Good	Injury Prevention Fair	Injury Prevention Poor
Quality of Life After the Injury	Quality of Life After the Injury Excellent	Quality of Life After the Injury Very Good	Quality of Life After the Injury Good	Quality of Life After the Injury Fair	Quality of Life After the Injury Poor
Mass Casualty Burn Management	Mass Casualty Burn Management Excellent	Mass Casualty Burn Management Very Good	Mass Casualty Burn Management Good	Mass Casualty Burn Management Fair	Mass Casualty Burn Management Poor

Additional Comments:

Question Title

* Breakout Sessions: Please indicate which session you attended:

Injury Prevention

Quality of Life After the Injury

Mass Casualty Burn Management

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* Please read each statement and select the response that best reflects your opinion:

	Strongly Agree	Agree	Disagree	Strongly Disagree	N/A
The workshop format allowed for open discussion of issues	The workshop format allowed for open discussion of issues Strongly Agree	The workshop format allowed for open discussion of issues Agree	The workshop format allowed for open discussion of issues Disagree	The workshop format allowed for open discussion of issues Strongly Disagree	The workshop format allowed for open discussion of issues N/A
Moderators were effective in leading discussion	Moderators were effective in leading discussion Strongly Agree	Moderators were effective in leading discussion Agree	Moderators were effective in leading discussion Disagree	Moderators were effective in leading discussion Strongly Disagree	Moderators were effective in leading discussion N/A
Effective consensus was reached at the conclusion of the breakout session	Effective consensus was reached at the conclusion of the breakout session Strongly Agree	Effective consensus was reached at the conclusion of the breakout session Agree	Effective consensus was reached at the conclusion of the breakout session Disagree	Effective consensus was reached at the conclusion of the breakout session Strongly Disagree	Effective consensus was reached at the conclusion of the breakout session N/A
The ABA should continue to focus on partnerships as an initiative	The ABA should continue to focus on partnerships as an initiative Strongly Agree	The ABA should continue to focus on partnerships as an initiative Agree	The ABA should continue to focus on partnerships as an initiative Disagree	The ABA should continue to focus on partnerships as an initiative Strongly Disagree	The ABA should continue to focus on partnerships as an initiative N/A

American Burn Association
2013 Partnership Conference
EvaluationForm

Question Title

* Please indicate your discipline:

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* Are you an ABA member?

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* How many years have you been a member?

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* Tuesday Morning Sessions: Please read each statement and select the response that best reflects your opinion:

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* Breakout Sessions: Please indicate which session you attended:

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* Please read each statement and select the response that best reflects your opinion:

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* What were the strengths of this conference?

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* What aspects of the conference could be improved?

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* How will the information from this conference be used in your practice?

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* Additional Comments: