All items with an asterisk * must be answered. 1. The following disclosure was provided prior to beginning this course: * 1 Yes 2 No a Acknowledgement of any conflict of interest. a Acknowledgement of any conflict of interest. - 1 Yes a Acknowledgement of any conflict of interest. - 2 No b Acknowledgement of any financial relationships. b Acknowledgement of any financial relationships. - 1 Yes b Acknowledgement of any financial relationships. - 2 No c Criteria for successful completion of course. c Criteria for successful completion of course. - 1 Yes c Criteria for successful completion of course. - 2 No 2. Were the learning methods appropriate? * Yes No 3. Did you learn what you expected to learn? * Yes No 4. Were the learning materials helpful? * Yes No 5. As a result of the course NAME OF COURSE HERE, I am able to : * 5 Strongly Agree 4 Agree 3 Neutral 2 Disagree 1 Strongly Disagree a. LIST OBJECTIVES FOR COURSE HERE a. LIST OBJECTIVES FOR COURSE HERE - 5 Strongly Agree a. LIST OBJECTIVES FOR COURSE HERE - 4 Agree a. LIST OBJECTIVES FOR COURSE HERE - 3 Neutral a. LIST OBJECTIVES FOR COURSE HERE - 2 Disagree a. LIST OBJECTIVES FOR COURSE HERE - 1 Strongly Disagree b. b. - 5 Strongly Agree b. - 4 Agree b. - 3 Neutral b. - 2 Disagree b. - 1 Strongly Disagree c. c. - 5 Strongly Agree c. - 4 Agree c. - 3 Neutral c. - 2 Disagree c. - 1 Strongly Disagree d d - 5 Strongly Agree d - 4 Agree d - 3 Neutral d - 2 Disagree d - 1 Strongly Disagree 6. The presenter or author was effective in communicating relevant information : * 5 Strongly Agree 4 Agree 3 Neutral 2 Disagree 1 Strongly Disagree a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE - 5 Strongly Agree a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE - 4 Agree a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE - 3 Neutral a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE - 2 Disagree a. PRESENTER FIRST NAME LAST NAME AND CREDENTIALS HERE - 1 Strongly Disagree b. FLORENCE NIGHTINGALE, MSN, RN b. FLORENCE NIGHTINGALE, MSN, RN - 5 Strongly Agree b. FLORENCE NIGHTINGALE, MSN, RN - 4 Agree b. FLORENCE NIGHTINGALE, MSN, RN - 3 Neutral b. FLORENCE NIGHTINGALE, MSN, RN - 2 Disagree b. FLORENCE NIGHTINGALE, MSN, RN - 1 Strongly Disagree 7. Please rate your overall learning experience with the course NAME OF COURSE: * 5 Strongly Agree 4 Agree 3 Neutral 2 Disagree 1 Strongly Disagree a. I will be able to apply the knowledge learned in my practice setting a. I will be able to apply the knowledge learned in my practice setting - 5 Strongly Agree a. I will be able to apply the knowledge learned in my practice setting - 4 Agree a. I will be able to apply the knowledge learned in my practice setting - 3 Neutral a. I will be able to apply the knowledge learned in my practice setting - 2 Disagree a. I will be able to apply the knowledge learned in my practice setting - 1 Strongly Disagree b. My clinical practice and/or skills were enhanced b. My clinical practice and/or skills were enhanced - 5 Strongly Agree b. My clinical practice and/or skills were enhanced - 4 Agree b. My clinical practice and/or skills were enhanced - 3 Neutral b. My clinical practice and/or skills were enhanced - 2 Disagree b. My clinical practice and/or skills were enhanced - 1 Strongly Disagree 8. List 1-2 things you will change since participating in this educational activity. * Type Here 9. Please indicate how you found out about BAYADA Education Connection: Employer Colleague Website Postcard Flyer Facebook Twitter LinkedIn Instagram Other... 9. Please indicate how you found out about BAYADA Education Connection: Other... 10. What other educational topics would you like to see offered in future courses? Type suggestions here 11. Comments 12. What is your professional designation? Check all that apply. * RN - Professional Nurse LPN - Licensed Practical Nurse SW - Social Worker PT - Physical Therapist OT - Occupational Therapist SLP - Speech Language Pathologist HHA - Home Health Aide Habilitation Technician Board Certified Case Manager Non Clinician Other Healthcare Professional 12. What is your professional designation? Check all that apply. Other Healthcare Professional By checking this box I attest that I completed all components of this course and that I completed this evaluation. * ELECTRONIC SIGNATURE Leave this field blank
