(
Form
Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX
Follow-up Questionnaire for Learners
1. Please indicate your current level of knowledge of the process by which Comparative Effectiveness Research (CER) reviews are developed by the Agency for Healthcare Research and Quality’s (AHRQ) Effective Health Care (EHC) program:
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No Some High Very High Knowledge Knowledge Knowledge Knowledge 1 2 3 4 5 6 7 8 9 10
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2. Have you been able to make use of the evidence-based research and materials that were presented during this CME activity in your clinical practice? (select all that apply)
Unsure
Yes; have used in discussing evidence-based clinical options with patients
Yes; have used in identifying areas for discussion with patients regarding their values and preferences concerning benefits and harms
Yes; have used in determining those treatments and interventions that are associated with the highest levels of evidence
Yes; have used in another way:
_____________________________________________________________________
_____________________________________________________________________
Did not make use of the information; Why not?
_____________________________________________________________________
_____________________________________________________________________
Public
reporting burden for this collection of information is estimated to
average 5 minutes
per response, the estimated time required to complete the
survey. An agency may not conduct or sponsor, and a person is
not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing
this burden, to: AHRQ Reports Clearance Officer Attention: PRA,
Paperwork Reduction Project (0935-XXXX) AHRQ,
540 Gaither Road, Room # 5036, Rockville, MD 20850.
4. To what extent has the evidence-based research presented during this CME activity enabled you to improve the care that you give to your patients?
No improvements made
Some improvements made
Significant improvements made
Uncertain
5. Please explain any challenges or barriers that hindered your application in practice:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
6. Are there additional tools or applications associated with CER evidence that would be useful to you?
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
DEMOGRAPHICS
7. What year did you graduate from medical school? __________
8. What is your professional category/degree?
MD/DO—in practice Nurse Specialist (e.g., CRNA, NP) PA-C
MD/DO—Resident/Fellow Nurse (e.g., RN, LVN) Allied Health
Pharmacist PhD/PsyD/EdD/DrPH Other
9. If you are a physician, how would you classify yourself?
Primary Care
Specialist
Surgeon
Other: ________________________________
10. If you are a physician, what is your practice setting?
Solo
Group
Hospital-based
Clinic-based
Other
11. If you are a physician, please indicate the population of the area where you conduct the majority of your practice:
0 – 5,000
5,001 – 10,000
10,001 – 25,000
25,001 – 50,000
50,001 – 100,000
100,001 – 250,000
250,001 – 500,000
500,001 – 1 million
1 million +
12. If you are a physician, what are your patient population(s)? (select all that apply)
Adults
Older adults
Children/Adolescents
Diverse cultural backgrounds
Diverse socioeconomic status (SES) conditions
The John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | jasonk |
| File Modified | 0000-00-00 |
| File Created | 2021-01-31 |