Course Evaluation for Continuing Education Webinars-WTCHP

Continuing Education Proposal Packet

Live Educational Activity and Enduring Materials

Course Evaluation

Activity title:

After the 9/11 Terrorist Attacks: The World Trade Center Health Program and Disaster Response

Activity #:

WD2811

Proposed start/release date: (MM/DD/YYYY)

3/1/2017

Please take a moment to give us your feedback and write your comments in the boxes provided.

Content and Learning Materials

Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

The content and learning materials addressed a need or a gap in my knowledge or skills.

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The difficulty level was appropriate.

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The length and pace of the activity was appropriate.

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Feedback (Q&A, knowledge checks) I received during the activity was helpful.

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Please share your comments about the content and learning materials.

Comments:

What suggestions do you have to improve this educational activity?

Comments:

Presentation

Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

The content expert(s) demonstrated expertise in the subject matter.

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The delivery method used (conference, journal article, webcast, e-learning, etc.) was appropriate for the subject matter and helped me learn the content.

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The instructional strategies (lecture, case scenarios, figures, tables, media, etc.) helped me learn the content.

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Learning Environment

The learning environment was conducive to learning.

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Do you believe this activity was influenced by commercial interests?

Yes

No

If yes, please explain.

Comments:

Did you experience technical difficulties with this activity?

Yes

No

If yes, please explain.

Comments:

Knowledge, Competence, and Practice

Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

This activity effectively met my educational needs.

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I will be able to apply the knowledge gained from this activity to increase or maintain my competence.

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I will be able to apply the knowledge gained from this activity to my practice.

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I will be able to apply the knowledge/skills gained from this activity to develop strategies/provide interventions.

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I will be able to apply the knowledge gained from this activity to improve performance.

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I will be able to apply the knowledge gained from this activity to improve performance of the team.

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What change or impact do you anticipate?

Do you anticipate barriers applying this knowledge?

Yes No

If yes, please explain

Comments:

Learning Objectives

Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

I can identify patients who are eligible for care under the WTC Health Program

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I can identify exposure-related health risks associated with environmental exposures from the WTC site

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I can describe the lessons learned from the 9/11 disaster response

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I can identify patients who are eligible for care under the WTC Health Program

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The content was relevant to the learning objectives.

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Please share your comments regarding the learning objectives.

Comments:

Access

Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

The CDC’s Training and Continuing Education Online (TCEO) system is easy to use. [Only use if using TCEO]

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The availability of CE credit/contact hours influenced my decision to participate in this activity.

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Activity Specific

31.

As a result of my participation in this activity, I intend to... (Select all that apply)

Review which cancers and screenings the World Trade Center Health Program (WTCHP) covers for patients who were at the sites of the 9/11 terrorist attacks at the World Trade Center (WTC), the Pentagon, and Shanksville, Pennsylvania Ask all patients whether they may have been exposed to WTC contaminants on 9/11 or in the months following Recommend that all patients who may have been exposed at any of the three 9/11 sites enroll in the WTCHP to receive monitoring or initial screening, and if they have a covered condition, to determine whether their condition is 9/11-related Inform exposed patients of the September 11th Victim Compensation Fund Make other change(s) Continue my existing practices, which this program confirmed None of the above

32.

As a result of this training, how will you change your clinical practices? (Select all that apply)

Increased knowledge/awareness Screening/ monitoring Treatment/ care plan Referral/Continuity-of-care Communication with patients/clients Communication with other providers and caregivers Other ____________________________ I do not anticipate changing any aspect of my clinical practice as a result of this training

33.

Please indicate any barriers that may prevent you from making changes in practice. (Select all that apply)

I do not have time in a typical office visit to query patients about their potential exposure on 9/11 I do not have time in a typical office visit to counsel patients about the WTCHP and available screenings and treatment I do not have patient education resources to help patients with questions about the WTCHP The WTCHP process for patients to have their cancer certified is cumbersome Patients are not forthcoming about their WTC experiences and exposures It is difficult to navigate the WTCHP website Other barrier(s) I do not anticipate any barriers to making desired changes in practice

34.

Have you visited World Trade Center Health Program training webpage of CE activities?

Yes

No

35.

In your practice, are you aware of any patients exposed to environmental contaminants on 9/11 or in the months following?

Yes

No

36.

What is your practice location? (Select one)

Manhattan New York City other than Manhattan New York State New Jersey Washington DC Pennsylvania Other

37.

Were you practicing in the New York metropolitan area; Washington, DC; or Pennsylvania on September 11, 2001?

Yes

No

38.

Have you ever: (Select all that apply)

Had a patient enrolled in the WTCHP Referred a patient to enroll in the WTCHP Had a patient with cancer certified by the WTCHP None of the above

39.

Please share any questions, additional comments, or suggestions for future trainings.

Comments:

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