3 2024 Ryan White CEU Session Evaluation

OMB Number: 0906-0084.

Program evaluation for Sample Session Title
Please fill in the following form to help us improve our educational activities. Your responses are anonymous.
Public Burden Statement: To help us plan for future conferences, please let us know about your overall experience by completing this brief conference
evaluation. 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. The OMB control number for this project is 0906-0086 and is valid until 2/28/2027. This information collection is voluntary.
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Please rate the following aspects of this educational activity on a descending scale where 5 = excellent to 1 = poor.
Rating

5

4

3

2

1

Overall quality of the educational activity:
Teaching strategy employed:
Relevance of the educational activity to your practice:
Quality of the materials used in the activity:
Helpfulness of the information presented:
Contributed to my knowledge, skills, and attitude to enhance the delivery of client care:

The intended result of this activity is to provide new knowledge to develop and enhance competencies that change performance and practices; and that impact and improve patient outcomes. Please rate the effectiveness of this activity to achieve
these learning objectives on a descending scale where 5 = excellent to 1 = poor.
Learning Objective

5

4

3

2

1

3

2

1

EXAMPLE OBJECTIVE or OUTCOME 1
EXAMPLE OBJECTIVE or OUTCOME 2
EXAMPLE OBJECTIVE or OUTCOME 3

Please rate presenters for this educational activity using a descending scale where 5 = excellent to 1 = poor.

EXAMPLE SPEAKER 1

Evaluation Area
Presentation Style:
Organization and Clarity:
Expertise:
Demonstrated Experiential Knowledge of the Topic:
Relevance to Outcomes:

5

4

EXAMPLE SPEAKER 2

Evaluation Area

5

4

3

2

1

5

4

3

2

1

Presentation Style:
Organization and Clarity:
Expertise:
Demonstrated Experiential Knowledge of the Topic:
Relevance to Outcomes:

EXAMPLE SPEAKER 3

Evaluation Area
Presentation Style:
Organization and Clarity:
Expertise:
Demonstrated Experiential Knowledge of the Topic:
Relevance to Outcomes:

Please answer the following questions as they relate to the educational activity.

Based on your previous knowledge and experience, the
level of this activity was:

Do you feel that the activity was objective, balanced, and

Too basic

Appropriate

Yes

No

Yes

No

Was the activity supported by scientifically-rigorous or
evidence-based data?

Yes

No

Did the activity meet your educational needs?

Yes

No

Too complex

free of commercial bias?

Was disclosure (financial relationships, unapproved or
unlabeled use of drugs or products) made available to you
during the activity?

Please rate how much you agree that this educational activity has contributed to your professional effectiveness and ability
to execute the following, using a descending scale where 5 = strongly agree to 1 = strongly disagree:
Improvement Area
Treat and/or manage my clients:
Communicate with clients:
Manage my clinical practice and/or program:

After completing this activity, do you intend changing any of

Yes

No

5

4

3

2

1

your patient care practices?

Do you see any barriers to implementing these changes?

Yes

No

Comments or suggestions for improvement:

AffinityCE is providing the Continuing Medical Education (CME) and Continuing Education Unit services during the 2022
National Ryan White Conference on Care and Treatment. AffinityCE, a Woman-Owned Small Business (WOSB), is a fullservice, accredited CME company providing education and training for more than 35 health professions.