1 Start 2 Complete

To what extent were the learning objectives of this module met? *

Not at all met

Partially met

Completely met

What did you like most about this module?

What would you change to improve future modules?

Please indicate the extent to which you agree with the following statements: *

	Strongly Disagree	Disagree	Agree	Strongly Agree	N/A
I gained new knowledge as a result of completing this module.	I gained new knowledge as a result of completing this module. - Strongly Disagree	I gained new knowledge as a result of completing this module. - Disagree	I gained new knowledge as a result of completing this module. - Agree	I gained new knowledge as a result of completing this module. - Strongly Agree	I gained new knowledge as a result of completing this module. - N/A
I learned new skills as a result of completing this module.	I learned new skills as a result of completing this module. - Strongly Disagree	I learned new skills as a result of completing this module. - Disagree	I learned new skills as a result of completing this module. - Agree	I learned new skills as a result of completing this module. - Strongly Agree	I learned new skills as a result of completing this module. - N/A
I am confident in my ability to use what I learned from this module in my practice.	I am confident in my ability to use what I learned from this module in my practice. - Strongly Disagree	I am confident in my ability to use what I learned from this module in my practice. - Disagree	I am confident in my ability to use what I learned from this module in my practice. - Agree	I am confident in my ability to use what I learned from this module in my practice. - Strongly Agree	I am confident in my ability to use what I learned from this module in my practice. - N/A

Please indicate the extent to which you agree with the following statements: *

	Strongly Disagree	Disagree	Agree	Strongly Agree	N/A
The information presented motivates me to change aspects of my current practice or treatments habits.	The information presented motivates me to change aspects of my current practice or treatments habits. - Strongly Disagree	The information presented motivates me to change aspects of my current practice or treatments habits. - Disagree	The information presented motivates me to change aspects of my current practice or treatments habits. - Agree	The information presented motivates me to change aspects of my current practice or treatments habits. - Strongly Agree	The information presented motivates me to change aspects of my current practice or treatments habits. - N/A
The information presented motivates me to enhance my team-based practices.	The information presented motivates me to enhance my team-based practices. - Strongly Disagree	The information presented motivates me to enhance my team-based practices. - Disagree	The information presented motivates me to enhance my team-based practices. - Agree	The information presented motivates me to enhance my team-based practices. - Strongly Agree	The information presented motivates me to enhance my team-based practices. - N/A
I see a connection between this information and how I care for my patients.	I see a connection between this information and how I care for my patients. - Strongly Disagree	I see a connection between this information and how I care for my patients. - Disagree	I see a connection between this information and how I care for my patients. - Agree	I see a connection between this information and how I care for my patients. - Strongly Agree	I see a connection between this information and how I care for my patients. - N/A

Please indicate the extent to which you agree with the following statements: *

	Strongly Disagree	Disagree	Agree	Strongly Agree	N/A
The information presented addressed a professional practice gap.	The information presented addressed a professional practice gap. - Strongly Disagree	The information presented addressed a professional practice gap. - Disagree	The information presented addressed a professional practice gap. - Agree	The information presented addressed a professional practice gap. - Strongly Agree	The information presented addressed a professional practice gap. - N/A
The information that was shared is relevant to my practice setting.	The information that was shared is relevant to my practice setting. - Strongly Disagree	The information that was shared is relevant to my practice setting. - Disagree	The information that was shared is relevant to my practice setting. - Agree	The information that was shared is relevant to my practice setting. - Strongly Agree	The information that was shared is relevant to my practice setting. - N/A
The information presented validated my current practice or treatment habits.	The information presented validated my current practice or treatment habits. - Strongly Disagree	The information presented validated my current practice or treatment habits. - Disagree	The information presented validated my current practice or treatment habits. - Agree	The information presented validated my current practice or treatment habits. - Strongly Agree	The information presented validated my current practice or treatment habits. - N/A
If I apply this information in my practice setting, patient outcomes will improve.	If I apply this information in my practice setting, patient outcomes will improve. - Strongly Disagree	If I apply this information in my practice setting, patient outcomes will improve. - Disagree	If I apply this information in my practice setting, patient outcomes will improve. - Agree	If I apply this information in my practice setting, patient outcomes will improve. - Strongly Agree	If I apply this information in my practice setting, patient outcomes will improve. - N/A

Please list any practice changes you plan on making as a result of what you learned from this module. If you do not plan on making any changes, please write "no changes". *

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