A Guide to Mainpro Accreditation - The College of Family Physicians ...
A Guide to Mainpro Accreditation - The College of Family Physicians ...
A Guide to Mainpro Accreditation - The College of Family Physicians ...
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APPENDIX 5: Sample Evaluation Form<br />
Title:<br />
CME PROGRAM EVALUATION<br />
Date:<br />
Location:<br />
EDUCATIONAL OBJECTIVES<br />
<strong>The</strong> program met the stated objectives:<br />
Strongly<br />
Strongly<br />
Neutral<br />
Agree<br />
Disagree<br />
1. 5 4 3 2 1<br />
2. 5 4 3 2 1<br />
3. 5 4 3 2 1<br />
4. 5 4 3 2 1<br />
PROGRAM CONTENT and DELIVERY<br />
Strongly<br />
Strongly<br />
Neutral<br />
Agree<br />
Disagree<br />
<strong>The</strong> program content was relevant <strong>to</strong> family medicine. 5 4 3 2 1<br />
<strong>The</strong> program met my expectations. 5 4 3 2 1<br />
<strong>The</strong> program was well organized. 5 4 3 2 1<br />
Disclosure <strong>of</strong> potential conflicts <strong>of</strong> interest was clearly communicated. 5 4 3 2 1<br />
Faculty members were effective in delivering/facilitating the program. 5 4 3 2 1<br />
<strong>The</strong>re were adequate opportunities <strong>to</strong> interact with my peers. 5 4 3 2 1<br />
<strong>The</strong>re were adequate opportunities <strong>to</strong> interact with program faculty. 5 4 3 2 1<br />
<strong>The</strong> information I learned will be used in my future practice. 5 4 3 2 1<br />
Did you perceive any degree <strong>of</strong> commercial bias in any part <strong>of</strong> the program Yes<br />
No<br />
*If ‘Yes’, please describe:<br />
What was the most effective part <strong>of</strong> the program Why<br />
What was the least effective part <strong>of</strong> this program Why<br />
Describe two ways in which you will change your practice as a result <strong>of</strong> attending this program:<br />
1.<br />
2.<br />
Please list any <strong>to</strong>pics you would like <strong>to</strong> see addressed in future programs:<br />
General Comments:<br />
Thank you for completing the program evaluation. Please return form <strong>to</strong> the program organizer.<br />
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