FULL NAME
*
BADGE # / Reference No. / Confirmation No.
*
TOPICS / SPEAKER
Culture
1-Poor
2-Average
3-Good
4-Excellent
Speaker
Content
Audio Visual
Discussion
Impact on Patient Care
Measuring & Improving Performance
1-Poor
2-Average
3-Good
4-Excellent
Speaker
Content
Audio Visual
Discussion
Impact on Patient Care
Patient Safety Risks & Solution
1-Poor
2-Average
3-Good
4-Excellent
Speaker
Content
Audio Visual
Discussion
Impact on Patient Care
Systems Thinking & Design and Human Factors Analysis
1-Poor
2-Average
3-Good
4-Excellent
Speaker
Content
Audio Visual
Discusion
Impact on Patient Care
Leadership
1-Poor
2-Average
3-Good
4-Excellent
Speaker
Content
Audio Visual
Discusion
Impact on Patient Care
This Represented New Knowledge:
None
Some
Moderate
All New
The Program
Yes
No
The program's objectives were clearly defined.
The program met the started objectives.
The program was relevant to the topic.
The program met my expectations.
There was suffiecient time for discussion.
The program was well organized.
Should this program be offered again, if YES
How Often ?
Annually
Biannually
Other
Kindly suggest any modifications that we can bring to our CME Programs.?
What topics would you like to see us present in the future.?
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