Kentucky Chapter of the American College of Surgeons Virtual Meeting 2020 Global Evaluation Survey

Kentucky Chapter 2020 Virtual Meeting Global Evaluation Survey

September 18, 2020
Name *

First Name Last Name
Email *
example@example.com
Are you claiming CME for this event *

Yes No
How many hours did you participate in this event?
Are you a member of the American College of Surgeons?

Yes No
ACS Membership ID (Required in order to receive ACS credits posted to MyCME webpage)
Specialty (Optional)
Number of Years in Practice (Optional)
AMA PRA Category 1 Credits™
The American College of Surgeons designates this live activity for a maximum of 4.00 AMA PRA Category 1 Credits™.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.

*Note: 15 minutes of session attendance = 0.25 AMA PRA Category 1 Credits™
As a participant of this educational activity, I am claiming ____ hours of CME Credit. *
Max of 4.00
Overall, how would you rate this educational activity?

Excellent Very Good Good Fair Poor
Program Topics and content met the stated objectives.

Strongly Agree Agree Neutral Disagree Strongly Disagree
Content was relevant to my educational needs.

Strongly Agree Agree Neutral Disagree Strongly Disagree
Educational format was conducive to learning

Strongly Agree Agree Neutral Disagree Strongly Disagree
This activity has improved my competence

Strongly Agree Agree Neutral Disagree Strongly Disagree
This activity will improve my performance

Strongly Agree Agree Neutral Disagree Strongly Disagree
This activity will enhance my communication skills

Strongly Agree Agree Neutral Disagree Strongly Disagree
This activity will improve patient outcomes

Strongly Agree Agree Neutral Disagree Strongly Disagree
This activity will improve processes of care and/or healthcare system performance.

Strongly Agree Agree Neutral Disagree Strongly Disagree
Program was free of commercial bias

Strongly Agree Agree Neutral Disagree Strongly Disagree
Please explain any specific instance(s) of bias or conflict of interest
How could this educational activity have been enhanced?
List a minimum of two things you are going to change as a result of what you have learned.
Describe the barriers anticipated when implementing the above changes.
Do you have any suggestions for future topics
Additional Comments
Should be Empty:

Kentucky Chapter 2020 Virtual Meeting Global Evaluation Survey