CME Evaluation
ASPO Annual Meeting at COSM April 29- May 1, 2022
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)
The educational activity has now been approved for 14
AMA PRA Category 1 Credits™
.
As a participant of this educational activity, I am claiming ____ hours of CME Credit.
*
Max of 14
Overall, how would you rate this educational activity?
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
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
Submit
Should be Empty: