Activity General Summary Report 2025

2025 Activity General Summary Report

ANCC Accredited Nursing Professional Development Provider Unit #P0623
Title of Activity:*
Date*

MonthDayYear
Date
Name of person completing this report*

First NameLast Name
Name of Educational Partner or Joint Provider*
Total Number of Participants*
Total Number of RNs attending*
The Nurse Planner is responsible for submitting a course roster and maintaining a copy for the Joint Provider's records.
Method of Evaluation*

Active Participation in Learning ActivityEvaluation StatisticsPre/Post testReturn Demonstration (simulated or in practice)Self-report Intent to Modify PracticeCase Study AnalysisSelf-report Change in Practice or Implementation into Practice Over a Period of TimeFollow-up SurveyChange in Quality Outcome MeasureReturn on Investment (ROI)Observation of Performance at a Predetermined Point in Time Post ActivityOther
Summary of Evaluation Responses:*
Comments from Participants:*
If no comments were recorded, type "No Comments" in this box.
List topic suggestions here:*
If no suggestions for topics were recorded, type "No Suggestions" in this box.
Nurse Planner/Staff Narratives
Instructions for Narrative 1:

Please write a summary in narrative form of the data highlighting whether the activity was effective in closing or narrowing the gap and achieving the educational outcome.

Answer the following questions in your narrative:
1. Did you reach your target audience of RN's?
2. What was the total number of participants including non-RN's/
3. What was the total number of contact hours offered upon completion of the activity?
4. What was the gap you were attempting to close or narrow?
5. Was there a change in the gap as a result of this activity?
6. What was the outcome of this activity?
7. Did you meet your outcome goals?
Narrative 1: Summary of data highlighting whether the activity was effective in closing or narrowing the gap and acheiving the educational activity outcome.*
Instructions for Narrative 2

Please write an analysis in narrative form of what was learned from the evaluation data and what can be applied to future activities.

Answer the following questions in your narrative:
1. What did the evaluation (in whatever format you used) reveal about the activity from the participant's perspective? (You may include gathered evaluation statistics as long as you explain the results.)
2. What changes will you make based on the evaluation/input of activity participants? (If this activity will only be presented one time, answer this question as if it were being repeated.)
3. What changes will you make before presenting this activity in the future in order to reach your outcomes?
4. What went well?
5. What information did you learn from this activity that could also be used when planning future activities?
Narrative 2: Analysis of what was learned from the evaluation data and what can be applied to future activities.*
How would you rate the performance of the speaker/presenter?*
Did you notice any bias in the presentation?*
What was your overall impression of this activity?*
Based on the evaluation responses and your comments above, are there any changes you would recommend for future offerings of this activity?*
Should be Empty:

2025 Activity General Summary Report

Nurse Planner/Staff Narratives