SMSNA RIG Post Event Evaluation
Date of Event:
*
-
Month
-
Day
Year
Date
RIG Name
*
Please Select
Albany, NY
Birmingham, AL
Burlington, VT
Central Virginia-Charlottesville/Richmond
Chicago, IL
Cleveland, OH
Cleveland Clinic, OH
Columbus, OH
Dallas, TX
Detroit, MI
Gainesville, FL
Houston, TX
Indiana
Irvine, CA
Los Angeles, CA
Montreal, QC
Nashville, TN
New England
New Haven, CT
New York, NY
Newark, NJ
Northern California
Philadelphia, PA
Phoenix, AZ
Portland, OR
Rochester, MN
Winnipeg, MB
Type of event
*
Please Select
Introductory Meeting
Research Meeting
Journal Club
Guest Lecture
Other
If other:
Type of event if "Other" was chosen above
Location of Event:
*
What is your current role/position?
*
Please Select
Student
Resident
Fellow
Faculty/Advisor
Other
If student, when do you expect to graduate?
If student, what is your major/area of study?
If resident, what year do you expect to complete your residency?
If resident, what is your specialty?
If fellow, what kind of fellowship are you doing?
If fellow, when do you complete your fellowship?
If 'Other' was chosen above, please specify.
Are you a current SMSNA member?:
*
Yes
No
If no, are you considering joining the SMSNA ?:
Yes
No
Prefer not to answer
How many RIG events have you attended?
*
This is my 1st event*
2-3 events
3-4 events
4-6 events
7 or more
* If this was your 1st event, please fill out the following:
Your Name:
First Name
Last Name
Designation:
(MD, DO, PhD, etc.)
Email:
example@example.com
How did you hear about the program?
Are you interested in mentorship/being a mentor?:
*
Yes * (please provide your email below)
No
* Are you seeking a mentor?:
Yes
No
* Are you interested in being a mentor?:
Yes
No
* Email:
example@example.com
How would you characterize the support you found at this RIG program meeting?
*
1
2
3
4
5
Poor
Exceptional
1 is Poor, 5 is Exceptional
How would you rate this meeting for its opportunity to network?
*
1
2
3
4
5
Poor
Exceptional
1 is Poor, 5 is Exceptional
Did you learn anything new at this meeting?
*
Yes
No
If yes, will you be able to use what you learned in your work/study?
Yes
No
If no, what were you hoping to learn or experience?
What topics would you like to see discussed during meeting activities?
*
How else do you think RIG groups could best serve attendee needs?
*
Are you interested in becoming more involved with the SMSNA?
*
Yes
No
Submit
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