2023 INS Fall Evaluation
Name
*
First Name
Last Name
Credentials
Email (certificate destination)
*
example@example.com
2022 Fall INS Evaluation Overall
(please rate experience of sessions overall)
You were satisfied with the overall quality of this activity
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A
Program content fulfilled the goals/objectives (please rate each session below individually)
Characteristics of FND’s • Mark Hallett, MD
(please rate each session individually)
Program content fulfilled the goals/objectives (Hallett)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (Hallett)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (Hallett)
*
Strongly agree
Agree
Disagree
Agree
N/A or did not attend session
Functional Movement Disorders • Sarah Lidstone, MD, PhD
(please rate each session individually)
Program content fulfilled the goals/objectives (Lidstone)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (Lidstone)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (Lidstone)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
PPPD and Functional Vestibular Disorders • Jeffrey Staab, MD
(please rate each session individually)
Program content fulfilled the goals/objectives (Staab)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (Staab)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (Staab)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Evaluation and Management of PNS • W Curt LaFrance, MD, MPH
(please rate each session individually)
Program content fulfilled the goals/objectives (LaFrance)
*
Strongly Agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (LaFrance)
*
Strongly Agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (LaFrance)
*
Strongly Agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Differential Dx & Pitfalls in Evaluation ofFND’s • Sara Finkelstein, MD, MSc
(please rate each session individually)
Program content fulfilled the goals/objectives ( Finkelstein)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (Finkelstein)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (Finkelstein)
*
Strongly agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Managing FND’s in the ED • Barbara Dworetzky, PhD
(please rate each session individually)
Program content fulfilled the goals/objectives (Dworetzky)
*
Strongly Agree
Agree
Disagree
Strongly disagree
N/A or did not attend session
Teaching methods were effective (Dworetzky)
*
Strongly Agree
Agree
Disagree
Strongly disagree
Did not attend session
Speaker’s syllabus material was an effective supplement to their presentation (Dworetzky)
*
Strongly Agree
Agree
Disagree
Strongly disagree
Did not attend session
The information provided in this overall program was relevant to my practice
*
Yes, much so
Yes, somewhat
Not very much
Not at all
Program independence from commercial relationships
(please rate each session individually)
Speaker and Planning Committee financial conflicts of interest were disclosed before the program
*
Yes
No
The activity was presented objectively and was free of commercial bias
*
Yes
No
Comments relating to commercial bias
Outcomes
This activity will assist in the improvement of my (mark all that apply):
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a. Competence
b. Performance
c. Patient outcomes
Which ONE of the following best describes the impact of this activity on your performance?
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a. This program will not change my behavior because my current practice is consistent with what was taught.
b. This activity will not change my behavior because I do not agree with the information presented.
c. I need more information before I can change my practice behavior.
d. I will immediately implement the information into my practice.
What changes will you make to your practice as a result of the information learned at this conference (mark all that apply)
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a. Maintain a broader knowledge base.
b. Modify screening parameters
c. Alter my diagnostic approach
d. Adjust management of disease process
e. Enhance communication to patients
f. none
Other
Indicate any barriers that might prevent you from applying this knowledge (mark all that apply):
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a. Cost
b. Lack of experience
c. Lack of opportunity
d. Lack of time
e. Lack of resources
f. Lack of specific “guideline”
g. Reimbursement/insurance issues
h. Patient adherence/compliance
No barriers
Other
Needs Assessment
A program on which of the following topics do you feel would be of most benefit to your practice of medicine? (Select 4 options and number them 1 through 4, such that 1 would have the most impact on your practice)
Rows
#1
#2
#3
#4
Pain management (e.g., medication, procedures)
Spinal pain (e.g., cervical, lumbar)
Complex Regional Pain Syndrome
CNS infections
CNS tumor management
Spinal cord disorders
Neurocutaneous syndromes
Sleep disorders
Syncope
Update on management of delirium
Peripheral Neuropathies
Neurodegenerative disorders
Reversible cerebrovascular syndromes (e.g., PRES, RCVS)
Attention deficit disorder
Autism spectrum disorder
Psychiatric comorbidity in neurological disease
Palliative Care in Neurology
Neurology for the LGBTQ Patient
Neurologic Complications of Systemic Disease
Neurotoxicology
Gait disturbances
Neuro-otology/vertigo
Neurophthamology
Neurorehabilitation
Neuroradiology in Specific Neurological Diseases
Interventional Neurology
Neuromodulation
New neurologic biomarkers (e.g., mRNA and NfL)
Genetics/genomics in neurology
Update in Pediatric Neurology
Sports neurology
Technology in neurology( e.g.,intraop monitor, endovasc, CVA treatment, magnetoencephalography, transcranialmagnetic stim)
Artificial Intelligence in management of neurologic
disorders
Neural Network Mechanisms of neurological Disease
The Neurology of art
Medicinal plants
Cannabis and derivatives in neurologic practice
Neuromuscular Disorders
Update in MS (eg., Dx criteria, Tx, complications, etc.)
Seizures and Epilepsy
Neurologic Emergencies
Critical Care Neurology
Neurosurgery for the Neurologist
Which of the following nonclinical topics would be of benefit to your practice? (choose 2)
Which of the following nonclinical topics would be of benefit to your practice? (choose 2)
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Brain Death Determination Medicolegal Update
Update on Neurology Residency Education
Electronic Health Records-Boom or Bust?
Statistics in Neurology
CME (outdated requirements; potential options
Diversity, equity, and inclusion for doctors and patients
Changing emphasis in Medical Education
Scientific Scrutiny or Misinformation
The Future of Neurology
Shortages in the Neurology Workforce
Additional suggestions or comments about today’s program:
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What is your primary specialty?
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Neurology
Cardiology
Physical Medicine & Rehabilitation
Interventional Neuroradiology
Vascular Surgery
NP, PA, RN
In Training (i.e., Fellow, Resident, Student)
Other
I participated in part of the activity and claim _____ CME credit(s)
*
1
2
3
4
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6
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