RSMD Aesthetics Training by Rebecca Small MD

Skills Lab Evaluation Form
Name:

First NameLast Name
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Date
Please take a moment to complete this evaluation form. Your feedback is essential for improving our training curriculum.
1) Please rate the following on a scale of 0 to 5 (0 Not Observed, 5 - Very Effective)
Overall experience

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Teaches about formulating diagnostic and therapeutic decisions that will be useful in practice

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Has comprehensive knowledge of field and applies it well to teaching

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Communicates effectively with patients

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Has a strong interest in participants education; is available and dedicated to teaching

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Demonstrates/teaches procedural techniques and skills well

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Provides a good learning experience

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Actively involves learner(s)

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Teaches and supervises in ways that facilitate learning

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2) How strongly do you agree/disagree with the following statements about today's training (0 Strongly Disagree, 5 - Strongly Agree)
Training improved my procedural skill

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Training improved my procedural confidence

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Training improved my ability to identify and manage complications

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Reading Dr. Small's book prepared me for the hands-on training

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3) Would you recommend this experience to other providers?
4) Did this session exceed your expectations?
5) If no, why not? Please list how this session could be improved
6) My favorite aspect of the training was
7) After the training, I feel more confident about
8) Safety zones are useful because
9) Dr. Small's expertise and training style were most helpful when
10) One thing that sets this training apart is
11) Would you be interested in providing botulinum toxin injections in a spa setting now or in the future?
12) Are you open to being contacted by our team in the future regarding job opportunities in aesthetics?
Thank you for taking the time to share your feedback. Your responses help us improve our program.
Date of Training Activity: {date}
Activity: RSMD Skills Lab
For: Rebecca Small, MD
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Skills Lab Evaluation Form

1) Please rate the following on a scale of 0 to 5 (0 Not Observed, 5 - Very Effective)

2) How strongly do you agree/disagree with the following statements about today's training (0 Strongly Disagree, 5 - Strongly Agree)