St. Luke's Health System RSS
Continuing Medical Education Evaluation & Credit Claim
Which activity did you attend?
*
Advanced Practice Providers (APP) GR ENDURING (watched recording on Healthstream)
Advanced Practice Providers (APP) GR LIVE (Microsoft Teams)
Anesthesia RSS
Cardiovascular Consultants Echocardiography Monthly Journal Club
Cardiovascular Consultants Evening Educational Sessions Grand Rounds
Cardiovascular - Adult Congenital Heart Disease (ACHD) Case Conference
Cardiovascular CICU Case Conference
Cardiovascular Grand Rounds
Cardiovascular MMI M&M
Epilepsy Surgical Case Conference
GI RSS
GU Tumor Case Conference
Hematologic Malignancies Tumor Case Conference
Insight to Impact CME Series Lunch & Learn GR
Internal Medicine Grand Rounds
Internal Medicine Journal Club
Maternal-Fetal Case Conference
Medical Record Documentation Grand Rounds
Multidisciplinary Cancer - Breast Case Conference
Multidisciplinary Cancer - Colorectal Case Conference
Multidisciplinary Cancer - GI Case Conference
Multidisciplinary Cancer - GYN Case Conference
Multidisciplinary Cancer - Head and Neck
Multidisciplinary Cancer - Thoracic
Multidisciplinary Wound Care / Limb Preservation Case Conference_St. Luke's South/St. Luke's East
Multi-Specialty Vascular Conference Case Conference
MWPOC Case Conference
Neonatal ICU PR M&M
Neonatal Journal Club
Neuroscience APP Case Conference
Neuroscience Fellow Journal Club
Neuroscience RSS (Grand Rounds / Journal Club)
Neuroscience Lunch & Learn
Neuroscience M&M
Neurosurgery Case Conference
Neurosurgical M&M
Neurovascular Case Conference
Oncology Grand Rounds
Orthopaedic Case Conference
Rehabilitation Institute M&M
Spine RSS (GR & CC)
STEMI Peer Review M&M
Structural Heart Case Conference
Surgery Grand Rounds
Surgery M&M
Trauma Grand Round
Trauma M&M
Trauma Peer Review M&M
Vascular Surgeon Case Conference
Date of activity
*
-
Month
-
Day
Year
Date
Do you want to evaluate and claim credit for another activity?
Yes
No
Which activity did you attend?
Advanced Practice Providers (APP) GR ENDURING (watched recording on Healthstream)
Advanced Practice Providers (APP) GR LIVE (Microsoft Teams)
Anesthesia RSS
Cardiovascular Consultants Echocardiography Monthly Journal Club
Cardiovascular Consultants Evening Educational Sessions Grand Rounds
Cardiovascular - Adult Congenital Heart Disease (ACHD) Case Conference
Cardiovascular CICU Case Conference
Cardiovascular Grand Rounds
Cardiovascular MMI M&M
Epilepsy Surgical Case Conference
GI RSS
GU Tumor Case Conference
Hematologic Malignancies Tumor Case Conference
Insight to Impact CME Series Lunch & Learn GR
Internal Medicine Grand Rounds
Internal Medicine Journal Club
Maternal-Fetal Case Conference
Medical Record Documentation Grand Rounds
Multidisciplinary Cancer - Breast Case Conference
Multidisciplinary Cancer - Colorectal Case Conference
Multidisciplinary Cancer - GI Case Conference
Multidisciplinary Cancer - GYN Case Conference
Multidisciplinary Cancer - Head and Neck
Multidisciplinary Cancer - Thoracic
Multidisciplinary Wound Care / Limb Preservation Case Conference_St. Luke's South/St. Luke's East
Multi-Specialty Vascular Conference Case Conference
MWPOC Case Conference
Neonatal ICU PR M&M
Neonatal Journal Club
Neuroscience APP Case Conference
Neuroscience Fellow Journal Club
Neuroscience RSS (Grand Rounds / Journal Club)
Neuroscience Lunch & Learn
Neuroscience M&M
Neurosurgery Case Conference
Neurosurgical M&M
Neurovascular Case Conference
Oncology Grand Rounds
Orthopaedic Case Conference
Rehabilitation Institute M&M
Spine RSS (GR & CC)
STEMI Peer Review M&M
Structural Heart Case Conference
Surgery Grand Rounds
Surgery M&M
Trauma Grand Round
Trauma M&M
Trauma Peer Review M&M
Vascular Surgeon Case Conference
Date of activity
-
Month
-
Day
Year
Date
Do you want to evaluate and claim credit for another activity?
Yes
No
Which activity did you attend?
Advanced Practice Providers (APP) GR ENDURING (watched recording on Healthstream)
Advanced Practice Providers (APP) GR LIVE (Microsoft Teams)
Anesthesia RSS
Cardiovascular Consultants Echocardiography Monthly Journal Club
Cardiovascular Consultants Evening Educational Sessions Grand Rounds
Cardiovascular - Adult Congenital Heart Disease (ACHD) Case Conference
Cardiovascular CICU Case Conference
Cardiovascular Grand Rounds
Cardiovascular MMI M&M
Epilepsy Surgical Case Conference
GI RSS
GU Tumor Case Conference
Hematologic Malignancies Tumor Case Conference
Insight to Impact CME Series Lunch & Learn GR
Internal Medicine Grand Rounds
Internal Medicine Journal Club
Maternal-Fetal Case Conference
Medical Record Documentation Grand Rounds
Multidisciplinary Cancer - Breast Case Conference
Multidisciplinary Cancer - Colorectal Case Conference
Multidisciplinary Cancer - GI Case Conference
Multidisciplinary Cancer - GYN Case Conference
Multidisciplinary Cancer - Head and Neck
Multidisciplinary Cancer - Thoracic
Multidisciplinary Wound Care / Limb Preservation Case Conference_St. Luke's South/St. Luke's East
Multi-Specialty Vascular Conference Case Conference
MWPOC Case Conference
Neonatal ICU PR M&M
Neonatal Journal Club
Neuroscience APP Case Conference
Neuroscience Fellow Journal Club
Neuroscience RSS (Grand Rounds / Journal Club)
Neuroscience Lunch & Learn
Neuroscience M&M
Neurosurgery Case Conference
Neurosurgical M&M
Neurovascular Case Conference
Oncology Grand Rounds
Orthopaedic Case Conference
Rehabilitation Institute M&M
Spine RSS (GR & CC)
STEMI Peer Review M&M
Structural Heart Case Conference
Surgery Grand Rounds
Surgery M&M
Trauma Grand Round
Trauma M&M
Trauma Peer Review M&M
Vascular Surgeon Case Conference
Date of activity
-
Month
-
Day
Year
Date
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What changes do you plan to make in your practice as a result of participating in this activity?
*
Rate your confidence in applying your new learning into practice:
*
1
2
3
4
5
Not confident
Confident
1 is Not confident, 5 is Confident
What barriers to implementing changes do you experience in your practice? Check all that apply.
Cost constraints
Insurance/Reimbursement issues
Lack of time with patients
Overwhelming amount of information
Lack of administrative or management support, workflow issues
Lack of authority to implement changes
Gaps in my knowledge and training
Lack of support staff
Gaps in support staff knowledge and training
I do not anticipate any barriers to implementing changes
Other
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What areas of your practice could be enhanced or improved with additional education?
Please indicate your level of agreement with the following statements:
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The speaker(s) were effective at presenting the content
The information presented is relevant to my clinical practice
This activity will improve my ability to care for patients
This activity will improve patient outcomes
This activity increased my competence of the subject matter
The educational format was appropriate for the setting, objectives, and desired results of this activity
What are your credentials
*
MD/DO
Other
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Physicians
MD/DO
Number of Continuing Medical Education credits you are claiming:
*
Name
*
First Name
Last Name
Credentials (as you want them to appear on your certificate)
*
Email address for CME tracking
*
example@example.com
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Non-Physician
Certificate of Completion
Name
First Name
Last Name
Credentials (as you want them to appear on your certificate):
Email
example@example.com
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Submit
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