AAI Fundamental Course Evaluation

Combined Use of Neurotoxins (BoNTA) and Dermal Fillers for Facial Enhancement: Fundamental Techniques

COURSE EVALUATION
Select Name*
Select Profession*

PhysicianNurseNurse PractitionerPharmacistDentistPhysician AssistantOther
Email*
example@example.com
State of Licensure*
License Number*
Please select the activity you attended*

As a result of my participation in this activity, I am better able to:*

	Strongly Agree	Agree	Disagree	Strongly Disagree
Identify and locate key anatomical structures as they apply to the safe and efficacious use of BoNTA and dermal filler injections.
Select the Neurotoxin (BoNTA) and/or filler product that provides the safest and most efficacious result for the targeted treatment site.
Implement safe and efficacious injection procedures and be able to recognize and implement appropriate treatment protocol of any potential adverse events.

Please indicate the extent of your agreement with the following statements:*

	Strongly Agree	Agree	Disagree	Strongly Disagree
The activity was appropriate and met my educational needs.
The speaker demonstrated experiential knowledge of the topic.
The educational materials were effective.
The faculty was knowledgeable, effective and free of bias.
The learning activities were effective and incorporated active learning methods.
The activity was well organized and well managed.
The content of this activity contributes valuable information that will assist me in improving patient outcomes.
Based on my experience today, I would recommend future activities on Combined Use of BoNTA and Dermal Fillers similar to this to my colleagues.
The teaching and learning methods were effective.
The learning assessment used for this activity was appropriate.

What was your overall rating of the speaker/instructor?*

ExcellentGoodFairPoor
Did the speaker(s) encourage questions/discussions or other participation from the audience?*

YesNo
The content was objective, current, scientifically sound, and free of commercial bias.*

YesNo
Based on information presented in the activity, I will:*

Do nothing because content was not convincingSeek additional information on this topicChange my practiceDo nothing as current practice reflects activity recommendationsDo nothing as lack of organizational support prevents my adoption of presented guidelines and recommendationsDo nothing as lack of financial support prevents my adoption of presented guidelines and recommendationsOther
As a result of this course, I will likely make changes to my practice in these categories:*

DiagnosisPatient SafetyDocumentation (appropriate)Treatment approachPatient EducationMedication
The most important takeaway I’ve learned from this activity:*
As a result of my participation in this activity, I plan to make the following change in my role on the healthcare team:*
Based on the objectives above and participation in the activity, my healthcare team will make the following changes in practice:*
Of the patients you will see in the next week, about how many will benefit from the information you learned today?*

More than 5026 to 5011 to 251 to 10Not applicable
Based on what I learned today, I will improve my practice by incorporating the following (check all that apply):*

Improved diagnosis/patient assessmentUseful therapies and appropriate usesCutting-edge science in this therapeutic areaBest practices of my colleagues and leadersI do not plan to make any changes to my practice at this timeOther
Which ONE delivery method do you find the most effective for CE learning?*

Live symposia at national/regional conferencesLive local meetingsLive grand roundsInternet webcastsInternet/print monographsOther

Please rate the professional practice value of each of the following in terms of improving your practice:*

	Most Valuable	Valuable	Somewhat Valuable	Least Valuable
Today's CE Event
Direct to consumer advertising
Sales representative visits
Promotional/other non-certified education

What motivated you to participate in this activity?*

CE CreditsFacultyTopic or therapeutic areaFormat type
Based upon the information presented in this educational activity, which of the following statements best reflects your sentiment toward education for Combined Use of Dermal Fillers and BoNTA for Facial Enhancement: Fundamental Techniques? (select one)*

I have learned everything I need to learn about Combined Use of Dermal Fillers and BoNTA for Facial Enhancement: Fundamental Techniques.I would like to learn more about Combined Use of Dermal Fillers and BoNTA for Facial Enhancement: Fundamental Techniques.
We would be interested in using your topic suggestions as a means to develop future education. What general comments or additional topics would you suggest for future activities?*
Can we share your opinions/comments regarding this course for promotional purposes?*

YesNo
Other comments or suggestions for improvement?*
Please select the hours you attended.*

8:00am - 12:00pm (Didactic Lecture on Dermal Fillers and Botulinum Toxins)12:30pm - 5:00pm (Hands-On Training for Dermal Fillers and Botulinum Toxins with Live Injections, Review, Discussion, Q&A)
Total Symposium CE Hours
Calculated based on the hours you attended (selected in the question above).
Evaluation Submission Date*

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Date
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Combined Use of Neurotoxins (BoNTA) and Dermal Fillers for Facial Enhancement: Fundamental Techniques