Please answer the following questions to help us determine this series effectiveness in meeting the identified educational needs.We appreciate your participation in this series and value your feedback. What is your area of specialty? e.g.: Family Medicine, Cardiology, Ob/Gyn, etc. How many years have you been in practice? -Years-0-56-1011-1516-2122-2728-3334+ Evaluate each presenter in terms of how they enhanced your knowledge and ability to apply new strategies and tools in your clinical practice. 1= Poor: Provided no new knowledge or strategies I can apply 2= Fair: Provided minimal new knowledge with limited strategies I can apply 3= Neutral: Reinforced current knowledge and strategies I currently apply 4= Good: Addressed gaps in knowledge and offered some strategies I will consider applying 5= Excellent: Addressed gaps in knowledge and offered strategies I will apply 12345 Ben Christenson, MD Ben Christenson, MD - 1 Ben Christenson, MD - 2 Ben Christenson, MD - 3 Ben Christenson, MD - 4 Ben Christenson, MD - 5 Rebecca Krill, MD Rebecca Krill, MD - 1 Rebecca Krill, MD - 2 Rebecca Krill, MD - 3 Rebecca Krill, MD - 4 Rebecca Krill, MD - 5 Sandra Schultz, MD Sandra Schultz, MD - 1 Sandra Schultz, MD - 2 Sandra Schultz, MD - 3 Sandra Schultz, MD - 4 Sandra Schultz, MD - 5 Provide individualized speaker comments or feedback Rate your ability to apply advances in treating depression to your clinical practice: * 1 = Not at all able 10 = Extremely able 12345678910 Before the activity: Before the activity: - 1 Before the activity: - 2 Before the activity: - 3 Before the activity: - 4 Before the activity: - 5 Before the activity: - 6 Before the activity: - 7 Before the activity: - 8 Before the activity: - 9 Before the activity: - 10 After the activity: After the activity: - 1 After the activity: - 2 After the activity: - 3 After the activity: - 4 After the activity: - 5 After the activity: - 6 After the activity: - 7 After the activity: - 8 After the activity: - 9 After the activity: - 10 As a result of attending this session, what new strategies will you apply? * What barriers will prevent you from making any desired changes? Check all that apply. Cost Need for more training Lack of opportunity or clinical application Resource availability Time constraints Patient adherence Lack of consensus on professional guidelines No perceived barriers Other. Please explain: What barriers will prevent you from making any desired changes? Other. Please explain: Will you attempt to address any identified barriers? Yes No Unsure If no, please explain: Please respond to the following statements: YesNoUnsure Session was free of commercial bias Session was free of commercial bias - Yes Session was free of commercial bias - No Session was free of commercial bias - Unsure Appropriate disclosure of conflict of interest was made for each speaker, author and/or planner Appropriate disclosure of conflict of interest was made for each speaker, author and/or planner - Yes Appropriate disclosure of conflict of interest was made for each speaker, author and/or planner - No Appropriate disclosure of conflict of interest was made for each speaker, author and/or planner - Unsure Educational content covered was balanced and evidenced-based Educational content covered was balanced and evidenced-based - Yes Educational content covered was balanced and evidenced-based - No Educational content covered was balanced and evidenced-based - Unsure Information provided was relevant to your scope of practice Information provided was relevant to your scope of practice - Yes Information provided was relevant to your scope of practice - No Information provided was relevant to your scope of practice - Unsure Instructional methods used during this activity appropriate for the content and audience Instructional methods used during this activity appropriate for the content and audience - Yes Instructional methods used during this activity appropriate for the content and audience - No Instructional methods used during this activity appropriate for the content and audience - Unsure If you answered no to any of the above, please explain: Describe any clinical situation(s) that you find difficult to manage or resolve that you would like addressed in future educational activities: Do you have any general comments or suggestions regarding the Primary Care Monthly Education Series? DO YOU WANT US TO SUBMIT YOUR COMPLETION OF THIS ACTIVITY TO ABIM AND/OR ABP?As an accredited CME provider we are able to partner with select ABMS boards to designate MOC/Continuing Certification Credits/Points. This activity is approved for the boards listed below. You can click the hyperlinked board(s) to check for your Board ID number:American Board of Internal Medicine (ABIM)American Board of Pediatrics (ABP)It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABIM and/or ABP points. Please answer the following questions in order to proceed. Submit to ABIM and/or ABP? * By responding “Yes” I agree to allow the HealthPartners Office of CME to share my completion information with the American Board of Internal Medicine (ABIM) and/or American Board of Pediatrics (ABP) and the ACCME (Accreditation Council for Continuing Medical Education) so that points can be uploaded to my transcript. No, I am not an ABIM or ABP diplomate Yes, I want ABIM and/or ABP points and agree to have my completion info shared First and Last name: * Verify that your name below appears how it is registered with your Board(s). Make changes if necessary. What is your month and day of birth? * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Which Board are you a member of? * Select the Board(s) you are claiming credit for: American Board of Internal Medicine (ABIM) American Board of Pediatrics (ABP) What is your ABIM ID number? * American Board of Internal Medicine What is your ABP ID number? * American Board of Pediatrics Please write a reflective statement on how you intend to change your practice based on the knowledge you gained from participating in this activity. Upon review and approval of your statement, your points will be submitted to the ABIM by the CME office.A good reflective statement includes:What you learned as a result of the activity & what will you do with new informationAny areas for improvementPlans for future learning or sustainabilityGeneric statements such as "Good conference. I learned a lot" or "This helps me treat my patients" will not be approved. Reflective Statement * Leave this field blank
