H2H 2021 Conference Day 3

Hand to Hold Conference for NICU Professionals - Day 3
Thank you for your time. This survey will only take you a FEW minutes to complete. Please note, that each individual requesting a Continuing Education Certificate must complete a separate evaluation form.
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Title*
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Module
Evaluate the Presentation Style and Content -- Mary Coughlin, MS, NNP, RNC-E*
Excellent Very Good Good Fair Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias
Evaluation of Learning Objective(s) -- Stories Matter - Embracing our shared stories to connect and heal*
Rate how well the presentation met the following learning objectives.
Excellent Very Good Good Fair Poor
Describe the power of story
List 2 examples of post traumatic growth

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Evaluate the Presentation Style and Content -- Vincent Smith, MD, MPH*
Excellent Very Good Good Fair Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias
Evaluation of Learning Objective(s) -- NICU Discharge Preparation and Transition Planning*
Rate how well the presentation met the following learning objectives.
Excellent Very Good Good Fair Poor
Explain the important of NICU discharge preparation
Describe the NPA guidelines for NICU discharge preparation and transition planning

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Evaluation of Learning Objective(s) -- Health Disparities and Cultural Competence in the NICU*

Rate how well the presentation met the following learning objectives.

	Excellent	Very Good	Good	Fair	Poor
Describe the state of health disparities currently present in the NICU
List two skills that NICU professionals need to possess in order to deliver culturally competent care in their organizations/units
Discuss the impact of culturally competent care on maternal and infant outcomes abound Black and Brown populations

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Continuing Education & Certificate Information
Complete the information below to receive a certificate of Participation & Continuing Education. By entering your information below, you certify that you have personally listened to the presentation and entered this information after doing so, and that you are submitting this form only for yourself.
Name*
First Last
Job Title/Credentials
Your State License #
This will be printed on your CE certificate
Email*
Hospital Name
Hospital State
Hospital City
Enter any other comments here. Thank you for your time!
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Course Code Prefix*

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Template Color*

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Number of Units Earned*

(Example: 1 hour, 3 hours, 10 magic beans -- be sure to add the measurement)

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Hand to Hold 2021 NICU Community Conference for NICU Professionals

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias