H2H Podcast 1 — Nurse Kathi

Hand to Hold Podcast Evaluation:
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.
Hidden
Title*
Parents of NICU babies experience which of the following social impacts:*
- Isolation
- Disruption of family life
- Sibling resentment
- All of the above
Even a short-term NICU stay can have a profound effect on the parents.*
- True
- False
The mental, physical, and social health of NICU families can be directly correlated to:*
- How NICU staff will treat families while in the hospital
- The long-term physical and developmental outcome of the baby
- How early the baby is born
- How long the baby has to stay in the NICU

Evaluate the Presentation Style and Content -- Kelli Kelly*
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
Evaluation of Learning Objective(s) --*
Rate how well the presentation met the following learning objectives.
Excellent Very Good Good Fair Poor
Recall at least social impact frequently experienced by NICU parents.
Identify the most common risk factor for mental, physical and social health of NICU families.

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
Please provide one of the following -- You State License#, Employee#, Last 4 digits of your Social (One of these is required for CE Certificate)
Email*
Hospital Name
Hospital State
Hospital City
Enter any other comments here. Thank you for your time!
Hidden
Module
Hidden
Course Code Prefix*

These numbers will show BEFORE the course code on the template.
Hidden
Template Color*

(Don't forget the #)
Hidden
Number of Units Earned*

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

	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

	Excellent	Very Good	Good	Fair	Poor
Recall at least social impact frequently experienced by NICU parents.
Identify the most common risk factor for mental, physical and social health of NICU families.

Hand to Hold Podcast Evaluation