Small Baby Mini Series - Evaluation
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Small Baby Mini Series Webinar 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.
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Title of Webinar
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Living with CP: Perspectives from the Incubator to the Clinic and Beyond
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Module:
Small Baby Mini Series
Can put the company's name if applicable. Will appear below the title of the webinar on the CE certificate. Must remove sample name.
Evaluate the Presentation Style and Content --
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Jan Brunstrom-Hernandez, MD
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 Objectives -- Rate how well the presentation met the following learning objectives.
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Living with CP: Perspectives from the Incubator to the Clinic and Beyond
Excellent
Very Good
Good
Fair
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Define CP and list at least two motor phenotypes or co-morbidities that may accompany the diagnosis
Discuss at least one benefit to the infant, child and/or family of an early diagnosis
Provide an example of a communication strategy that may improve how the diagnosis of CP is delivered to parents/caregivers
Evaluate the Webinar Content --
The content was relevant to my daily practice
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Excellent
Very Good
Good
Fair
Poor
Overall, this presentation was
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Excellent
Very Good
Good
Fair
Poor
List one new thing you learned in this presentation
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 watched the complete webinar presentation for a total of 50 minutes or more, that you entering this information after doing so, and that you are submitting this form only for yourself.
Name
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First
Last
Email
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Job Title/Credentials
Please provide your State License # (this will appear on the CE Certificate)
Enter any other comments here. Thank you for your time!
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Course Code Prefix
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These numbers will show BEFORE the course code on the template.
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Template Color - be sure to match to the company color
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(Don't forget the #)
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Number of Units Earned
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(Example: 1 hour, 3 hours, 10 magic beans -- be sure to add the measurement)
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CONTACT INFORMATION
Email for Questions – ceuprovider@nursekathi.com