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HPE HSS 08-23-21

Questions marked with a * are required

Health Professions Educator Series - HSS Open Forum Series 08-23-21 Patient Safety and Quality Improvement

To receive Category 1 CME credit please complete the full CME Evaluation Form. *Note: If you viewed the session via recorded video from the TEACH website, you will be required to answer two content questions at the end of the video to receive credit.

Name

Credentials (MD, DO, PhD, PA, NP, etc.)

Department

Email Address

Did you receive disclosure information prior to the presentation?

Yes

No (If No, please explain)

Was the speaker biased in the discussion of any product(s) or service(s)?

Yes (If Yes, please explain)

Based on this lecture what do you feel more competent (Competence) doing?

Based on what you learned from this lecture tell us one thing you will commit to change in your practice (Performance).

Please rate each section.

	Excellent	Very Good	Acceptable	Fair
Content was relevant to my needs	Excellent	Very Good	Acceptable	Fair

Objectives were accomplished	Excellent	Very Good	Acceptable	Fair

Speaker was organized	Excellent	Very Good	Acceptable	Fair

Overall Evaluation	Excellent	Very Good	Acceptable	Fair

Comments

Suggestions for future topics

How did you attend this session?

In person or by Zoom on the day the session was scheduled (Evaluation of a live session must be submitted with 7 days of the session date)

By recorded video

Date viewed (mm/dd/yyyy)