Lafayette Medical Education Foundation, Inc.
Program Evaluation
ON-LINE
“Laryngeal Cancer”
Mark Lobo, MD
Faith, Hope and Love Cancer Center, Lafayette, IN.
August 12, 2016
Franciscan St. Elizabeth East
What are your professional Credentials?
O O O
MD/DO PA/NP Other______
Overall Thoughts on the Program
The program met my professional expectations and needs.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
The program provided tools which are helpful to my practice.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
The program content was at appropriate level for audience.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
Which of the following professional organization core competencies have been addressed by this program?(check all that apply)
PATIENT CENTERED CARE: Identify, respect, and care about patients’ differences, values, preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to, clearly inform, communicate with, and educate patients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of health lifestyles, including a focus on population health.
EVIDENCE BASED PRACTICE: Integrate best research with clinical expertise and patient values for optimum care, and participate in learning and research activities to the extent feasible.
QUALITY IMPROVEMENT: Identify errors and hazards in care; understand and implement basic safety design principles, such as standardization and simplification; continually understand and measure quality of care in terms of structure , process, and outcomes in relation to patient and community needs; and design and test interventions to change processes and systems of care, with the objective of improving quality.
INTERDISCIPLINARY TEAMS: Facilitating collaboration with other members of the health care team to ensure that care is coordinated, continuous, and reliable.
INFORMATICS: Utilizing information technology to improve communication and support decision-making systems.
MEDICAL KNOWLEDGE: Helping learners become aware of established or evolving clinical and research data and explaining how this information can be applied to the improvement of patient care.
PATIENT SAFETY:
Based on your participation in this program, which of the following do you expect to improve? (check all that apply)
KNOWLEDGE (awareness, recollection, and understanding)
COMPETENCE (ability to apply knowledge, skills, and judgment)
PERFORMANCE (what is actually being done in professional practice)
PATIENT OUTCOMES
NONE
Based on your participation in this program, how do you plan to change your clinical practice? (check all that apply)
Develop/revise and implement new or revised protocols, processes, policies, and procedures (please explain below)
Apply new strategies to better manage my patients and develop more effective treatment plans (please explain below)
N.A, the sessions validated my current practice
Other (please explain below)
If you need to explain any of your answers from the previous question-do so here:
______
Which of the following barriers do you expect to encounter in implementing these changes? (check all that apply)
Resources/economic
Lack of time to assess/counsel patients
Patient compliance
None
Other
Please suggest any other topics that may be of interest to you:
______
Additional comments:
______
Course Objectives
As a result of attending this program, I will be better able to: Describe patterns of spread of cancers of the supraglottic larynx, glottis larynx, and subglottic larynx.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
As a result of attending this program, I will be better able to: Describe the diagnostic work-up of laryngeal cancers.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
As a result of attending this program, I will be better able to: Identify the treatment selection and technique in vocal cord carcinoma: CIS, early vocal cord carcinoma, moderately advanced vocal cord cancer, and advanced vocal cord carcinoma.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
As a result of attending this program, I will be better able to: Recognize the treatment selection and technique in supraglottic larynx carcinoma.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
As a result of attending this program, I will be better able to: Describe results (e.g. local control) of treatment in vocal cord cancer and supraglottic larynx carcinoma.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
As a result of attending this program, I will be better able to: Describe radiation sequelae of treatment.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
Speaker Evaluation
Mark Lobo, MD
The speaker demonstrated expertise and presented high quality scientific content based on the best available evidence.
O O O O O
Strongly Agree Neutral Disagree Strongly
Agree Disagree
The scientific content was presented appropriately for the target audience and related to your current scope of practice.
O O O O O O
Strongly Agree Neutral Disagree Strongly N/A
Agree Disagree
Do you feel this presentation was objective, fair, and balanced?
O Yes O No
Was this presentation free of commercial bias or influence?
O Yes O No (please explain) ______
FACULTY DISCLOSURE STATEMENT - Full disclosure of all commercial relationships must be made in writing to the audience prior to the activity. Mark Lobo, MD has no financial disclosures to disclose. All additional planning committee members ,and the Lafayette Medical Education Foundation, Inc. staff have no financial relationships to disclose.
REQUEST FOR CREDITIf you wish to receive acknowledgement of participations for this activity, please fill in your contact information and return this form to the registration desk upon your departure.
Degree (please mark appropriate box and circle appropriate degree)MD/DO / PharmD/RPh / RN / Social worker / PA / OTHER
Family Practice / Internal Medicine / Adv. Practice Nurse
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