Continuing Education Proposal Packet

Live Educational Activity and Enduring Materials

Course Evaluation

Activity title: / Module 6: Reducing the Risks of Opioids
Activity #: / WB2864 / Proposed start/release date: (MM/DD/YYYY) / 12/19/17
Please take a moment to give us your feedback and write your comments in the boxes provided.
Content and Learning Materials
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
The content and learning materials addressed a need or a gap in my knowledge or skills. /  /  /  /  /  / 
The difficulty level was appropriate. /  /  /  /  /  / 
The length and pace of the activity was appropriate. /  /  /  /  /  / 
Feedback (Q&A, knowledge checks)I received during the activity was helpful. /  /  /  /  /  / 
Please share your comments about the content and learning materials. / Comments:
What suggestions do you have to improve this educational activity? / Comments:
Presentation
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
The content expert(s) demonstrated expertise in the subject matter. /  /  /  /  /  / 
The delivery method used (conference, journal article, webcast, e-learning, etc.) was appropriate for the subject matter and helped me learn the content. /  /  /  /  /  / 
The instructional strategies (lecture, case scenarios, figures, tables, media, etc.) helped me learn the content. /  /  /  /  /  / 
Learning Environment
The learning environment was conducive to learning. /  /  /  /  /  / 
Do you believe this activity was influenced by commercial interests? / Yes / No
If yes, please explain. / Comments:
Did you experience technical difficulties with this activity? / Yes / No
If yes, please explain. / Comments:
Knowledge, Competence, and Practice
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
This activity effectively met my educational needs. /  /  /  /  /  / 
I will be able to apply the knowledge gained from this activity to increase or maintain my competence. /  /  /  /  /  / 
I will be able to apply the knowledge gained from this activity to my practice. /  /  /  /  /  / 
I will be able to apply the knowledge/skills gained from this activity to develop strategies/provide interventions. /  /  /  /  /  / 
I will be able to apply the knowledge gained from this activity to improve performance. /  /  /  /  /  / 
What change or impact do you anticipate?
Do you anticipate barriers applying this knowledge? / Yes No
If yes, please explain / Comments:
Learning Objectives
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
I can recognize high-risk situations in patients on opioid therapy. /  /  /  /  /  / 
I can explain the range of clinical tools and tests that can provide data to help in risk assessment and clinical decision-making, such as prescription drug monitoring program (PDMP) data and urine drug testing (UDT). /  /  /  /  /  / 
I candescribe strategies for mitigating risk in patients taking opioids. /  /  /  /  /  / 
I can identify recommended next steps based on the results of urine drug testing, PDMP data, physical examination, and medical history.
The content was relevant to the learning objectives. /  /  /  /  /  / 
Please share your comments regarding the learning objectives. / Comments:
Access
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
The CDC’s Training and Continuing Education Online (TCEO) system is easy to use. /  /  /  /  /  / 
The availability of CE credit/contact hours influenced my decision to participate in this activity. /  /  /  /  /  / 
Activity Specific
Strongly Agree / Agree / Neither / Undecided / Disagree / Strongly Disagree / N/A
32. / If applicable: Insert your specific questions here. /  /  /  /  /  / 
33. / If applicable: Insert your specific request for comments here. / Comments:

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