Training Evaluation

CME Training Evaluation Form

In order to receive your certificate for participation in this internet enduring material, please submit your feedback via this required evaluation form.

*STOP! Please fill out Certificate Details and Customer Details now.

First Name*

Last Name*

Degree*

Email*

1. Will participation in this training affect change in your practice/work?*

2. List two ways in which participation in this training will affect change in your practice/work of medicine, leadership performance or with your research.*

3. What barriers, if any, do you foresee in your ability to affect change in your practice/work, your health care institution or in your research?*

4. Were the learning objectives for this training met?*

4.1 If any of the objectives were not met, please explain

5. Please rate the overall activity*

Excellent	Good	Fair	Poor

6. This CME activity was balanced, promoted improvements and/or quality in healthcare/public health, and was not unduly biased toward a specific commercial interest.*

6.1 Please Explain

7. Has this training improved your overall grantsmanship skills?*

8. Would you recommend this training to a colleague?*

9. Did you experience any technical difficulties with this online learning platform?*

10. Please share your thoughts about this training.*

11. How did you hear about this training? (e.g., Forwarded Email, Internet Search, My Organization, Colleague)*

STOP! Click SUBMIT first and MARK COMPLETE.

If you do not click both buttons, your evaluation will not be complete.

Training Evaluation

CME Training Evaluation Form

In order to receive your certificate for participation in this internet enduring material, please submit your feedback via this required evaluation form. *STOP! Please fill out Certificate Details and Customer Details now.

In order to receive your certificate for participation in this internet enduring material, please submit your feedback via this required evaluation form.

*STOP! Please fill out Certificate Details and Customer Details now.