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  • Date Format: MM slash DD slash YYYY

  • Please rate the impact of the following objectives:

  • Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
    Participate in dialogue about what constitutes medical professionalism.
    Recognize factors that influence professional behavior.
    Recognize unprofessional behaviors in myself and in others.
    Access tools that aid in professional behavior identification and improvement.

  • Please rate the projected impact of this activity on your knowledge/competence, skills/strategy, performance, and patient outcomes*:

    (competence is defined as the ability to apply knowledge, skills, and judgment in practice [knowing how to do something])
  • YesNoNo Change
  • YesNoNo Change
  • YesNoNo Change
  • YesNoNo Change
  • *Joint Accreditation requires us to analyze changes in learners’ knowledge/competence, skills/strategies, performance, or patient outcomes.
  • *Commercial bias is defined as a personal judgment in favor of a specific product or service of a commercial interest.
    YesNo
  • YesNoN/A
  • YesNo
  • YesNo
  • YesNo
  • YesNo
  • Please enter a number from 000000 to 999999.
  • Your certificate will be sent to you by email after this survey has been processed.
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