Educational Activity Evaluation

Title:

Date:

To assist us in evaluating the effectiveness of the CNE activity and to make recommendations for future programs, please complete the evaluation form by circling the appropriate rating.

KEY: / 1 = Not at all / 2 = Low / 3 = Medium / 4 = High
Was the educational program goal met through the content and activities provided?
Educational goal: / 1 / 2 / 3 / 4
To what extent did the content and activities help you meet the following educational program objectives?
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
How would you rate the teaching effectiveness of each presenter?
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
1 / 2 / 3 / 4
How useful will the information presented be to your practice? / 1 / 2 / 3 / 4
Did you meet your personal goal for attending this educational program? / Yes / No
If no, what was your goal?
Did the program provide objective, complete, evidence-based information without expressing a professional preference for any one product or service? / Yes / No
If no, please explain:
Required disclosures
Were you notified before the start of this program about what you needed to do to receive CNE credit? / Yes / No
Were you notified whether there were any potential conflicts of interest for presenters or authors and, if so, what they were? / Yes / No
Were you notified that there was commercial support for this program? / Yes / No
Were you notified that there was non-commercial sponsorship for this program? / Yes / No

Other comments you wish to share with us about this program: