EVALUATION: Alternate Medical Media Demo CourseName* First Last TitleSelect TitleMDPhDRNNPThis title will follow your full name on your certificate. Leave blank if none of the above apply.Credit Type*AMA PRA Category 1Contact HoursAttendanceSelect the type of educational credit you will be claiming for this course.Credit Hours*Please enter a value between 0 and 5.00.Select the number of CME credits you will be claiming for this course.Contact Hours*Please enter a value between 0 and 6.00.Select the number of contact hours you will be claiming for this course.Attendance Hours*5.00Email* Course Completion Date* Evaluation Questions 1. Please respond regarding how much you agree or disagree that the gaps listed above were addressed Participating in this educational activity changed your KNOWLEDGE in the professional practice gaps listed above.(1 = disagree, 4 = agree)Participating in this educational activity changed your COMPETENCE in the professional practice gaps listed above.(1 = disagree, 4 = agree)Do you feel participating in this educational activity will change your PERFORMANCE in the professional gaps listed above?(1 = disagree, 4 = agree)2. Please elaborate on your previous answers.*3. Please evaluate the effectiveness of the course author in improving your knowledge, competence and/or performance.Michelle Reillo, Ph.D4. Please elaborate on your previous answer.*5. Please identify a change that you will implement into your practice as a result of attending this educational activity (new protocols, different medications, etc.)*6. How certain are you that you will implement this change?*Select an OptionVery CertainCertainMaybeNot CertainWill Not ImplementN/A7. What topics do you want to hear more about, and what issue(s) in your practice will they address?*8. Were the patient recommendations based on acceptable practices in medicine?*Select an OptionYesNo9. If you answered No on the question above, please explain which recommendation(s) were not based on acceptable practices in medicine.10. Do you think the presentation was without commercial bias?*Select an OptionYesNo11. If you answered No on the above question, please list the topics that were biased.12. Please provide any additional comments you may have about this educational activity.As one of the participants of this educational activity, we want to encourage you to implement those ideas that are appropriate to your healthcare environment. This evaluation is confidential and no individual will be identified by Alternate Medical Media or the University of Louisville Office of Continuing Medical Education and Professional Development. It will only be used for quality improvement. This iframe contains the logic required to handle Ajax powered Gravity Forms.