pharmacy form link

CE Seminar *

	Excellent	Good	Fair	Poor
Overall program	Overall program Excellent	Overall program Good	Overall program Fair	Overall program Poor
Program organization and format	Program organization and format Excellent	Program organization and format Good	Program organization and format Fair	Program organization and format Poor
Relevance to personal needs	Relevance to personal needs Excellent	Relevance to personal needs Good	Relevance to personal needs Fair	Relevance to personal needs Poor
Overall knowledge of topics presented	Overall knowledge of topics presented Excellent	Overall knowledge of topics presented Good	Overall knowledge of topics presented Fair	Overall knowledge of topics presented Poor
Overall quality of speakers’ presentation	Overall quality of speakers’ presentation Excellent	Overall quality of speakers’ presentation Good	Overall quality of speakers’ presentation Fair	Overall quality of speakers’ presentation Poor
Dr. Mei Chang	Dr. Mei Chang Excellent	Dr. Mei Chang Good	Dr. Mei Chang Fair	Dr. Mei Chang Poor
Dr. Azru Moosvi	Dr. Azru Moosvi Excellent	Dr. Azru Moosvi Good	Dr. Azru Moosvi Fair	Dr. Azru Moosvi Poor
Dr. Tooba Piracha	Dr. Tooba Piracha Excellent	Dr. Tooba Piracha Good	Dr. Tooba Piracha Fair	Dr. Tooba Piracha Poor
Dr. Fawad Piracha	Dr. Fawad Piracha Excellent	Dr. Fawad Piracha Good	Dr. Fawad Piracha Fair	Dr. Fawad Piracha Poor
Dr. Zachary Piracha	Dr. Zachary Piracha Excellent	Dr. Zachary Piracha Good	Dr. Zachary Piracha Fair	Dr. Zachary Piracha Poor
Value of discussion time	Value of discussion time Excellent	Value of discussion time Good	Value of discussion time Fair	Value of discussion time Poor
Course materials distributed	Course materials distributed Excellent	Course materials distributed Good	Course materials distributed Fair	Course materials distributed Poor
Physical facilities	Physical facilities Excellent	Physical facilities Good	Physical facilities Fair	Physical facilities Poor
Refreshments	Refreshments Excellent	Refreshments Good	Refreshments Fair	Refreshments Poor
Scheduled date and time	Scheduled date and time Excellent	Scheduled date and time Good	Scheduled date and time Fair	Scheduled date and time Poor

Additional Comments

Using the same scale as above, please indicate how well the following program learning objectives were met:

Outpatient Antibiotic Spectrum & Urine Culture Management *

	Excellent	Good	Fair	Poor
Summarize the antibiotic spectrum of commonly prescribed outpatient antibiotics	Summarize the antibiotic spectrum of commonly prescribed outpatient antibiotics Excellent	Summarize the antibiotic spectrum of commonly prescribed outpatient antibiotics Good	Summarize the antibiotic spectrum of commonly prescribed outpatient antibiotics Fair	Summarize the antibiotic spectrum of commonly prescribed outpatient antibiotics Poor
Apply strategies for interpreting positive urine culture results	Apply strategies for interpreting positive urine culture results Excellent	Apply strategies for interpreting positive urine culture results Good	Apply strategies for interpreting positive urine culture results Fair	Apply strategies for interpreting positive urine culture results Poor

Community Pharmacy-Based Test and Treat *

	Excellent	Good	Fair	Poor
Educate pharmacists about the different types of point-of-care testing (POCT) that can be performed at the community level	Educate pharmacists about the different types of point-of-care testing (POCT) that can be performed at the community level Excellent	Educate pharmacists about the different types of point-of-care testing (POCT) that can be performed at the community level Good	Educate pharmacists about the different types of point-of-care testing (POCT) that can be performed at the community level Fair	Educate pharmacists about the different types of point-of-care testing (POCT) that can be performed at the community level Poor
List and describe the steps of a pharmacist-led POCT appointment	List and describe the steps of a pharmacist-led POCT appointment Excellent	List and describe the steps of a pharmacist-led POCT appointment Good	List and describe the steps of a pharmacist-led POCT appointment Fair	List and describe the steps of a pharmacist-led POCT appointment Poor
Describe the basic process of specimen collection for POCT	Describe the basic process of specimen collection for POCT Excellent	Describe the basic process of specimen collection for POCT Good	Describe the basic process of specimen collection for POCT Fair	Describe the basic process of specimen collection for POCT Poor
Describe the steps for developing a pharmacy-based CLIA-waived laboratory	Describe the steps for developing a pharmacy-based CLIA-waived laboratory Excellent	Describe the steps for developing a pharmacy-based CLIA-waived laboratory Good	Describe the steps for developing a pharmacy-based CLIA-waived laboratory Fair	Describe the steps for developing a pharmacy-based CLIA-waived laboratory Poor
Review successful business models for POCT in the pharmacy	Review successful business models for POCT in the pharmacy Excellent	Review successful business models for POCT in the pharmacy Good	Review successful business models for POCT in the pharmacy Fair	Review successful business models for POCT in the pharmacy Poor

Approaches in Preventing Medication Errors in the Community Pharmacy Setting *

	Excellent	Good	Fair	Poor
Recognize commonly occurring medication errors in the community pharmacy setting	Recognize commonly occurring medication errors in the community pharmacy setting Excellent	Recognize commonly occurring medication errors in the community pharmacy setting Good	Recognize commonly occurring medication errors in the community pharmacy setting Fair	Recognize commonly occurring medication errors in the community pharmacy setting Poor
List major reasons why medication errors occur in the community setting	List major reasons why medication errors occur in the community setting Excellent	List major reasons why medication errors occur in the community setting Good	List major reasons why medication errors occur in the community setting Fair	List major reasons why medication errors occur in the community setting Poor
Identify recommendations to reduce rate of incidence in medication errors	Identify recommendations to reduce rate of incidence in medication errors Excellent	Identify recommendations to reduce rate of incidence in medication errors Good	Identify recommendations to reduce rate of incidence in medication errors Fair	Identify recommendations to reduce rate of incidence in medication errors Poor

Overview of Alzheimer’s Disease and current treatment options *

	Excellent	Good	Fair	Poor
Identify the early signs of Alzheimer’s disease	Identify the early signs of Alzheimer’s disease Excellent	Identify the early signs of Alzheimer’s disease Good	Identify the early signs of Alzheimer’s disease Fair	Identify the early signs of Alzheimer’s disease Poor
Identify differences in types of dementia	Identify differences in types of dementia Excellent	Identify differences in types of dementia Good	Identify differences in types of dementia Fair	Identify differences in types of dementia Poor
Identify risk factors for AD	Identify risk factors for AD Excellent	Identify risk factors for AD Good	Identify risk factors for AD Fair	Identify risk factors for AD Poor
Discuss current treatment options, safety profiles and counseling points	Discuss current treatment options, safety profiles and counseling points Excellent	Discuss current treatment options, safety profiles and counseling points Good	Discuss current treatment options, safety profiles and counseling points Fair	Discuss current treatment options, safety profiles and counseling points Poor

Did you feel there were any aspects of commercialism? *

yes
No

If yes, please elaborate (check all that apply):

Unbalanced view of therapeutic options
Failure to use generic names
Use of single brand name versus several brand names
Illustrative material reflected company product promotion
Failure to disclose that product recommended for off-label use or still investigational
Other (please specify):

Other (please specify):

Which aspect of the lecture did you feel was most significant to your needs and why: *

Will you make any changes in your practice as a result of the information from this seminar? *

Yes
No

If yes, please explain (check all that apply): *

Alter my practice performance
Won’t alter my performance, but convinced me I’m doing the right thing
Is relevant to my practice
Will result in better patient outcomes
Other (please specify):

Other (please specify):

The content covered will improve my following competencies (check all that apply): *

Other (please specify):

prior to the presentation *

	Very low	Low	Average	High	Higest
How would you rate your knowledge level of the subject matter discussed prior to the presentation(s)	How would you rate your knowledge level of the subject matter discussed prior to the presentation(s) Very low	How would you rate your knowledge level of the subject matter discussed prior to the presentation(s) Low	How would you rate your knowledge level of the subject matter discussed prior to the presentation(s) Average	How would you rate your knowledge level of the subject matter discussed prior to the presentation(s) High	How would you rate your knowledge level of the subject matter discussed prior to the presentation(s) Higest

following the presentation *

	Very Low	Low	Average	High	Higest
How would you rate your knowledge level of the subject matter discussed following the presentation(s)	How would you rate your knowledge level of the subject matter discussed following the presentation(s) Very Low	How would you rate your knowledge level of the subject matter discussed following the presentation(s) Low	How would you rate your knowledge level of the subject matter discussed following the presentation(s) Average	How would you rate your knowledge level of the subject matter discussed following the presentation(s) High	How would you rate your knowledge level of the subject matter discussed following the presentation(s) Higest

What future topics would you like to see offered in the area of Obesity? Other areas? *

Thank Your For Your Input