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NYSACCP NYSCHP Joint Webinar Activity Evaluation Form
Pain Management in Substance Use Disorder (11/17/22 webinar)
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Please select the number which best indicates your opinion.
What is your overall evaluation of this educational program?
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please select the number which best indicates your opinion.
How well did this program live up to your expectations?
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please select the number which best indicates your opinion.
How well did this activity meet your needs?
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please rate if each of the following learning objectives was achieved:
Explain the pharmacology of medication assisted therapy and its interaction with common pain medications
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please rate if each of the following learning objectives was achieved:
Describe barriers to optimal pain management in patients with substance use disorder
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please rate if each of the following learning objectives was achieved:
Summarize pain management treatment strategies in patients with substance use disorder
1 - Not at all satisfied
2
3 - Somewhat satisfied
4
5 - Very satisfied
Clear selection
Please rate the following elements:
Presentation scope, depth, and relevance to practice:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
Clear selection
Please rate the following elements:
Objectivity and balance:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
Clear selection
Please rate the following elements:
Usefulness of educational materials:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
Clear selection
Please rate the following elements:
Effectiveness of presenter Ebtesam Ahmed:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
Clear selection
Please rate the following elements:
Effectiveness of presenter Bennett Doughty:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
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Please rate the following elements:
Effectiveness of the teaching and learning methods used:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
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Please rate the following elements:
Use of active learning:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
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Please rate the following elements:
Appropriateness of the learning assessment activities:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
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Please rate the following elements:
Overall evaluation:
1 - Inadequate
2
3 - Adequate
4
5 - Excellent
Clear selection
Was the activity free of bias, promotion, or advertisement of commercial products?
Yes
No
Not sure
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Please indicate your area of professional practice:
Clinical pharmacist
Hospital pharmacist
Community pharmacist
Student
Resident
Fellow
Other:
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