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Local Anesthetics Learner Assessment and Program Evaluation
Each participant is requested to complete this evaluation tool as a way to assess the
effectiveness of his/her learning following his/her participation in the program.
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* Indicates required question
Name:
*
Your answer
AANA #
*
Your answer
Email Address:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
Indicate your level of achievement for each learner objective on the rating scale.
Select One
1. After attending this session, the attendee will be able to describe the pharmacology of local anesthetics.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
2. The information provided was effective in presenting the material.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
3. Teaching methods were effective.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
4. Online learning format facilitated learning.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
5. The content was related to the objectives.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
6. My personal learning objectives were met.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
7. State one item you learned that will improve your nurse anesthesia practice.
*
Your answer
8. State any barriers to implement this change.
*
Your answer
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