1 Start 2 Complete

Learner Demographics *

Physician

Nurse

Other

Overall Series Rating *

	Excellent	Satisfactory	Poor
Overall, how would you rate this series?	Overall, how would you rate this series? - Excellent	Overall, how would you rate this series? - Satisfactory	Overall, how would you rate this series? - Poor

Extent to which identified Series objectives were met: I am better able to ... *

	Outstanding	Good	Satisfactory	Fair	Poor
Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews.	Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews. - Outstanding	Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews. - Good	Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews. - Satisfactory	Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews. - Fair	Promote interprofessional learning and foster blame-free culture through inquiry-based approach to surgical case reviews. - Poor
Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS.	Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS. - Outstanding	Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS. - Good	Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS. - Satisfactory	Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS. - Fair	Improve clinical practice through review of presentations of complications, 30-day mortality, PSI and excessive LOS. - Poor
Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review.	Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review. - Outstanding	Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review. - Good	Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review. - Satisfactory	Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review. - Fair	Increase patient safety and improve outcomes through enterprise-level discussion of cases submitted by site Chiefs of Surgery after local peer review. - Poor
Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics).	Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics). - Outstanding	Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics). - Good	Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics). - Satisfactory	Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics). - Fair	Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics). - Poor

Do you believe the subject matter presented/discussed was: *

	Yes	No
Objective	Objective - Yes	Objective - No
Fair & Balanced	Fair & Balanced - Yes	Fair & Balanced - No
Free of Commercial Bias	Free of Commercial Bias - Yes	Free of Commercial Bias - No

Have you made changes to your practice as a result of this series?

Yes

No

Please describe:

Do you have any recommendations for the moderator(s)/facilitator(s) of this series?

Yes

No

Please describe:

The Series included educational components that addressed cultural linguistic competency and implicit bias

Yes

No

N/A (If a research or non-direct patient care series)

Outside of this activity, what additional topics would you like addressed in other educational opportunities?

Leave this field blank