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
Demonstrate evidence-based medicine practice in Supportive Care medicine.	Demonstrate evidence-based medicine practice in Supportive Care medicine. - Outstanding	Demonstrate evidence-based medicine practice in Supportive Care medicine. - Good	Demonstrate evidence-based medicine practice in Supportive Care medicine. - Satisfactory	Demonstrate evidence-based medicine practice in Supportive Care medicine. - Fair	Demonstrate evidence-based medicine practice in Supportive Care medicine. - Poor
Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice.	Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice. - Outstanding	Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice. - Good	Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice. - Satisfactory	Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice. - Fair	Assess and integrate new developments in the field of Supportive and Palliative Care medicine into daily practice. - Poor
Implement the institutional growth of the Supportive and Palliative Care Department as an academic center.	Implement the institutional growth of the Supportive and Palliative Care Department as an academic center. - Outstanding	Implement the institutional growth of the Supportive and Palliative Care Department as an academic center. - Good	Implement the institutional growth of the Supportive and Palliative Care Department as an academic center. - Satisfactory	Implement the institutional growth of the Supportive and Palliative Care Department as an academic center. - Fair	Implement the institutional growth of the Supportive and Palliative Care Department as an academic center. - 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?

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