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
Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials.	Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials. - Outstanding	Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials. - Good	Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials. - Satisfactory	Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials. - Fair	Outline pending and active protocols to ensure that all eligible patients are offered the option of the treatment on clinical trials. - Poor
Identify areas of research with potential impact in the field of study.	Identify areas of research with potential impact in the field of study. - Outstanding	Identify areas of research with potential impact in the field of study. - Good	Identify areas of research with potential impact in the field of study. - Satisfactory	Identify areas of research with potential impact in the field of study. - Fair	Identify areas of research with potential impact in the field of study. - Poor
Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols.	Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols. - Outstanding	Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols. - Good	Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols. - Satisfactory	Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols. - Fair	Demonstrate the ability to evaluate the current research portfolio including prioritization of the protocols. - 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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