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
Discuss cases which are considered for HCT and have high risk features.	Discuss cases which are considered for HCT and have high risk features. - Outstanding	Discuss cases which are considered for HCT and have high risk features. - Good	Discuss cases which are considered for HCT and have high risk features. - Satisfactory	Discuss cases which are considered for HCT and have high risk features. - Fair	Discuss cases which are considered for HCT and have high risk features. - Poor
Identify modifiable risk factors and provide plans for optimization before and after HCT.	Identify modifiable risk factors and provide plans for optimization before and after HCT. - Outstanding	Identify modifiable risk factors and provide plans for optimization before and after HCT. - Good	Identify modifiable risk factors and provide plans for optimization before and after HCT. - Satisfactory	Identify modifiable risk factors and provide plans for optimization before and after HCT. - Fair	Identify modifiable risk factors and provide plans for optimization before and after HCT. - Poor
Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement.	Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement. - Outstanding	Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement. - Good	Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement. - Satisfactory	Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement. - Fair	Examine the outcomes of these high risk cases on an ongoing basis during their transplant and as an aggregate summary for quality improvement. - 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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