Learner Demographics *

Physician

Nurse

Other

Please specify: *

Future activities on this subject matter are necessary/important to my practice? *

Yes

No

I would like to see more activities on...

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

	Outstanding	Good	Satisfactory	Fair	Poor
Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations.	Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations. - Outstanding	Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations. - Good	Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations. - Satisfactory	Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations. - Fair	Identify current colorectal cancer screening guidelines and explain the importance of screening for early detection and prevention in diverse patient populations. - Poor
Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV.	Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV. - Outstanding	Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV. - Good	Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV. - Satisfactory	Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV. - Fair	Describe the risk factors, epidemiology, and screening considerations for HPV-related anal cancer, particularly in high-risk populations including men who have sex with men and people living with HIV. - Poor
Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment.	Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment. - Outstanding	Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment. - Good	Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment. - Satisfactory	Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment. - Fair	Demonstrate effective, culturally affirming communication techniques for initiating conversations about colorectal and anal cancer screening with patients, including strategies to overcome stigma and embarrassment. - Poor
Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening.	Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening. - Outstanding	Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening. - Good	Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening. - Satisfactory	Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening. - Fair	Integrate patient-centered approaches into clinical practice that address the unique healthcare needs and barriers faced by LGBTQ+ patients regarding cancer screening. - 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

The information presented (check all that apply): *

Reinforced my current practice/treatment habits

Will assist me in improving patient care and outcomes

Was timely and will influence how I practice, by providing new ideas and information I expect to use

Fulfilled my educational needs and enhanced my current knowledge

Does not directly apply to my practice

Will the information presented cause you to make any changes in your practice? *

Yes

No

Please describe any change(s) you plan to make in your practice as a result of this activity: *

How committed are you to making these changes? *

5 is very committed, 1 is not at all committed

5

4

3

2

1

Are there any existing barriers/factors that may prevent you from implementing a change in practice? *

Yes

No

Please describe: *

How would you rate the effectiveness of the following faculty? *

	Outstanding	Good	Satisfactory	Fair	Poor
David Russo, BS, MBA	David Russo, BS, MBA - Outstanding	David Russo, BS, MBA - Good	David Russo, BS, MBA - Satisfactory	David Russo, BS, MBA - Fair	David Russo, BS, MBA - Poor
Paula Chambers Raney	Paula Chambers Raney - Outstanding	Paula Chambers Raney - Good	Paula Chambers Raney - Satisfactory	Paula Chambers Raney - Fair	Paula Chambers Raney - Poor
Gregory Idos, MD, MS	Gregory Idos, MD, MS - Outstanding	Gregory Idos, MD, MS - Good	Gregory Idos, MD, MS - Satisfactory	Gregory Idos, MD, MS - Fair	Gregory Idos, MD, MS - Poor
Naomi Jay, PhD, RN, NP, FAAN	Naomi Jay, PhD, RN, NP, FAAN - Outstanding	Naomi Jay, PhD, RN, NP, FAAN - Good	Naomi Jay, PhD, RN, NP, FAAN - Satisfactory	Naomi Jay, PhD, RN, NP, FAAN - Fair	Naomi Jay, PhD, RN, NP, FAAN - Poor

Was any bias toward a commercial interest noted in the information provided (products/services unduly favored or promoted)?

Yes

No

Please identify products/service, faculty and or presentation(s) that were biased: *

The presentation included an educational component that addressed cultural and linguistic competency and implicit bias

Yes

No

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

Comments:

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