CME Jan 5 2022 GHS Survey Form – American Association of Physicians of Indian Origin

Continuing Medical Education
Competence Evaluation

Troubled waters in Safe Harbors, Avoiding legal pitfalls, fraud and abuse. A practical guide for health care practitioners
CME Hours:: 2.5

First name*

Last name*

Address*

City*

State*

Zip*

CMS Member:*

Yes

ABIN Member:*

Yes

ABIM Number

Email*

Phone*

Fax

PRE-SURVEY COMPETENCE EVALUATION

Instructions: For each statement, circle the appropriate number to indicate your response:

Pre-Survey Competence Evaluation*

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
1. The professional practice gap (educational needs) identified for this activity matches my current professional needs.
2. This CME activity promotes practical changes or strategies that will enhance my professional practice and competence.
3. This activity addresses areas of content that are relevant and have a direct impact on my professional practice or competence.
4. It is clear to me what the desired learning outcomes (educational /objectives) are for this activity.
5. Based on the stated desired learning outcomes (ideal competence) designed for this activity, my professional practice is in need of improvement(s).

Notes for Q4:
At the conclusion of this activity, participants should be able to:
LEARNING OBJECTIVES

TOPIC: Malignant Hyperthermia - Time For India To Act!
1. Provide an update on the etiology and incidence of malignant hyperthermia
2. Review the results with and without dantrolene sodium
3. Review the role of genetics in diagnosis and its relationship to the in-vitro contracture test
4. Emphasize the need for dantrolene - the antidote -in anesthetizing locations

TOPIC: The Management of Weapons of Mass Destruction
The participants will learn what to do if they encounter Weapons of Mass Destruction
1. Mitigation
2. Preparation
3. Response
4. Recovery

TOPIC: Prostate specific antigen-to do or not to
1. Be familiar with the controversies surrounding PSA screening
2. Know the differences between the aggressive and non-aggressive prostate cancer (the hares and the tortoises)
3. Management options so as to educate the patients so that the patient might be able to decide on which specialist to refer

TOPIC: The Latest and Greatest in Cataract Surgery
1. To know the recent advances in cataract surgery
2. How one can see the distance as well as near without dependence on glasses after cataract surgery.

TOPIC: Prevention of mental illness and promotion of mental well-being
1. The audience will learn the various factors implicated in mental illness
2. Participants will learn about the various bio-psycho-social programs used to prevent mental illness
3. Participants will learn about the prevention of mental illness through a simple Mnemonic called the "BASICS"

POST-SURVEY COMPETENCE EVALUATION

Instructions: For each statement, circle the appropriate number to indicate your response:

Post-Survey Competence Evaluation*

	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
1. This activity met with my current professional needs.
2. Upon completion of this activity, I feel empowered to implement specific changes or strategies that will enhance my professional practice and competence.
3. The content of this activity served to enhance my professional practice and competence.
4. It is clear to me how I would implement the desired learning outcomes (changes or new strategies) in my practice, if given the chance.
5. The selected faculty members, moderators and/or facilitators met with my professional expectations.
6. The educational design and format chosen for this activity were appropriate for the setting, and desired learning outcomes.

7. In what way could this CME activity be improved? (Please respond in terms of content, faculty selection, learning outcomes or expected changes, etc)*

8. What were some of the strengths of this CME activity?*

9. As a result of this activity, and in striving for ideal professional practice and competence, I will make the following changes:*

10. Did this CME activity actively promote improvements in health care that were free of commercial bias and/or promotion?*

Yes

If No, please explain why?

11. Please list at least three (3) professional practice gaps (educational needs or problems areas) that you would like to see addressed for your practice in future CME activities:*

Signature*

Instructions: For each statement, circle the appropriate number to indicate your response:

Instructions: For each statement, circle the appropriate number to indicate your response:

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