Evaluation Form: Addressing Cultural Dimensions of Pain Management
Learning Objectives
Learning Objectives
At the conclusion of this webinar, participants will be able to... 1. Explore differences in responses to pain among individuals based on culture, gender, age and other characteristics. 2. Discuss cultural attitudes toward pain medication. 3. Address ways in which clinics and providers can approach pain management in a culturally appropriate manner.
1. Did the training meet all of the stated learning objectives?
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1 - The learning objectives were not met 2 - The learning objectives were somewhat met 3 - The learning objectives were mostly met 4 - The learning objectives
2. The scholarship and expertise of Deliana Garcia, MA?
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1 - None 2 - Slight 3 - Moderate 4 - Excellent
3. Your overall satisfaction with this webinar training?
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1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied
4. The webinar presented new areas of knowledge, and/or new ideas/methods to implement.
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1 - Disagree 2- Somewhat agree 3 - Mostly agree 4 - Completely agree
5. The webinar contained information at a level commensurate with my training and experience.
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1 - Disagree 2- Somewhat agree 3 - Mostly agree 4 - Completely agree
6. How helpful was the information you learned today in enhancing the performance and operations of your health center or organization?
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N/A - Not applicable 1 - Not helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful
7. If applicable, how do you intend to use the information learned in your daily work?
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If you have nothing to enter please type "N/A"
8. Was the content balanced and free of commercial bias?
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1 - Yes 2 - No
9. Did the speaker(s) fully disclose any conflict of interest and/discussion of off-label usage of medications and/or medical devices?
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1 - Yes 2 - No
10. Please mentioned one thing you learned during this webinar training.
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If you have nothing to enter please type "N/A"
11. Are there any additional resources, technical assistance, or training that would be helpful to you or your organization?
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If you have nothing to enter please type "N/A"
12. What is the biggest challenge for you or your organization in providing quality care or services?
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If you have nothing to enter please type "N/A"
13. Please state any additional comments, questions, or suggestions below.
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If you have none enter "N/A"
CERTIFICATES FOR THIS TRAINING WILL BE SENT ELECTRONICALLY. IF YOU WISH TO RECEIVE A HARD-COPY OF YOUR CERTIFICATE, PLEASE BE SURE TO PROVIDE A MAILING ADDRESS IN THE APPROPRIATE FIELD(S) BELOW.
14. Name (as it should appear on your certificate)
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15. Mailing Address (street # or P.O. Box)
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16. City
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17. State
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18. Zip Code
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19. Please identify the type of certificate you would like to recieve.
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NOTE: TEXAS CHW CERTIFICATES WILL NOT BE MADE AVAILABLE FOR THIS TRAINING. 1 - Continuing Medical Education (CME) 2 - Continuing Nursing Education (CNE) 3 - Texas CHW Ceritifcate 4 - Certificate of Attendance
20. Email Address
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21. Phone Number
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Please enter your phone number in one of the following formats: (123) 456-7890 or 123-456-7890
22. Please indicate the type of phone number you provided.
1 - Cell/Mobile 2 - Home 3 - Work/Office
THANK YOU FOR COMPLETING THE EVALUATION. YOUR ELECTRONIC CERTIFICATE WILL BE SENT OUT 1 - 2 WEEKS POST TRAINING DATE.
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