Evaluation - Module 6: Supporting Patient Self-Engagement in a Team-Based Setting

PLEASE NOTE: ALL CERTIFICATES WILL BE SENT ELECTRONICALLY. IF YOU WOULD LIKE TO RECEIVE A HARD-COPY OF YOUR CERTIFICATE, BE SURE TO PROVIDE YOUR COMPLETE MAILING ADDRESS IN THE APPROPRIATE QUESTIONS BELOW. --------------------------------------------------------------------------- Learning Objectives: 1. Understand/discuss current practices utilized by health centers in patient engagement, the specific roles of the healthcare team, and how these practices can be improved. 2. Participants will identify both facilitators and barriers to patient engagement. 3. Participants will become familiar with and understand SMART goals that can be utilized in their health center.

Please utilize the 1 - 4 rating scale below: 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 were fully met.

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Please utilize the 1 - 4 rating scale below: 1 - Poor 2 - Fair 3 - Good 4 - Excellent

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Please utilize the 1 - 4 rating scale below: 1 - Poor 2 - Fair 3 - Good 4 - Excellent

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Please utilize the 1 - 4 rating scale below: 1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied

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Please utilize the 1 - 4 rating scale below: 1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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Please utilize the 1 - 4 rating scale below: 1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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Please utilize the 1 - 4 rating scale below: N/A - Not applicable 1 - Not helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful

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If this is not applicable, simply respond N/A.

Please utilize the key below: 1 - Yes 2 - No

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Please utilize the key below: 1 - Yes 2 - No

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If you do not have any type of needs, please respond N/A.

If your clinic does not have any challenges in providing care, please respond N/A.

1 - PCA 2 - Health Center 3 - HCCN 4 - Government (state/federal) 5 - Self reported other 6 - None of the above / I'm not sure

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Key: 1 - Continuing Medical Education (CME) 2 - Continuing Nursing Education (CNE) 3 - Texas CHW Certificate 4 - Certificate of Attendance

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Key: 1 - Yes please 2 - No thanks

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Key: 1 - Cell / Mobile 2 - Home / Residence 3 - Work / Business

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