Evaluation: Witnessing and the Camp Fire

LEARNING OBJECTIVES:

At the end of this presentation participants will be able to... 1. Describe the four witness positions and daily sources of distress. 2. Understand strategies to cope with their own distress while helping people who lived through traumatic experiences. 3. Identify sources of resilience and reasonable hope in their own lives.

1. Did the training meet all of the stated learning objectives?*

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 completely met

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2. The scholarship and expertise of Kaethe Weingarten, PhD?*

1 - Poor 2 - Slight 3 - Moderate 4 - Excellent

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3. Your overall satisfaction with this webinar training?*

1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied

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4. The webinar presented new areas of knowledge, and/or new ideas/methods to implement.*

1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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5. The webinar contained information at a level commensurate with my training and experience.*

1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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6. How helpful was the information you learned today in enhancing the performance and operations of your health center or organization?*

N/A - Not applicable 1 - Not helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful

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7. If applicable, how do you intend to use the information learned in your daily work?

8. Was the content balanced and free of commercial bias?*

1 - Yes 2 - No

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9. Did the speaker(s) fully disclose any conflict of interest and discussion of off-label usage of medications and/or medical devices?*

1 - Yes 2 - No

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10. Witness to Witness is a free program for providers, including people who support Camp Fire survivors and Camp Fire-affected communities, sponsored by the American Family Therapy Academy. In one to four in-depth conversations (phone or video), a licensed clinical specialist listens to your experience and helps you develop a personal toolkit for acute stress or what you witness daily in your job. How likely are you to use this program?*

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11. Which of the following types of additional trainings are of interest to you? Please check all that apply.*

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12. If one of your selections to the previous question is "Other," please specify below.

13. What challenges do you/your organization face in providing quality support/services to fire survivors or fire-affected communities? Please check all that apply.*

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14. If one of your selections to the previous question is "Other," please specify below.

15. Are there any additional resources or training that would be helpful to you or your organization?

16. Please state any additional comments, questions, or suggestions below.*

If you do not have anything to add please enter "N/A"

CERTIFICATES FOR THIS TRAINING WILL BE SENT ELECTRONICALLY.

17. Name (as it should appear on your certificate)*

18. Mailing Address (street # or P.O. Box)*

19. City*

20. State*

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21. Zip Code*

22. Please identify the type of certificate you would like to receive.*

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 Certificate 4 - Certificate of Attendance

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23. E-mail Address*

24. Phone Number*

Please enter your phone number in one of the following formats: (123) 456-7890 or 123-456-7890

25. Please indicate the type of phone number you provided.*

1 - Cell/Mobile 2 - Home 3 - Work/Office

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THANK YOU FOR COMPLETING THE EVALUATION. ELECTRONIC CERTIFICATES WILL BE SENT OUT 1 - 2 WEEKS AFTER THE TRAINING DAY.

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