Evaluation - Workers and Health: How Frontline Providers Make a Difference

LEARNING OBJECTIVES

At the conclusion of this presentation participants will be able to... 1. Understand the reasons for integrating Environmental and Occupational Health into primary care. 2. Recognize the role of the clinician in work-related exposures. 3. Become familiar with tools and resources to address occupational injuries and exposures in primary care.

Primary Column

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 Ed Zuroweste, MD?*

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

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3. The scholarship and expertise of Amy Liebman, MPA, MA?*

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

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4. Your overall satisfaction with this webinar training?*

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

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5. 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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6. 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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7. How helpful was the information you learned today in enhancing the performance and operations of your health center?*

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

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8. If applicable, how do you plan to use the information you learned in your daily work?*

Please do not leave blank. Respond N/A if not applicable.

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

1 - Yes 2 - No

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

1 - Yes 2 - No

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11. Do you have any training, technical assistance, or resource needs? If so, please specify below.*

If you do not have any training or technical assistance needs please reply "None"

12. What is the biggest challenge for your clinic in providing quality care to patients?*

If not applicable please respond "N/A"

13. Additional comments*

If you do not have any additional comments, please reply "None"

ONLY ELECTRONIC CERTIFICATES WILL BE AVAILABLE FOR THIS TRAINING. PLEASE BE SURE TO PROVIDE YOUR EMAIL ADDRESS IN THE APPROPRIATE FIELD BELOW.

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

15. Organization affiliation*

16. Occupational Title (please include any credentials)*

17. Please identify the type of organization you represent.*

1 - PCA (Primary Care Association) 2 - Health Center 3 - HCCN (Health Center Controlled Network) 4 - State/Federal Government Agency 5 - Other / Not included in this list 6 - I'm not sure / Don't know

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18. Address (street address or p.o. box)*

19. City*

20. State*

Select or enter value

21. Zip code*

22. Phone Number*

Please provide your phone number in the following format: 123-456-7890

23. E-mail address*

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

NOTE: TEXAS CHW CERTIFICATES ARE NOT 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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