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21
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HIPAA
Compliance
1
Name
*
This field is required.
First and Last Name
Credentials
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2
Email
*
This field is required.
example@example.com
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3
Date of Lecture
*
This field is required.
2024-05-07
-
Date
Year
Month
Day
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4
This series has increased, improved, or positively impacted my: (select all that apply)
*
This field is required.
Knowledge
Competence
Performance
Patient Outcomes
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5
Do you feel the series is scientifically sound and free of commercial bias?
*
This field is required.
YES
NO
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6
If No, please explain:
1
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7
Were the speakers/presenters
knowledgeable
regarding the content of their presentation?
*
This field is required.
Hilary Mabel, JD
YES
NO
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8
If No, please explain:
2
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9
Were the speakers/presenters
relevant
regarding the content of their presentation?
*
This field is required.
Hilary Mabel, JD
YES
NO
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10
If No, please explain:
3
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11
Were the speakers/presenters
effective
regarding the content of their presentation?
*
This field is required.
Hilary Mabel, JD
YES
NO
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12
If No, please explain:
4
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13
Were the speakers/presenters
knowledgeable
regarding the content of their presentation?
*
This field is required.
Sarah Raiser, MD
YES
NO
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14
If No, please explain:
5
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15
Were the speakers/presenters
relevant
regarding the content of their presentation?
*
This field is required.
Sarah Raiser MD
YES
NO
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16
If No, please explain:
6
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17
Were the speakers/presenters
effective
regarding the content of their presentation?
*
This field is required.
Sarah Raiser MD
YES
NO
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18
If No, please explain:
7
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19
Were the speakers/presenters
knowledgeable
regarding the content of their presentation?
Kelsey Pontius, RD
YES
NO
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20
If No, please explain:
8
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21
Were the speakers/presenters
relevant
regarding the content of their presentation?
*
This field is required.
Kelsey Pontius, RD
YES
NO
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22
If No, please explain:
9
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23
Were the speakers/presenters
effective
regarding the content of their presentation?
*
This field is required.
Kelsey Pontius, RD
YES
NO
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24
If No, please explain:
10
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25
Do you feel that the following learning objectives were met?
*
This field is required.
Identify common ethical issues in sports medicine practice.
Yes
No
Partially
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26
Do you feel that the following learning objectives were met?
*
This field is required.
Comment on study design for research centering on ethical issues in sports medicine.
Yes
No
Partially
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27
Do you feel that the following learning objectives were met?
*
This field is required.
Articulate their own moral viewpoints on several ethical issues in sports medicine
Yes
No
Other
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28
Do you feel that the following learning objectives were met?
*
This field is required.
Describe gait-associated risk factors for running related injuries
Yes
No
Partially
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29
Do you feel that the following learning objectives were met?
*
This field is required.
The ability to implement a performance plate
Yes
No
Partially
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30
Do you feel that the following learning objectives were met?
*
This field is required.
o understand nutrient training
Yes
No
Partially
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31
If you answered NO to any of these, please explain:
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32
If No, please explain:
Yes
No
Partially
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33
Please indicate which of the following ACGME core competencies have been addressed by this series (select all that apply):
*
This field is required.
Patient care
Practice-based learning & improvement
Interpersonal and communication skills
Systems-based practice
Medical knowledge
Professionalism
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34
Please rate the barriers you perceive in implementing these changes.
*
This field is required.
None/Minimal
Sizable
Insurmountable
Reimbursement/Insurance issues
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Cost effectiveness
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Time management
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Patient compliance issues
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Administrative support
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Lack of experience
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Reimbursement/Insurance issues
Cost effectiveness
Time management
Patient compliance issues
Administrative support
Lack of experience
None/Minimal
Row 0, Column 0
Sizable
Row 0, Column 1
Insurmountable
Row 0, Column 2
None/Minimal
Row 1, Column 0
Sizable
Row 1, Column 1
Insurmountable
Row 1, Column 2
None/Minimal
Row 2, Column 0
Sizable
Row 2, Column 1
Insurmountable
Row 2, Column 2
None/Minimal
Row 3, Column 0
Sizable
Row 3, Column 1
Insurmountable
Row 3, Column 2
None/Minimal
Row 4, Column 0
Sizable
Row 4, Column 1
Insurmountable
Row 4, Column 2
None/Minimal
Row 5, Column 0
Sizable
Row 5, Column 1
Insurmountable
Row 5, Column 2
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35
How will you address these barriers to implement changes in knowledge and/or behavior?
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36
How might the format of this series be improved in order to be most appropriate for the content presented? (select all that apply)
*
This field is required.
Format is appropriate; no changes needed
Include more case-based presentations
Increase interactivity with attendees
Add a hands-on instructional component
Allow more time for Q&A
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37
Other comments:
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