2026 MCI Breast Cancer Performance Improvement and Quality Improvement Series Evaluation Form - April 16 2026

Please select one: *

I am in active clinical practice

I am retired

I am a student

Please score your agreement with or assessment of the following questions and statements by rating on a scale of 1 to 5, with 5 representing the highest level of satisfaction or agreement. *

Scoring Key: 5=Strongly Agree 4=Agree 3=Neutral 2=Disagree 1=Strongly Disagree 0=Not applicable to my practice

	5	4	3	2	1	0
The information and/or skills learned will enhance my professional competence or ability.	The information and/or skills learned will enhance my professional competence or ability. - 5	The information and/or skills learned will enhance my professional competence or ability. - 4	The information and/or skills learned will enhance my professional competence or ability. - 3	The information and/or skills learned will enhance my professional competence or ability. - 2	The information and/or skills learned will enhance my professional competence or ability. - 1	The information and/or skills learned will enhance my professional competence or ability. - 0
This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients.	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 5	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 4	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 3	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 2	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 1	This activity conveyed information which will assist me in improving the health and/or treatment outcomes of of my patients. - 0

As a result of participating in this activity, to what extent do you agree that you will be better able to accomplish these objectives *

Scoring Key: 5=Strongly Agree 4=Agree 3=Neutral 2=Disagree 1=Strongly Disagree 0=Not applicable to my practice

	5	4	3	2	1	0
Define what constitutes an adverse event and review which adverse event warrant reporting	Define what constitutes an adverse event and review which adverse event warrant reporting - 5	Define what constitutes an adverse event and review which adverse event warrant reporting - 4	Define what constitutes an adverse event and review which adverse event warrant reporting - 3	Define what constitutes an adverse event and review which adverse event warrant reporting - 2	Define what constitutes an adverse event and review which adverse event warrant reporting - 1	Define what constitutes an adverse event and review which adverse event warrant reporting - 0
Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 5	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 4	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 3	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 2	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 1	Ensure timely identification and reporting of adverse events associated with Antibody-Drug Conjugates (ADCs) and understand the value of reporting - 0
Describe the purpose of MIDAS and its role in adverse event reporting	Describe the purpose of MIDAS and its role in adverse event reporting - 5	Describe the purpose of MIDAS and its role in adverse event reporting - 4	Describe the purpose of MIDAS and its role in adverse event reporting - 3	Describe the purpose of MIDAS and its role in adverse event reporting - 2	Describe the purpose of MIDAS and its role in adverse event reporting - 1	Describe the purpose of MIDAS and its role in adverse event reporting - 0
Demonstrate how to effectively report adverse events in MIDAS	Demonstrate how to effectively report adverse events in MIDAS - 5	Demonstrate how to effectively report adverse events in MIDAS - 4	Demonstrate how to effectively report adverse events in MIDAS - 3	Demonstrate how to effectively report adverse events in MIDAS - 2	Demonstrate how to effectively report adverse events in MIDAS - 1	Demonstrate how to effectively report adverse events in MIDAS - 0
Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 5	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 4	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 3	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 2	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 1	Review FDA Adverse Event Reporting System (FAERS) for general knowledge and awareness of this vital program - 0

Was this course fair, balanced and without commercial bias? *

Yes

No

If you checked "No,” please explain why: *

As a result of what was discussed at this activity what do you intend to do differently? Identify at least two learnings that could be incorporated into your practice *

What are the potential barriers or obstacles that might prevent you from implementing new strategies you learned at this activity? *

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2026 MCI Breast Cancer Performance Improvement and Quality Improvement Series Evaluation Form - April 16 2026