ACLS Renewal Evaluation

As a result of participating in this course, 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
Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome.	Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome. - 5	Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome. - 4	Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome. - 3	Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome. - 2	Recognize and initiate early management of peri-arrest conditions that may result in cardiac arrest or complicate resuscitation outcome. - 1
Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use.	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 5	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 4	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 3	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 2	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 1
Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care.	Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care. - 5	Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care. - 4	Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care. - 3	Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care. - 2	Manage cardiac arrest until return of spontaneous circulation (ROSC), termination of resuscitation, or transfer of care. - 1
Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes.	Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes. - 5	Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes. - 4	Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes. - 3	Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes. - 2	Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes. - 1
Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death.	Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death. - 5	Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death. - 4	Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death. - 3	Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death. - 2	Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death. - 1
Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance.	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 5	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 4	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 3	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 2	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 1

Rate the following *

Scoring Key: 5=Excellent 4=Very Good 3=Good 2=Fair 1=Poor

	5	4	3	2	1
Appropriateness of topic for your educational needs	Appropriateness of topic for your educational needs - 5	Appropriateness of topic for your educational needs - 4	Appropriateness of topic for your educational needs - 3	Appropriateness of topic for your educational needs - 2	Appropriateness of topic for your educational needs - 1
How well the conference objectives were met	How well the conference objectives were met - 5	How well the conference objectives were met - 4	How well the conference objectives were met - 3	How well the conference objectives were met - 2	How well the conference objectives were met - 1
Practical value of the conference to your daily practice	Practical value of the conference to your daily practice - 5	Practical value of the conference to your daily practice - 4	Practical value of the conference to your daily practice - 3	Practical value of the conference to your daily practice - 2	Practical value of the conference to your daily practice - 1
Overall impression of the conference	Overall impression of the conference - 5	Overall impression of the conference - 4	Overall impression of the conference - 3	Overall impression of the conference - 2	Overall impression of the conference - 1
Effectiveness of learning aids used (audio-visual, etc.)	Effectiveness of learning aids used (audio-visual, etc.) - 5	Effectiveness of learning aids used (audio-visual, etc.) - 4	Effectiveness of learning aids used (audio-visual, etc.) - 3	Effectiveness of learning aids used (audio-visual, etc.) - 2	Effectiveness of learning aids used (audio-visual, etc.) - 1
Instructors	Instructors - 5	Instructors - 4	Instructors - 3	Instructors - 2	Instructors - 1

What did you learn at this conference that could impact patient care in your practice? *

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M.D., D.O.

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