Baptist Health – Advanced Practice Providers Grand Rounds Evaluation Form - March 12, 2025

Please select one: *

I am in active clinical practice

I am retired

I am a student

Other

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
Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 5	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 4	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 3	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 2	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 1	Identify basic anatomy of the lumbar spine and common pathology of painful lumbar conditions - 0
Implement evidence-based treatment plan for patients seen in the clinic with low back pain	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 5	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 4	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 3	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 2	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 1	Implement evidence-based treatment plan for patients seen in the clinic with low back pain - 0
Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 5	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 4	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 3	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 2	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 1	Analyze diagnostic imaging and clinical signs/symptoms to identify neurologic emergencies with appropriate emergency room/neurosurgical referrals - 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? *

Comments

Name

You are here

Baptist Health – Advanced Practice Providers Grand Rounds Evaluation Form - March 12, 2025