Baptist Health – Advanced Practice Providers Grand Rounds Evaluation Form - September 9, 2026

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
Describe the etiology and pathophysiology of heart failure.	Describe the etiology and pathophysiology of heart failure. - 5	Describe the etiology and pathophysiology of heart failure. - 4	Describe the etiology and pathophysiology of heart failure. - 3	Describe the etiology and pathophysiology of heart failure. - 2	Describe the etiology and pathophysiology of heart failure. - 1	Describe the etiology and pathophysiology of heart failure. - 0
Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients.	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 5	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 4	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 3	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 2	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 1	Apply diagnostic strategies, including laboratory, imaging, and hemodynamic assessment, to evaluate heart failure patients. - 0
Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate.	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 5	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 4	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 3	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 2	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 1	Implement guideline-directed medical therapy and non-pharmacologic management strategies for heart failure, including electrophysiology and structural interventions when appropriate. - 0
Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant.	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 5	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 4	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 3	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 2	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 1	Evaluate patients with acute decompensated heart failure or cardiogenic shock for advanced therapies, including Heart Recovery Clinic referral, LVAD, or heart transplant. - 0

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

Yes

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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Baptist Health – Advanced Practice Providers Grand Rounds Evaluation Form - September 9, 2026