Bethesda Cardiac Cath Evaluation Form

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 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	0
Apply new diagnostic and interventional tools and techniques into practice.	Apply new diagnostic and interventional tools and techniques into practice. - 5	Apply new diagnostic and interventional tools and techniques into practice. - 4	Apply new diagnostic and interventional tools and techniques into practice. - 3	Apply new diagnostic and interventional tools and techniques into practice. - 2	Apply new diagnostic and interventional tools and techniques into practice. - 1	Apply new diagnostic and interventional tools and techniques into practice. - 0
Determine patient candidates for new therapies for the treatment of complex heart disease.	Determine patient candidates for new therapies for the treatment of complex heart disease. - 5	Determine patient candidates for new therapies for the treatment of complex heart disease. - 4	Determine patient candidates for new therapies for the treatment of complex heart disease. - 3	Determine patient candidates for new therapies for the treatment of complex heart disease. - 2	Determine patient candidates for new therapies for the treatment of complex heart disease. - 1	Determine patient candidates for new therapies for the treatment of complex heart disease. - 0
Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research.	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 5	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 4	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 3	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 2	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 1	Implement evidence-based strategies into clinical practice based on the leading cardiovascular evidence-based research. - 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 conference? *

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Bethesda Cardiac Cath Evaluation Form