Boca Raton Regional Hospital Internal Medicine Grand Rounds Evaluation Form - Dec 14

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
Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding.	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 5	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 4	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 3	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 2	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 1	Delineate the differential diagnoses of gastrointestinal bleeding, and differentiate upper GI bleeding, small bowel bleeding, and lower GI bleeding. - 0
Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding.	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 5	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 4	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 3	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 2	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 1	Explore management strategies in gastrointestinal bleeding, with a focus on non-variceal upper GI bleeding. - 0

Rate the following *

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

	5	4	3	2	1
Course content.	Course content. - 5	Course content. - 4	Course content. - 3	Course content. - 2	Course content. - 1
Speaker	Speaker - 5	Speaker - 4	Speaker - 3	Speaker - 2	Speaker - 1

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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Boca Raton Regional Hospital Internal Medicine Grand Rounds Evaluation Form - Dec 14