A Guide to Effective Conversations About Advance Care Planning - Evaluation May 17, 2018

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
Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones.	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 5	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 4	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 3	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 2	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 1	Facilitate end-of-life conversations with patients about what matters most to them and to their loves ones. - 0
Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers.	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 5	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 4	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 3	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 2	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 1	Implement strategies that will encourage patients to have end-of-life preference conversations with their loved ones and their healthcare providers. - 0
Provide patients and their families with a four-step guide for having the conversation about end-of-life care.	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 5	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 4	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 3	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 2	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 1	Provide patients and their families with a four-step guide for having the conversation about end-of-life care. - 0
Describe the three types of advance directives and how to properly complete them.	Describe the three types of advance directives and how to properly complete them. - 5	Describe the three types of advance directives and how to properly complete them. - 4	Describe the three types of advance directives and how to properly complete them. - 3	Describe the three types of advance directives and how to properly complete them. - 2	Describe the three types of advance directives and how to properly complete them. - 1	Describe the three types of advance directives and how to properly complete them. - 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
Ana M. Viamonte-Ros, M.D.	Ana M. Viamonte-Ros, M.D. - 5	Ana M. Viamonte-Ros, M.D. - 4	Ana M. Viamonte-Ros, M.D. - 3	Ana M. Viamonte-Ros, M.D. - 2	Ana M. Viamonte-Ros, M.D. - 1
Rose Allen, DNP, MSM/HM, RN, CHPN	Rose Allen, DNP, MSM/HM, RN, CHPN - 5	Rose Allen, DNP, MSM/HM, RN, CHPN - 4	Rose Allen, DNP, MSM/HM, RN, CHPN - 3	Rose Allen, DNP, MSM/HM, RN, CHPN - 2	Rose Allen, DNP, MSM/HM, RN, CHPN - 1

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

Yes

No

If you checked "No,” please explain why: *

How many patients will you see in your practice who will likely be impacted by what you learned at this activity? *

1-5

6-10

Over 10

Not applicable to my practice

What do you intend to do differently in the treatment of your patients as a result of what you learned? What new strategies will you apply in your practice of patient care? *

If you do not plan to implement any new strategies learned, please list any barriers or obstacles that might keep you from doing so. *

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A Guide to Effective Conversations About Advance Care Planning - Evaluation May 17, 2018