MCI Skin Cancer Evaluation

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= Somewhat agree 3=Neither agree nor disagree 2= Somewhat disagree 1=Strongly disagree NA=Not applicable

	5	4	3	2	1	NA
The skills learned in this CME course enhanced my professional competence.	The skills learned in this CME course enhanced my professional competence. - 5	The skills learned in this CME course enhanced my professional competence. - 4	The skills learned in this CME course enhanced my professional competence. - 3	The skills learned in this CME course enhanced my professional competence. - 2	The skills learned in this CME course enhanced my professional competence. - 1	The skills learned in this CME course enhanced my professional competence. - NA
The skills learned in this CME course will be applied in the treatment of my patients.	The skills learned in this CME course will be applied in the treatment of my patients. - 5	The skills learned in this CME course will be applied in the treatment of my patients. - 4	The skills learned in this CME course will be applied in the treatment of my patients. - 3	The skills learned in this CME course will be applied in the treatment of my patients. - 2	The skills learned in this CME course will be applied in the treatment of my patients. - 1	The skills learned in this CME course will be applied in the treatment of my patients. - NA

How confident are you in your ability to: *

5 = High level of confidence 4 = Moderately high level of confidence 3 = Average level of confidence 2 = Low level of confidence 1 = No level of confidence NA|Not applicable to my practice

	5	4	3	2	1
Recognize and assess risk factors associated with skin cancer in primary care settings?	Recognize and assess risk factors associated with skin cancer in primary care settings? - 5	Recognize and assess risk factors associated with skin cancer in primary care settings? - 4	Recognize and assess risk factors associated with skin cancer in primary care settings? - 3	Recognize and assess risk factors associated with skin cancer in primary care settings? - 2	Recognize and assess risk factors associated with skin cancer in primary care settings? - 1
Implement evidence-based guidelines in the diagnosis and management of skin cancer?	Implement evidence-based guidelines in the diagnosis and management of skin cancer? - 5	Implement evidence-based guidelines in the diagnosis and management of skin cancer? - 4	Implement evidence-based guidelines in the diagnosis and management of skin cancer? - 3	Implement evidence-based guidelines in the diagnosis and management of skin cancer? - 2	Implement evidence-based guidelines in the diagnosis and management of skin cancer? - 1

How satisfied or dissatisfied were you with the Speaker's effectiveness in addressing the learning objectives? *

Scoring Key: 5=Strongly satisfied 4= Somewhat satisfied 3=Neither satisfied nor dissatisfied 2= Somewhat dissatisfied 1=Strongly dissatisfied

	5	4	3	2	1
Recognize and assess risk factors associated with skin cancer in primary care settings.	Recognize and assess risk factors associated with skin cancer in primary care settings. - 5	Recognize and assess risk factors associated with skin cancer in primary care settings. - 4	Recognize and assess risk factors associated with skin cancer in primary care settings. - 3	Recognize and assess risk factors associated with skin cancer in primary care settings. - 2	Recognize and assess risk factors associated with skin cancer in primary care settings. - 1
Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer.	Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer. - 5	Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer. - 4	Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer. - 3	Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer. - 2	Apply the latest evidence-based guidelines for the diagnosis and management of skin cancer. - 1
Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings.	Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings. - 5	Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings. - 4	Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings. - 3	Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings. - 2	Demonstrate effective communication with patients regarding skin cancer prevention and the importance of regular screenings. - 1
Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary.	Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary. - 5	Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary. - 4	Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary. - 3	Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary. - 2	Develop strategies for timely referral and collaboration with dermatology specialists for advanced care when necessary. - 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? *

What, if any, new skills/strategies will you apply in your clinical practice? *

If you do not plan to implement any new skills/strategies in your clinical practice, what is keeping you from doing so? *

Please provide any additional comments or suggestions.

Name

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