MCI Urology Journal Club 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 NA=Not applicable to my practice

	5	4	3	2	1	NA
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. - NA
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. - NA

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
Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral.	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 5	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 4	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 3	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 2	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 1	Discuss new medical treatments, such as the rise of PD-1 and PD-L1 inhibitors, and the appropriate indications for referral. - 0
Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices.	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 5	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 4	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 3	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 2	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 1	Implement the latest and most up to date treatments and technological advances for well-known malignancies, as well as discuss strategies to implement these within our practices. - 0
Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing.	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 5	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 4	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 3	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 2	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 1	Evaluate and assess the overtreatment of relatively indolent conditions. e.g. the discussion of prostate cancer and PSA testing. - 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

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 you’re 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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MCI Urology Journal Club Evaluation Form