PALS Provider Two-day Evaluation

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
Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments.	Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments. - 5	Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments. - 4	Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments. - 3	Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments. - 2	Understand and be able to perform the systematic approach to pediatric assessment, including general, primary, secondary and tertiary assessments. - 1
Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use.	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 5	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 4	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 3	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 2	Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and integrating Automatic External Defibrillator (AED) use. - 1
Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child.	Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child. - 5	Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child. - 4	Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child. - 3	Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child. - 2	Use the assess-categorize-decide-act approach to assessment and management of the seriously ill child. - 1
Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock.	Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock. - 5	Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock. - 4	Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock. - 3	Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock. - 2	Recognize and manage a child in respiratory distress or failure and/or compensated or hypotensive shock. - 1
Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm.	Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm. - 5	Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm. - 4	Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm. - 3	Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm. - 2	Recognize and manage a child with life-threatening bradyarrhythmia, tachyarrhythmia or arrest rhythm. - 1
Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance.	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 5	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 4	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 3	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 2	Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance. - 1
Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration.	Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration. - 5	Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration. - 4	Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration. - 3	Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration. - 2	Demonstrate proper technique for intraosseous (IO) access and fluid bolus administration. - 1
Perform as a team leader or team member in simulated cases.	Perform as a team leader or team member in simulated cases. - 5	Perform as a team leader or team member in simulated cases. - 4	Perform as a team leader or team member in simulated cases. - 3	Perform as a team leader or team member in simulated cases. - 2	Perform as a team leader or team member in simulated cases. - 1
Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion.	Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion. - 5	Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion. - 4	Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion. - 3	Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion. - 2	Demonstrate appropriate use of electrical therapy, including defibrillation and synchronized cardioversion. - 1

Rate the following *

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

	5	4	3	2	1
Appropriateness of topic for your educational needs	Appropriateness of topic for your educational needs - 5	Appropriateness of topic for your educational needs - 4	Appropriateness of topic for your educational needs - 3	Appropriateness of topic for your educational needs - 2	Appropriateness of topic for your educational needs - 1
How well the conference objectives were met	How well the conference objectives were met - 5	How well the conference objectives were met - 4	How well the conference objectives were met - 3	How well the conference objectives were met - 2	How well the conference objectives were met - 1
Practical value of the conference to your daily practice	Practical value of the conference to your daily practice - 5	Practical value of the conference to your daily practice - 4	Practical value of the conference to your daily practice - 3	Practical value of the conference to your daily practice - 2	Practical value of the conference to your daily practice - 1
Overall impression of the conference	Overall impression of the conference - 5	Overall impression of the conference - 4	Overall impression of the conference - 3	Overall impression of the conference - 2	Overall impression of the conference - 1
Effectiveness of learning aids used (audio-visual, etc.)	Effectiveness of learning aids used (audio-visual, etc.) - 5	Effectiveness of learning aids used (audio-visual, etc.) - 4	Effectiveness of learning aids used (audio-visual, etc.) - 3	Effectiveness of learning aids used (audio-visual, etc.) - 2	Effectiveness of learning aids used (audio-visual, etc.) - 1
Instructors	Instructors - 5	Instructors - 4	Instructors - 3	Instructors - 2	Instructors - 1

What did you learn at this conference that could impact patient care in your practice? *

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M.D., D.O.

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PALS Provider Two-day Evaluation