Sim Lab - April 2017 - Advanced 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

	5	4	3	2	1
Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication.	Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication. - 5	Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication. - 4	Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication. - 3	Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication. - 2	Demonstrate basic principles of effective teamwork- leadership, role clarity and closed loop communication. - 1
Explain the advanced principles of team dynamics- situational awareness and shared mental models.	Explain the advanced principles of team dynamics- situational awareness and shared mental models. - 5	Explain the advanced principles of team dynamics- situational awareness and shared mental models. - 4	Explain the advanced principles of team dynamics- situational awareness and shared mental models. - 3	Explain the advanced principles of team dynamics- situational awareness and shared mental models. - 2	Explain the advanced principles of team dynamics- situational awareness and shared mental models. - 1
Assess how human factors affect individual and team performance.	Assess how human factors affect individual and team performance. - 5	Assess how human factors affect individual and team performance. - 4	Assess how human factors affect individual and team performance. - 3	Assess how human factors affect individual and team performance. - 2	Assess how human factors affect individual and team performance. - 1
Summarize the impact of crisis resource management on patient safety and outcomes.	Summarize the impact of crisis resource management on patient safety and outcomes. - 5	Summarize the impact of crisis resource management on patient safety and outcomes. - 4	Summarize the impact of crisis resource management on patient safety and outcomes. - 3	Summarize the impact of crisis resource management on patient safety and outcomes. - 2	Summarize the impact of crisis resource management on patient safety and outcomes. - 1

Regarding the scenario in which you participated, to what extend would you agree that: *

Scoring Key: 5=Strongly Agree 4=Agree 3=Neutral 2=Disagree 1=Strongly Disagree

	5	4	3	2	1
The content of the scenario was current and relevant to my practice.	The content of the scenario was current and relevant to my practice. - 5	The content of the scenario was current and relevant to my practice. - 4	The content of the scenario was current and relevant to my practice. - 3	The content of the scenario was current and relevant to my practice. - 2	The content of the scenario was current and relevant to my practice. - 1
The scenario was realistic.	The scenario was realistic. - 5	The scenario was realistic. - 4	The scenario was realistic. - 3	The scenario was realistic. - 2	The scenario was realistic. - 1

Regarding the debriefing, to what extent would you agree that: *

Scoring Key: 5=Strongly Agree 4=Agree 3=Neutral 2=Disagree 1=Strongly Disagree

	5	4	3	2	1
The debriefing encouraged open dialogue.	The debriefing encouraged open dialogue. - 5	The debriefing encouraged open dialogue. - 4	The debriefing encouraged open dialogue. - 3	The debriefing encouraged open dialogue. - 2	The debriefing encouraged open dialogue. - 1
I felt at ease throughout the debriefing discussion.	I felt at ease throughout the debriefing discussion. - 5	I felt at ease throughout the debriefing discussion. - 4	I felt at ease throughout the debriefing discussion. - 3	I felt at ease throughout the debriefing discussion. - 2	I felt at ease throughout the debriefing discussion. - 1
The debriefing helped me discover areas of improvement.	The debriefing helped me discover areas of improvement. - 5	The debriefing helped me discover areas of improvement. - 4	The debriefing helped me discover areas of improvement. - 3	The debriefing helped me discover areas of improvement. - 2	The debriefing helped me discover areas of improvement. - 1

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

Yes

No

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

Would you recommend this course to your colleagues *

What did you take away from the debriefing process? In what ways did you benefit from the discussion? *

Give an example of how the debriefing discussion changed your perspective on how to apply crisis resource management in your clinical practice. *

Name

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Sim Lab - April 2017 - Advanced Evaluation