TEST COURSE EVAL

Please rate the following statements from Strongly Disagree to Strongly Agree *

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
The course covered what I expected based on the learning objectives.	The course covered what I expected based on the learning objectives. - Strongly Disagree	The course covered what I expected based on the learning objectives. - Disagree	The course covered what I expected based on the learning objectives. - Neutral	The course covered what I expected based on the learning objectives. - Agree	The course covered what I expected based on the learning objectives. - Strongly Agree
The content presented in this course was based on the best available evidence.	The content presented in this course was based on the best available evidence. - Strongly Disagree	The content presented in this course was based on the best available evidence. - Disagree	The content presented in this course was based on the best available evidence. - Neutral	The content presented in this course was based on the best available evidence. - Agree	The content presented in this course was based on the best available evidence. - Strongly Agree
This activity provided new approaches to help me manage the care of my patients.	This activity provided new approaches to help me manage the care of my patients. - Strongly Disagree	This activity provided new approaches to help me manage the care of my patients. - Disagree	This activity provided new approaches to help me manage the care of my patients. - Neutral	This activity provided new approaches to help me manage the care of my patients. - Agree	This activity provided new approaches to help me manage the care of my patients. - Strongly Agree
I intend to share the activity information with a colleague.	I intend to share the activity information with a colleague. - Strongly Disagree	I intend to share the activity information with a colleague. - Disagree	I intend to share the activity information with a colleague. - Neutral	I intend to share the activity information with a colleague. - Agree	I intend to share the activity information with a colleague. - Strongly Agree

If you marked “disagree” or “strongly disagree” for any of the previous statements, is there anything we could have done differently to change your minds?

As a result of participating in this activity, will you make a change in your current practice or patient care (including work in the clinic, research, teaching residents, interacting with colleagues, referring patients, etc)? *

Yes

No

Not applicable

Please indicate the change(s) you will make (check all that apply) *

I will modify/improve my communication with and/or counseling of patients.

I will modify/improve my collaboration with other treatment team members.

I will modify my current treatment plans/process.

I will make one or more changes to the policies and/or procedures of my practice.

I will seek additional sources to improve my personal knowledge and/or skill.

I will modify the way I teach or train residents, fellow or staff members.

Other, please specify

Please indicate the change(s) you will make (check all that apply) Other, please specify

Please describe the changes you will make. *

How confident are you that you will make this change in your practice? *

If applicable, why will you not make any practice changes?

The program reinforced my current practice.

The content presented was not applicable to me and/or my practice.

I need more information before changing my practice.

There is not enough evidence to prompt a change.

There are too many barriers for me to make a change.

Other, please explain.

If applicable, why will you not make any practice changes? Other, please explain.

What barriers to changing or improving your practice could ASTRO address through education? Please choose all that apply. *

Lack of evidence based guidelines

Treatment-related adverse events

Lack of applicability of guidelines to my current practice/patient

Gaps in understanding of all available treatment options

Multidisciplinary miscommunication

Other, please specify

What barriers to changing or improving your practice could ASTRO address through education? Please choose all that apply. Other, please specify

How are you accessing this activity? *

Computer

Tablet

Phone

What new educational activities are you most interested in seeing?

What new educational activities are you most interested in seeing? Other...

Testimonial

ASTRO uses personal testimonials in marketing materials for future meetings. If you would like your testimonial used in our marketing materials, please write a personal statement of how ASTRO Academy was valuable to you and your practice and/or what you enjoyed about ASTRO Academy in the box below. Also include your name or initials as you would like it to appear on any future marketing materials, should ASTRO use your testimonial

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TEST COURSE EVAL