POST-PRESENTATION SURVEY

Q1I am a(n)...
 MD/DO NP PA RN PharmD Other
       
Q2How many years have you been in practice?
 1-5 6-10 11-15 16-20 Over 20
      
Q3Please describe your practice setting:
 Solo Practice Group Practice Hospital Setting Clinic Other
      
Q4Number of patients seen per month with T2DM
 1-10 11-20 21-30 31-40 41-50 Over 50
       
Q5Please rate the following:
 Unsatisfactory Needs Improvement Average Above Average Excellent
 Degree to which educational expectations met    
 Material was relevant to my practice    
 Effective Faculty Presenters    
 Overall Program    
Q6As a result of what you have learned during this program, will you change your practice behaviors?
 No Unlikely Unsure Probably Absolutely
      
Q7What changes will you make to your practice behaviors?
 
Q8
 
Q9What barriers to change do you foresee, if any? Select all that apply.
 Cost Insurance Coverage Formulary Time with Patient Patient compliance Other
       
Q10
 
Q11Did the content contribute valuable information that will assist in improving patient outcomes?
 Strongly Disagree Disagree Neutral Agree Strongly Agree
      
Q12Please rate your ability to achieve the Learning Objectives of this presentation:
 Not at all Somewhat Mostly Completely
     
Q13What was your level of expertise on this topic?
 None Little Some Considerable Extensive
 BEFORE     
 AFTER    
Q14Do you believe the activity was fair and balanced, free from commercial influences?
 Yes No
   
Q15Did the program increase your competence?
 Yes No
   
Q16Medicare requires self-monitoring of blood glucose 4x per day prior to CGM approval.
 True False
   
Q17Medicare covers CGMs as Durable Medical Equipment (DME).
 True False
   
Q18How confident are you in your answer to the last question?
 Not at all Somewhat Confident Very confident
     
Q19
 

 
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