POSTGRADUATE INSTITUTE FOR MEDICINE
"Modern Approaches to Anemia Mangagement: Current Models for Clinical and Practice Operation Success"
Post-Test Answer Sheet and Evaluation Form
Project ID: 031256 ES 13


To obtain a statement of participation, you must complete the post-test by recording the best answer to each question in the answer key on the evaluation form, complete the evaluation form, and mail or fax the evaluation form with answer key to the Postgraduate Institute for Medicine. The Post-Test / Evaluation Form must be submitted by December 31, 2003. Mail/fax to:

Postgraduate Institute of Medicine
P.O. Box 26020
Littleton, CO 80163-0620
(303)790-4876 - FAX

Certificates will be mailed within 4-6 weeks after receipt to those who successfully complete the Post-Test/Evaluation form. There is no registration fee to participate in this activity.

Name (please print) __________________________________________________________________
Degree
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Specialty
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Mailing Address for Certificate:

Street
__________________________________________________________________
City/State/Zip Code

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Signature
__________________________________________________________________
Date
__________________________________________________________________
Phone #
__________________________________________________________________
Fax #
__________________________________________________________________
E-mail: __________________________________________________________________

 

I completed the entire activity and claim _____ credit hours.
I completed only part of the activity and claim credit hours based on _____ hours of participation.

 

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Signature




Post-Test ANSWER SHEET
Mark the answer that is correct for each PostTest question below: First click on the Post-Test Questions link and print out the questions for your reference.

. A. B. C. D. E.
1. o o o o  
2. o o o o  
3. o o o o  
4. o o      
5. o o o o  
6. o o o o o
7.
o o o o  
8.
o o      

Please answer the following questions by circling the appropriate rating:

5 = Outstanding

4 = Good

3 = Satisfactory

2 = Fair

1 = Poor


Extent to Which Program Activities Met the Identified Objectives


Upon completion of this activity, participants should be able to:

Discuss the emerging Medicare data that support the correlation between anemia and morbidity, mortality and hospitalization. 5 4 3 2 1
Discuss the problem of underdiagnosis and undertreatment of anemia. 5 4 3 2 1
Describe new data that further link anemia and cardiovascular disease. 5 4 3 2 1
Describe the clinical and economic impact of anemia management in various practice settings. 5 4 3 2 1


Overall Effectiveness of the Activity

Objectives were related to overall purpose/goal(s) of activity 5 4 3 2 1
Related to my practice needs 5 4 3 2 1
Will influence how I practice 5 4 3 2 1
Will help me improve patient care 5 4 3 2 1
Stimulated my intellectual curiosity 5 4 3 2 1
Overall quality of material 5 4 3 2 1
Overall, the activity met my expectations 5 4 3 2 1
Avoided commercial bias or influence 5 4 3 2 1

Will the information presented cause you to make any changes in your practice?


____Yes____No

If Yes, please describe any change(s) you plan to make in your practice as a result of this activity.

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How committed are you to making these changes?
    

5 (Very committed)   4    3    2    1 (Not at all committed)

Additional comments about this activity?
 

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Do you feel future activities on this subject matter are necessary and/or important to your practice?

____Yes ____No

Please list any other topics that would be of interest to you for future educational activities:

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