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CPE Evaluation Form

CDR requires that Examine utilize evaluations to promote quality improvement in CPE activities. Completing this evaluation assists Examine, learners, and CDR.

For assistance, please contact membership@examine.com.

RDs and DTRs may share information with CDR staff regarding the quality of this CDR CPEU Prior Approved Activity by emailing QualityCPE@eatright.org.

Please fill out this form and tap "Submit". A copy of this form will be sent to your inbox from notifications@forms.examine.com.

Email

*

Full name

*

What is your profession?

*

Provider: Examine

Name of Activity: (e.g. Study Summaries: January 2024)

*

Date completed:

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Select Yes or No to describe attributes of the Continuing Professional Education:

Utilized best available research evidence

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Utilized best available research evidence

Yes

No

Included ample peer-reviewed references to substantiate content

*

Included ample peer-reviewed references to substantiate content

Yes

No

Expertise of Provider / presenter contributed to content quality

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Expertise of Provider / presenter contributed to content quality

Yes

No

Target audience was appropriate

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Target audience was appropriate

Yes

No

Met educational needs and / or addressed practice gaps

*

Met educational needs and / or addressed practice gaps

Yes

No

Included practical information for implementing changes to practice

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Included practical information for implementing changes to practice

Yes

No

Provided a balanced perspective / stated benefits and shortcomings

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Provided a balanced perspective / stated benefits and shortcomings

Yes

No

Please describe any other noteworthy attributes of the CPE activity

Select Yes or No to describe if the CPE activity enhanced knowledge, skills, and behaviors as described in CDR’s Essential Practice Competencies for Ethics or Health Equity:

Included materials and content which emphasized and included diverse representation in the learning group

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Included materials and content which emphasized and included diverse representation in the learning group

Yes

No

Included a focus on differences that may vary within and between patient / client populations

*

Included a focus on differences that may vary within and between patient / client populations

Yes

No

Established an environment or facilitated interactions which encouraged and respected diverse and divergent experiences and viewpoints

*

Established an environment or facilitated interactions which encouraged and respected diverse and divergent experiences and viewpoints

Yes

No

Encouraged reflection on bias and privilege and the promotion of personal growth.

*

Encouraged reflection on bias and privilege and the promotion of personal growth.

Yes

No

Encouraged and respected diverse and divergent experiences and viewpoints

*

Encouraged and respected diverse and divergent experiences and viewpoints

Yes

No

Select Yes or No or No Answer to describe the language in the materials / presentation:

Free of bias

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Free of bias

Yes

No

No Answer

Non-discriminatory

*

Non-discriminatory

Yes

No

No Answer

Inclusive

*

Inclusive

Yes

No

No Answer

Conscious of honoring how individuals choose to identify themselves

*

Conscious of honoring how individuals choose to identify themselves

Yes

No

No Answer

Free of microaggressions

*

Free of microaggressions

Yes

No

No Answer

Untitled checkboxes field

Unfamiliar with one or more of the concepts presented above

As a result of the education do you plan to: (select all that apply)

*

As a result of the education do you plan to: (select all that apply)

Share the information / collaborate with colleagues

Review supplementary information to support or expand your learning

Seek additional CPE activities related to the topic

Alter the methods in which you care for patients / clients / customers

No action

Other (describe)

CPE Evaluation Form

Email

Full name

What is your profession?

Provider: Examine

Select Yes or No to describe attributes of the Continuing Professional Education:

Please describe any other noteworthy attributes of the CPE activity

Select Yes or No to describe if the CPE activity enhanced knowledge, skills, and behaviors as described in CDR’s Essential Practice Competencies for Ethics or Health Equity:

Select Yes or No or No Answer to describe the language in the materials / presentation:

As a result of the education do you plan to: (select all that apply)

Any additional comments?