ADA Evaluation

What best describes your current professional status?

Private

Hospital

Academic

Other

How many patients with type 2 diabetes do you see each week?

How many years have you been in practice?

I participated in this activity and claim ____ AMA PRA Category 1 credits.

0

1

2

Please rate the extent to which the Symposium met the following objectives:

5=Excellent, 4=Very Good, 3=Good, 2=Fair, 1=Poor

	5	4	3	2	1
Identify how multiple barriers to glycemic control can be removed to achieve better patient.	Identify how multiple barriers to glycemic control can be removed to achieve better patient. - 5	Identify how multiple barriers to glycemic control can be removed to achieve better patient. - 4	Identify how multiple barriers to glycemic control can be removed to achieve better patient. - 3	Identify how multiple barriers to glycemic control can be removed to achieve better patient. - 2	Identify how multiple barriers to glycemic control can be removed to achieve better patient. - 1
Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans.	Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans. - 5	Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans. - 4	Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans. - 3	Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans. - 2	Evaluate clinical roles of available insulin preparations and appropriate use in patient-centered treatment plans. - 1
Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum	Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum - 5	Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum - 4	Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum - 3	Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum - 2	Design effective strategies for initiating, titrating, and identifying insulin therapy through disease spectrum - 1
Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies.	Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies. - 5	Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies. - 4	Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies. - 3	Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies. - 2	Review efficacy, novel benefits, safety and tolerability of emerging insulin therapies. - 1
Ascertain potential impact of emerging insulin-based therapies on patient outcomes.	Ascertain potential impact of emerging insulin-based therapies on patient outcomes. - 5	Ascertain potential impact of emerging insulin-based therapies on patient outcomes. - 4	Ascertain potential impact of emerging insulin-based therapies on patient outcomes. - 3	Ascertain potential impact of emerging insulin-based therapies on patient outcomes. - 2	Ascertain potential impact of emerging insulin-based therapies on patient outcomes. - 1

Please provide us with feedback regarding your experience at the Symposium by selecting the appropriate rating.

5=Strongly Agree, 4=Agree, 3=Neutral, 2=Disagree, 1=Strongly Disagree

	5	4	3	2	1
Overall, I was satisfied with this program.	Overall, I was satisfied with this program. - 5	Overall, I was satisfied with this program. - 4	Overall, I was satisfied with this program. - 3	Overall, I was satisfied with this program. - 2	Overall, I was satisfied with this program. - 1
The content was relevant to my practice.	The content was relevant to my practice. - 5	The content was relevant to my practice. - 4	The content was relevant to my practice. - 3	The content was relevant to my practice. - 2	The content was relevant to my practice. - 1
The information presented was without promotional or commercial bias.	The information presented was without promotional or commercial bias. - 5	The information presented was without promotional or commercial bias. - 4	The information presented was without promotional or commercial bias. - 3	The information presented was without promotional or commercial bias. - 2	The information presented was without promotional or commercial bias. - 1
The information presented was scientifically rigorous and evidence based.	The information presented was scientifically rigorous and evidence based. - 5	The information presented was scientifically rigorous and evidence based. - 4	The information presented was scientifically rigorous and evidence based. - 3	The information presented was scientifically rigorous and evidence based. - 2	The information presented was scientifically rigorous and evidence based. - 1
The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A).	The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A). - 5	The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A). - 4	The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A). - 3	The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A). - 2	The information presented provided appropriate and effective opportunities for active learning (discussion, Q&A). - 1
The information presented promoted improvements or quality in healthcare.	The information presented promoted improvements or quality in healthcare. - 5	The information presented promoted improvements or quality in healthcare. - 4	The information presented promoted improvements or quality in healthcare. - 3	The information presented promoted improvements or quality in healthcare. - 2	The information presented promoted improvements or quality in healthcare. - 1
The quality of the educational process was satisfactory and appropriate.	The quality of the educational process was satisfactory and appropriate. - 5	The quality of the educational process was satisfactory and appropriate. - 4	The quality of the educational process was satisfactory and appropriate. - 3	The quality of the educational process was satisfactory and appropriate. - 2	The quality of the educational process was satisfactory and appropriate. - 1
The format of the discussion was relevant and enhanced my knowledge of the subject.	The format of the discussion was relevant and enhanced my knowledge of the subject. - 5	The format of the discussion was relevant and enhanced my knowledge of the subject. - 4	The format of the discussion was relevant and enhanced my knowledge of the subject. - 3	The format of the discussion was relevant and enhanced my knowledge of the subject. - 2	The format of the discussion was relevant and enhanced my knowledge of the subject. - 1
The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes.	The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes. - 5	The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes. - 4	The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes. - 3	The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes. - 2	The format of the discussion was relevant and enhanced my competence to treat patients with Type 2 diabetes. - 1
The faculty/speakers were effective.	The faculty/speakers were effective. - 5	The faculty/speakers were effective. - 4	The faculty/speakers were effective. - 3	The faculty/speakers were effective. - 2	The faculty/speakers were effective. - 1
I plan to make changes to my practice as a result of what I learned from this program.	I plan to make changes to my practice as a result of what I learned from this program. - 5	I plan to make changes to my practice as a result of what I learned from this program. - 4	I plan to make changes to my practice as a result of what I learned from this program. - 3	I plan to make changes to my practice as a result of what I learned from this program. - 2	I plan to make changes to my practice as a result of what I learned from this program. - 1

What strategies do you plan to implement in your practice?

What barriers do you see to making changes in your practice?

Please rate each faculty on his/her overall teaching ability, overall knowledge and level of expertise regarding the subject of this program.

5=Excellent, 4=Very Good, 3=Good, 2=Fair, 1=Poor

	5	4	3	2	1
James R. Gavin, III, MD, PhD	James R. Gavin, III, MD, PhD - 5	James R. Gavin, III, MD, PhD - 4	James R. Gavin, III, MD, PhD - 3	James R. Gavin, III, MD, PhD - 2	James R. Gavin, III, MD, PhD - 1
Richard E. Pratley, MD	Richard E. Pratley, MD - 5	Richard E. Pratley, MD - 4	Richard E. Pratley, MD - 3	Richard E. Pratley, MD - 2	Richard E. Pratley, MD - 1
Chantal Mathieu, MD, PhD	Chantal Mathieu, MD, PhD - 5	Chantal Mathieu, MD, PhD - 4	Chantal Mathieu, MD, PhD - 3	Chantal Mathieu, MD, PhD - 2	Chantal Mathieu, MD, PhD - 1

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