LEARNER RECORDS: EVALUATION You must complete the program evaluation and applicable activity evaluation(s) in order to earn AMA PRA Category 1 Credits TM , MOC points, or participation in MIPS. For each of the objectives determine if the activity increased your: A Competence B Performance C Outcome D No Change COURSE 1 - IMPLICIT BIAS IMPLICATIONS FOR PHYSICIANS AND HEALTHCARE PROFESSIONALS: 1. Recognize factors that contribute to the development of implicit bias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Utilize strategies to mitigate the impact of implicit bias in decision making . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Please identify a specific change, if any, you will make in your practice related to implicit bias in the workplace.
A B C D
4. What do you see as a barrier to making these changes?
COURSE 2 -EFFECTIVE MANAGEMENT OF ACUTE AND CHRONIC PAIN WITH OPIOID ANALGESICS:
A B C D
5. Assess non-pharmacological, non-opioid, and opioid analgesic therapies in comprehensive pain plans for patients with acute or chronic pain. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Identify and manage patients with opioid use disorder and recognize when to incorporate emergency opioid antagonists into prescribing practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Please identify a specific change, if any, you will make in your practice related to safe prescribing of opioid analgesics.
8. What do you see as a barrier to making these changes?
COURSE 3 - SEXUAL HARASSMENT IN HEALTHCARE:
A B C D
9. Mitigate and prevent sexual harassment in the workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Address sexual harassment behaviors initiated by patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Please identify a specific change, if any, you will make in your practice related to sexual harassment prevention and reporting.
12. What do you see as a barrier to making these changes?
COURSE 4 - SUBSTANCE USE DISORDERS: A DEA REQUIREMENT:
A B C D
13. Discuss substance use disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Describe the roles of the U.S. Drug Enforcement Agency (DEA), Food and Drug Administration (FDA), and Department of Health and Human Services (HHS) in scheduling controlled substances and enforcing controlled substance laws and regulations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 15. Understand the different DEA Controlled Substance Schedules and prescribing regulations associated with the different DEA Controlled Substance Schedules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Review medical marijuana legislation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Describe essential considerations when prescribing controlled substances, including regulatory exceptions and clinical concerns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Describe controlled substance prescribing practices.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Understand the treatment options for patients suffering from substance use disorder (SUD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Please identify a specific change, if any, you will make in your practice related to substance abuse disorders.
21. What do you see as a barrier to making these changes?
OVERALL PROGRAM:
Yes No If no, please explain:
22. The program was balanced, objective & scientifically valid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Do you feel the program was scientifically sound & free of commercial bias or influence? .
24. How can this program be improved?
25. Based on your educational needs, please provide us with suggestions for future program topics & formats.
26. For which activities would you like to use your participation as a clinical practice improvement activity (CPIA) for MIPS? Course 1 Course 2 Course 3 Course 4 None
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