LEARNER RECORDS: EVALUATION You must complete the program evaluation and applicable activity evaluation(s) in order to earn AMA PRA Category 1 Credit 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 - RECOGNIZING AND RESPONDING TO HUMAN TRAFFICKING IN TEXAS:
A B C D
1. Utilize communication strategies to better identify the victims of human trafficking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Evaluate and assist patients in a safe environment and provide appropriate resources or referrals. . . . . . . . . . . . . . . . . . . . . . 3. Please identify a specific change, if any, you will make in your practice related to human trafficking.
4. What do you see as a barrier to making these changes?
COURSE 2 - BEST PRACTICES FOR TREATING PAIN WITH OPIOID ANALGESICS:
A B C D
5. Identify and employ a full range of therapeutic options when developing a pain treatment plan . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Screen patients for presence or risk of OUD, assess and manage patients who demonstrate signs of OUD, or refer if necessary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 - EXISTING AND EMERGING PATIENT SAFETY PRACTICES:
A B C D
9. Protect patient safety by understanding system-level or organization-level factors involved with medical errors or harms. . . 10. Improve system-level or organization-level factors to further reduce medical errors or harms . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Identify patient-centered strategies that can help reduce potential harms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Implement patient-centered strategies to help reduce rates of hospital-acquired infections and a range of other potential harms, such as adverse events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Please identify a specific change, if any, you will make in your practice related to improving patient safety.
14. What do you see as a barrier to making these changes?
COURSE 4 - SUBSTANCE USE DISORDERS: A DEA REQUIREMENT:
C D B A
15. Discuss substance use disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 17. Understand the different DEA Controlled Substance Schedules and prescribing regulations associated with the different DEA Controlled Substance Schedules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Review medical marijuana legislation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. Describe essential considerations when prescribing controlled substances, including regulatory exceptions and clinical concerns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Describe controlled substance prescribing practices.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Understand the treatment options for patients suffering from substance use disorder (SUD).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. Please identify a specific change, if any, you will make in your practice related to substance abuse disorders.
23. What do you see as a barrier to making these changes?
OVERALL PROGRAM:
If no, please explain: Yes No
24. The program was balanced, objective & scientifically valid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Do you feel the program was scientifically sound & free of commercial bias or influence? .
26. How can this program be improved?
27. Based on your educational needs, please provide us with suggestions for future program topics & formats.
28. 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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