Evaluation of this Program (PDPN)

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1. Was the information presented in this activity biased and/or compromised by commercial support? (Required.)

Yes

If Yes, please explain.

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2. How do you rate Dr. Stanos's delivery of this education? (Required.)

Excellent

Very Good

Average

Needs Improvement

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3. To what degree did this activity meet the learning objectives?

Understand pathophysiology of neuropathic pain including positive and negative signs and symptoms.

Recognize expanding understanding of thermoperception including pharmacologic targets for the treatment of neuropathic pain.

Review treatment guidelines for the management of neuropathic pain including diabetic peripheral neuropathy (DPN).

Discuss nonpharmacologic interventions for neuropathic pain.

(Required.)

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

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4. Did this activity provide new information to you? (Required.)

Yes

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5. Was the educational approach used in this activity conducive to your learning experience? (Required.)

Yes

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6. Was the information presented applicable to your clinical practice? (Required.)

Yes

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7. Will the information presented help you to improve your patients’ outcomes? (Required.)

Yes

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8. This activity increased my knowledge, competence, and/or will improve my performance in my practice (Required.)

Yes

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9. Of the patients you will see in the next week, about how many will benefit from the information you learned by participating in this activity? (Required.)

1-10

11-25

26-50

>50

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10. Based upon your participation in this activity, do you intend to change your practice behavior? (Required.)

Yes, I plan to implement changes in my practice based on the information presented

No, I need more information before I will make any changes to my practice behavior

Not applicable – My current practice has been reinforced by the information presented

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11. If you plan to change your practice behavior, what type of change(s) do you plan to implement? Check all that apply.

Differentiate and diagnose nerve pain and PDPN.

Treat and manage nerve pain and PDPN.

Utilize nerve pain and PDPN management techniques on a case-by-case basis.

Recognize patients that qualify for therapy to expand management capabilities.

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12. Are there any barriers that would keep you from implementing the practice paradigms discussed in this activity? (Required.)

No perceived barriers

Lack of evidence-based guidelines

Lack of applicability of guidelines to my current practice and/or patients

Lack of time

Organizational/Institutional

Insurance/Financial

Patient Adherence/Compliance

Treatment related adverse events

Other (please specify)

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13. Please give us your overall comments regarding this activity.

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14. Claim Credit (Required.)

I certify that I have participated in the number of hours (0.5 hours) of this educational activity and request a CME certificate indicating that number of credits. I will claim only the total number of hours for which I participated.

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15. Please Fill out the form below for your CME/CE Certificate (Required.)

First and Last Name

Title (MD, DO, NP, PA, RN, etc.)

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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16. What is your specialty (Ex. Family Practice, Neurology, etc) (Required.)

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17. How many years have you been in practice? (Required.)

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18. How many days a week do you see patients? (Required.)

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19. How many patients do you typically see per day? (Required.)

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20. What is your practice like? (Required.)

Solo or small group (1-5 providers)

Large group (> 5 providers)

Government Owned Facility/Clinic

Retired/Not Seeing Patients

Other (please specify)

Evaluation of this Program (PDPN)

Question Title

* 1. Was the information presented in this activity biased and/or compromised by commercial support? (Required.)

Question Title

* 2. How do you rate Dr. Stanos's delivery of this education? (Required.)

Question Title

Question Title

* 4. Did this activity provide new information to you? (Required.)

Question Title

* 5. Was the educational approach used in this activity conducive to your learning experience? (Required.)

Question Title

* 6. Was the information presented applicable to your clinical practice? (Required.)

Question Title

* 7. Will the information presented help you to improve your patients’ outcomes? (Required.)

Question Title

* 8. This activity increased my knowledge, competence, and/or will improve my performance in my practice (Required.)

Question Title

* 9. Of the patients you will see in the next week, about how many will benefit from the information you learned by participating in this activity? (Required.)

Question Title

* 10. Based upon your participation in this activity, do you intend to change your practice behavior? (Required.)

Question Title

* 11. If you plan to change your practice behavior, what type of change(s) do you plan to implement? Check all that apply.

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* 12. Are there any barriers that would keep you from implementing the practice paradigms discussed in this activity? (Required.)

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* 13. Please give us your overall comments regarding this activity.

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* 14. Claim Credit (Required.)

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* 15. Please Fill out the form below for your CME/CE Certificate (Required.)

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* 16. What is your specialty (Ex. Family Practice, Neurology, etc) (Required.)

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* 17. How many years have you been in practice? (Required.)

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* 18. How many days a week do you see patients? (Required.)

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* 19. How many patients do you typically see per day? (Required.)

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* 20. What is your practice like? (Required.)

1. Was the information presented in this activity biased and/or compromised by commercial support? (Required.)

2. How do you rate Dr. Stanos's delivery of this education? (Required.)

4. Did this activity provide new information to you? (Required.)

5. Was the educational approach used in this activity conducive to your learning experience? (Required.)

6. Was the information presented applicable to your clinical practice? (Required.)

7. Will the information presented help you to improve your patients’ outcomes? (Required.)

8. This activity increased my knowledge, competence, and/or will improve my performance in my practice (Required.)

9. Of the patients you will see in the next week, about how many will benefit from the information you learned by participating in this activity? (Required.)

10. Based upon your participation in this activity, do you intend to change your practice behavior? (Required.)

11. If you plan to change your practice behavior, what type of change(s) do you plan to implement? Check all that apply.

12. Are there any barriers that would keep you from implementing the practice paradigms discussed in this activity? (Required.)

13. Please give us your overall comments regarding this activity.

14. Claim Credit (Required.)

15. Please Fill out the form below for your CME/CE Certificate (Required.)

16. What is your specialty (Ex. Family Practice, Neurology, etc) (Required.)

17. How many years have you been in practice? (Required.)

18. How many days a week do you see patients? (Required.)

19. How many patients do you typically see per day? (Required.)

20. What is your practice like? (Required.)