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DIVISION OF RENAL DISEASES AND HYPERTENSION RENAL GRAND ROUNDS EVALUATION FORM

TITLE OF PRESENTATION: SPEAKER: DATE:

SCALE: 5 Point Likert Scale Range: 1:Strongly Disagree, 2: Disagree, NA: Not applicable.

3: Undecided,

4: Agree,

5: Strongly Agree

Please circle the appropriate number of the rating scale and return. 1. 2. 3. 4. 5. 6. 7. 8. Level of content was appropriate. Content was relevant. Content organization promoted learning. Audiovisual/Printed material was of high quality. The speaker was knowledgeable about the topic. 1 1 1 1 1 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 NA

Appropriate literature/research was included in the lecture. 1 Any questions were answered appropriately. Overall conference was of high quality. 1 1

This educational activity has contributed to my professional effectiveness and improved my ability to: 9. 10. Treat / manage patients 1 2 3 4 5 NA

Other ______________________________________________________________________

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