APPLY | Crucial Conversations & Accountability & Influencing without Authority Evaluation

Session Name: APPLY | Crucial Conversations & Accountability & Influencing without Authority

Time: 01/16

We appreciate your time and effort in participating in this CME Sessional Evaluation. This evaluation is a pipeline to bring your voice to the leadership, instructors, and CME team. We value your voice and try our best to improve the quality of future activities.

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In what aspect(s) do you feel satisfied with this session? (Check all that apply)

The session met my learning needs.

The content was relevant to my current practices.

The conversation was interprofessional.

The conversation was constructive.

None

Please check here and explain your choice:____________

1 Please check here and explain your choice:____________

This session enhanced my professional competence or ability in the following ways: (Check all that apply)

The ability to provide compassionate, appropriate, and effective Patient Care.

Medical Knowledge.

Interpersonal and Communication Skills with patients, their families, and health professionals.

Commitment to carrying out Professional responsibilities and an adherence to ethical principles.

The ability to investigate and evaluate patient care, to appraise and assimilate scientific evidence, and to improve patient care based on self-evaluation and life-long learning.

The awareness of and the ability to call effectively on other resources in the larger context and system of health care.

None of above

Please check here and explain your choice:____________

2 Please check here and explain your choice:____________

My practice was/will be changed and improved in the following way(s) as a result of the content presented in the session? (Check all that apply)

Diagnostic approach

Therapeutic approach

Disease prevention or health education

System process improvement

No Change

Please check here and explain your choice:____________

3 Please check here and explain your choice:____________

Did/Will you use this information for specific patient(s)?

yes

If Yes, please check all that apply.

As a result of this information, I managed/will manage this patient differently.

I had several options for this patient, and I used/will use this information to justify a choice.

I thought I knew what to do, and I used/will use this information to be more certain about the management of this patient.

I used/will use this information to better understand a particular issue related to this patient.

I used/will use this information to recommend this patient, or other health professionals to make a change for this patient.

Other...

5 Other...

If No, please check all that apply.

This information does not apply to my patients.

This infromation is too old.

This information is too new.

This strategy is too expensive.

Patient access barriers.

System based barrier (time, staff,ect).

Other...

5 Other...

This patient(s) got/will get the following health benefits as a result of applying this information (Check all that apply)

This information helped/will help to improve this patient's health status, functioning or resilience (i.e., ability to adapt to significant life stressors)

This information helped/will help to prevent a disease or worsening of disease for this patient

This information helped/will help to avoid unnecessary or inappropriate treatment, diagnostic procedures, preventative interventions or a referral, for this patient

Other...

6 Other...

Is there anything which the speaker did exceptionally well? (Select all that apply)

Explained content well

Clear and organized slides/materials

Incorporated interactivity

Engaging style of presentation

Highlighted key points

Develop content appropriate for postgraduate peers and care team

Other...

7 Other...

What patient/health care problem recently challenged you, and you wish you knew more about?

This information was free of commercial bias. If no, please explain.

Yes

No, Why

9 No, Why

Comments and Feedback on the learning experience, content, procedure, and instructors, etc. in this session.

As a result of my participation in this activity, I am better able to... 4 - Strongly Agree 3- Agree 2 - Somewhat Disagree 1- Strongly disagree

	1	2	3	4
Describe what influence means in the context of authority with the caveat of working remotely	Describe what influence means in the context of authority with the caveat of working remotely - 1	Describe what influence means in the context of authority with the caveat of working remotely - 2	Describe what influence means in the context of authority with the caveat of working remotely - 3	Describe what influence means in the context of authority with the caveat of working remotely - 4
Distinguish between personal and positional sources of power in the absence of proximity	Distinguish between personal and positional sources of power in the absence of proximity - 1	Distinguish between personal and positional sources of power in the absence of proximity - 2	Distinguish between personal and positional sources of power in the absence of proximity - 3	Distinguish between personal and positional sources of power in the absence of proximity - 4
Apply the influence model to increase influence in the organization by identifying potential allies and understanding their work style preferences	Apply the influence model to increase influence in the organization by identifying potential allies and understanding their work style preferences - 1	Apply the influence model to increase influence in the organization by identifying potential allies and understanding their work style preferences - 2	Apply the influence model to increase influence in the organization by identifying potential allies and understanding their work style preferences - 3	Apply the influence model to increase influence in the organization by identifying potential allies and understanding their work style preferences - 4
How to be intentional about remaining connected	How to be intentional about remaining connected - 1	How to be intentional about remaining connected - 2	How to be intentional about remaining connected - 3	How to be intentional about remaining connected - 4
Create a culture of candor where people are able to come to agreement about difficult changes	Create a culture of candor where people are able to come to agreement about difficult changes - 1	Create a culture of candor where people are able to come to agreement about difficult changes - 2	Create a culture of candor where people are able to come to agreement about difficult changes - 3	Create a culture of candor where people are able to come to agreement about difficult changes - 4
Talk openly and honest with people no matter how delicate the topic or powerful the individual.	Talk openly and honest with people no matter how delicate the topic or powerful the individual. - 1	Talk openly and honest with people no matter how delicate the topic or powerful the individual. - 2	Talk openly and honest with people no matter how delicate the topic or powerful the individual. - 3	Talk openly and honest with people no matter how delicate the topic or powerful the individual. - 4
Make decisions in a way that encourages people to act on them with conviction; eliminating resistance and negativity.	Make decisions in a way that encourages people to act on them with conviction; eliminating resistance and negativity. - 1	Make decisions in a way that encourages people to act on them with conviction; eliminating resistance and negativity. - 2	Make decisions in a way that encourages people to act on them with conviction; eliminating resistance and negativity. - 3	Make decisions in a way that encourages people to act on them with conviction; eliminating resistance and negativity. - 4
Speak up when things are getting off track (in or out of meetings) and suggest how to make improvements.	Speak up when things are getting off track (in or out of meetings) and suggest how to make improvements. - 1	Speak up when things are getting off track (in or out of meetings) and suggest how to make improvements. - 2	Speak up when things are getting off track (in or out of meetings) and suggest how to make improvements. - 3	Speak up when things are getting off track (in or out of meetings) and suggest how to make improvements. - 4
Effectively hold conversations in which stakes are high, emotions are strong, and opinions differ.	Effectively hold conversations in which stakes are high, emotions are strong, and opinions differ. - 1	Effectively hold conversations in which stakes are high, emotions are strong, and opinions differ. - 2	Effectively hold conversations in which stakes are high, emotions are strong, and opinions differ. - 3	Effectively hold conversations in which stakes are high, emotions are strong, and opinions differ. - 4
Hold anyone accountable – no matter the person’s power, position, or temperament	Hold anyone accountable – no matter the person’s power, position, or temperament - 1	Hold anyone accountable – no matter the person’s power, position, or temperament - 2	Hold anyone accountable – no matter the person’s power, position, or temperament - 3	Hold anyone accountable – no matter the person’s power, position, or temperament - 4
Master performance discussions – get positive results and maintain good relationships	Master performance discussions – get positive results and maintain good relationships - 1	Master performance discussions – get positive results and maintain good relationships - 2	Master performance discussions – get positive results and maintain good relationships - 3	Master performance discussions – get positive results and maintain good relationships - 4
Motivate others without using power – clearly and concisely explain specific, natural consequences, and permanently resolve problems	Motivate others without using power – clearly and concisely explain specific, natural consequences, and permanently resolve problems - 1	Motivate others without using power – clearly and concisely explain specific, natural consequences, and permanently resolve problems - 2	Motivate others without using power – clearly and concisely explain specific, natural consequences, and permanently resolve problems - 3	Motivate others without using power – clearly and concisely explain specific, natural consequences, and permanently resolve problems - 4
Manage projects without taking over – creatively help others avoid excuses, keep projects on track, and resolve performance barriers	Manage projects without taking over – creatively help others avoid excuses, keep projects on track, and resolve performance barriers - 1	Manage projects without taking over – creatively help others avoid excuses, keep projects on track, and resolve performance barriers - 2	Manage projects without taking over – creatively help others avoid excuses, keep projects on track, and resolve performance barriers - 3	Manage projects without taking over – creatively help others avoid excuses, keep projects on track, and resolve performance barriers - 4
Move to action – agree on a plan, follow up, engage in good reporting practices, and manage new expectations	Move to action – agree on a plan, follow up, engage in good reporting practices, and manage new expectations - 1	Move to action – agree on a plan, follow up, engage in good reporting practices, and manage new expectations - 2	Move to action – agree on a plan, follow up, engage in good reporting practices, and manage new expectations - 3	Move to action – agree on a plan, follow up, engage in good reporting practices, and manage new expectations - 4

The following speaker(s) demonstrated experiential knowledge of the topic 4 - Strongly Agree 3- Agree 2 - Somewhat Disagree 1- Strongly Disagree

	1	2	3	4
Nate Filzen	Nate Filzen - 1	Nate Filzen - 2	Nate Filzen - 3	Nate Filzen - 4

Choose the option that best fits your evaluation of this activity: 4 - Strongly Agree 3- Agree 2 - Somewhat Disagree 1- Strongly Disagree

	1	2	3	4
The content provided a fair and balanced coverage of the topic	The content provided a fair and balanced coverage of the topic - 1	The content provided a fair and balanced coverage of the topic - 2	The content provided a fair and balanced coverage of the topic - 3	The content provided a fair and balanced coverage of the topic - 4
The content was free of commercial bias	The content was free of commercial bias - 1	The content was free of commercial bias - 2	The content was free of commercial bias - 3	The content was free of commercial bias - 4

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Medical College of Wisconsin

Office of Continuing and Professional Education

APPLY | Crucial Conversations & Accountability & Influencing without Authority Evaluation

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APPLY | Crucial Conversations & Accountability & Influencing without Authority Evaluation