APPLY Evaluation| April 2026

Session Name: Legacy Mapping, Trust & Building Relationships, Customer Service Excellence, & Imposter Syndrome

Time: April 23, 2026

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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Last Name *

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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
Recognize self-awareness skills and emotional limitations to engage in appropriate help-seeking behaviors.	Recognize self-awareness skills and emotional limitations to engage in appropriate help-seeking behaviors. - 1	Recognize self-awareness skills and emotional limitations to engage in appropriate help-seeking behaviors. - 2	Recognize self-awareness skills and emotional limitations to engage in appropriate help-seeking behaviors. - 3	Recognize self-awareness skills and emotional limitations to engage in appropriate help-seeking behaviors. - 4
Practice various self-reflective skills and tools to support reflection and growth strategies.	Practice various self-reflective skills and tools to support reflection and growth strategies. - 1	Practice various self-reflective skills and tools to support reflection and growth strategies. - 2	Practice various self-reflective skills and tools to support reflection and growth strategies. - 3	Practice various self-reflective skills and tools to support reflection and growth strategies. - 4
Identify stages of professional identity and the contributions to professionalism.	Identify stages of professional identity and the contributions to professionalism. - 1	Identify stages of professional identity and the contributions to professionalism. - 2	Identify stages of professional identity and the contributions to professionalism. - 3	Identify stages of professional identity and the contributions to professionalism. - 4
Analyze how personal values, professional interests, and prior experiences shape a meaningful leadership legacy in advanced practice.	Analyze how personal values, professional interests, and prior experiences shape a meaningful leadership legacy in advanced practice. - 1	Analyze how personal values, professional interests, and prior experiences shape a meaningful leadership legacy in advanced practice. - 2	Analyze how personal values, professional interests, and prior experiences shape a meaningful leadership legacy in advanced practice. - 3	Analyze how personal values, professional interests, and prior experiences shape a meaningful leadership legacy in advanced practice. - 4
Develop at least one declared legacy statement that aligns with their professional mission, leadership goals, and intended impact in healthcare.	Develop at least one declared legacy statement that aligns with their professional mission, leadership goals, and intended impact in healthcare. - 1	Develop at least one declared legacy statement that aligns with their professional mission, leadership goals, and intended impact in healthcare. - 2	Develop at least one declared legacy statement that aligns with their professional mission, leadership goals, and intended impact in healthcare. - 3	Develop at least one declared legacy statement that aligns with their professional mission, leadership goals, and intended impact in healthcare. - 4
Create a draft legacy map that organizes current activities, competing responsibilities, and next steps into an actionable professional development plan.	Create a draft legacy map that organizes current activities, competing responsibilities, and next steps into an actionable professional development plan. - 1	Create a draft legacy map that organizes current activities, competing responsibilities, and next steps into an actionable professional development plan. - 2	Create a draft legacy map that organizes current activities, competing responsibilities, and next steps into an actionable professional development plan. - 3	Create a draft legacy map that organizes current activities, competing responsibilities, and next steps into an actionable professional development plan. - 4
Describe effective mentorship strategies; Plan for being a mentor or mentee.	Describe effective mentorship strategies; Plan for being a mentor or mentee. - 1	Describe effective mentorship strategies; Plan for being a mentor or mentee. - 2	Describe effective mentorship strategies; Plan for being a mentor or mentee. - 3	Describe effective mentorship strategies; Plan for being a mentor or mentee. - 4
Identify key literature and tools for self reflection and mentorship and Create a plan for future professional development.	Identify key literature and tools for self reflection and mentorship and Create a plan for future professional development. - 1	Identify key literature and tools for self reflection and mentorship and Create a plan for future professional development. - 2	Identify key literature and tools for self reflection and mentorship and Create a plan for future professional development. - 3	Identify key literature and tools for self reflection and mentorship and Create a plan for future professional development. - 4
Build professional relationships based on trust, interpersonal skills, and clear communication to handle challenging situations.	Build professional relationships based on trust, interpersonal skills, and clear communication to handle challenging situations. - 1	Build professional relationships based on trust, interpersonal skills, and clear communication to handle challenging situations. - 2	Build professional relationships based on trust, interpersonal skills, and clear communication to handle challenging situations. - 3	Build professional relationships based on trust, interpersonal skills, and clear communication to handle challenging situations. - 4
Reflect on how organizational change impacts your role and understand your ability to adapt and influence others during change.	Reflect on how organizational change impacts your role and understand your ability to adapt and influence others during change. - 1	Reflect on how organizational change impacts your role and understand your ability to adapt and influence others during change. - 2	Reflect on how organizational change impacts your role and understand your ability to adapt and influence others during change. - 3	Reflect on how organizational change impacts your role and understand your ability to adapt and influence others during change. - 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
Sarah Vanderlinden DMSc, PA-C	Sarah Vanderlinden DMSc, PA-C - 1	Sarah Vanderlinden DMSc, PA-C - 2	Sarah Vanderlinden DMSc, PA-C - 3	Sarah Vanderlinden DMSc, PA-C - 4
Jen McMahon, MSN, RN, AGACNP	Jen McMahon, MSN, RN, AGACNP - 1	Jen McMahon, MSN, RN, AGACNP - 2	Jen McMahon, MSN, RN, AGACNP - 3	Jen McMahon, MSN, RN, AGACNP - 4
Nate Filzen, BS	Nate Filzen, BS - 1	Nate Filzen, BS - 2	Nate Filzen, BS - 3	Nate Filzen, BS - 4
Keenan Horness, MPAS, PA-C	Keenan Horness, MPAS, PA-C - 1	Keenan Horness, MPAS, PA-C - 2	Keenan Horness, MPAS, PA-C - 3	Keenan Horness, MPAS, PA-C - 4
Meghan Roller, PhD, MSN, RN	Meghan Roller, PhD, MSN, RN - 1	Meghan Roller, PhD, MSN, RN - 2	Meghan Roller, PhD, MSN, RN - 3	Meghan Roller, PhD, MSN, RN - 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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