2018 CME Evaluation & Post Test: Care for the Caregiver

Oct 23, 2018 - Evaluation - Care for the Caregiver, John Merson, MD - ABIM MOC - ENDURING MATERIALS Estimated Time to complete the activity is 45 minutes. Activity and content expires: Oct 23, 2021
Statement of disclosure: The planners and faculty for this activity have no relevant financial relationships with commercial interests. No others individuals involved in the planning or presentation of this activity have any relevant financial relationships with commercial interests to disclose.
Accreditation Statement: John Muir Health is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians.
Credit Designation Statement: John Muir Health designates this enduring material for a maximum of one (.75) AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Minimum level of achievement: Must score 75% correct on posttest and complete the statement of how you will improve your practice after participation is mandatory.
JMH Internet Policy: https://www.johnmuirhealth.com/website-privacy-policy1.html

1. YOUR ABIM INFORMATION WILL BE MADE PUBLIC ON THE ACCME'S PROGRAM AND ACTIVITY REPORTING SYSTEM (PARS

Please complete and return this evaluation form in order to receive a maximum of .75 AMA PRA Category 1 Credit™ for this session

2. Physician Info

Physician First Name

Physician Last Name

3. Physician Date of Birth (if expecting ABIM MOC)? This question requires a valid date format of MM/DD/YYYY.

calendar

4. Member ABIM

If yes, ABIM ID?

5. Date of Completion? This question requires a valid date format of MM/DD/YYYY.

calendar

6. As a result of attending this CME activity, which of these do you plan to implement and/or change in your practice?

Space Cell	Definitely	Maybe	No Change
Understand concept of ‘second victim’ phenomena
Become familiar with Scott’s Six Stages of Recovery
Identify the three tiers of support interventions
Recognize signs indicating the need for help
Understand leadership’s role in peer support
Determine five things you can do to manage your stress
Describe the phenomenon affecting caregivers after direct involvement in an error or patient harm event
Identify key components of and ability to develop an organizational response to support caregivers after an adverse event
Create a process to identify and train peer supporters within your organization
Demonstrate the skills necessary to provide emotional first aid for peers

7. Please list additional improvements or changes you plan to make as a result of attending this activity *This question is required.

8. Please list any barriers that you must overcome to implement your planned improvements or changes: 

9. Please REFLECT and relate a circumstance when information you received from a previous Clinical Conference has helped you in your practice

10. Comments Regarding this topic/speaker?

11. What topics would you like covered at future sessions?

12. Was there active participation in the case-discussions and of outcomes of cases shared?

13. Was their evidence of commercial bias in this session? 

If yes, please explain

14. Medical Errors are the leading cause of death in the United States:

15. It is unethical not to have a clinician support program.

16. Barriers to Medical Staff seeking support:

17. When to seek help: