2021/22 Case Sharing Webinar Evaluation Form

Thank you for completing this form, to help CAMAP improve this program and meet the requirements of CFPC and the Royal College. If you would like a CPD certificate for your records, please make sure you include your first and last name. The certificate will be emailed to you once you submit this form.
Name (required if you would like a CPD certificate; optional otherwise)
1. Please tell us what your role is(Required)
2. What is your role in the delivery of MAiD?(Required)
What was the date of the Case Sharing even you are evaluating today?(Required)
4. Did the speakers disclose their respective Conflicts of Interests?(Required)
5. Did you perceive any degree of bias in this program?(Required)
7. For participants from Quebec, does the content respect the Code of Ethics of the CQDPCM (http://cqdpcm.ca/tool/code-dethique/)?(Required)
8. Do you feel the objectives for this program were met?(Required)
Our objectives for this MAID Case Webinar series are that after participating, attendees will be better able to: (1) Identify the elements of complex clinical scenarios when persons request (2) Critique various approaches to assess and/or provide MAiD in those complex scenarios (3) Interpret standards and guidelines in MAiD provision with patients and healthcare provider colleagues (4) Devise, develop and implement high quality end of life care (5) Explain how other colleagues ensure that MAiD medico-legal criteria are assessed and evaluated appropriately
10. Did you feel there was adequate time for discussion?(Required)
12. Please indicate which of the CanMEDS-FM Roles you feel were addressed by your participation in the Webinar. Please select all that apply. (This question is required by CFPC; if you are not a family physician, you can note that below).(Required)
13. Do you plan to attend a future Case Sharing Webinar?(Required)
15. Would you be willing to present at a future Case Sharing Webinar?
If you answer "yes" to this question, please make sure you have included your name at the start of this from.

Thank you for completing this evaluation form!