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CME Demographic and Evaluation Form - Prospects for GLP-1 Receptor Agonists: When, Who, and How to Treat
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1. What is your profession? Check all that apply.
MD
DO
NP
RN
PA
RPh
CDE
  Other

2. Faculty and Content
When: Glycemic Benefits of GLP-1 Receptor Agonists Along the Spectrum of Diabetes
James R. Gavin III MD, PhD
  Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent
 
(A): Knowledge of subject

1     2     3     4     5    
 
(B): Presentation was orderly and understandable

1     2     3     4     5    
 
(C): Use of audiovisual and discussion were effective in helping me learn

1     2     3     4     5    

3. Was all data reported objectively and with appropriate referencing?
Yes
No

4. Was the overall content of this educational activity presented objectively and free of bias?
Yes
No

5. If you answered 'No' to question 3 or 4, please explain:
 

6. FACULTY AND CONTENT
Who: GLP-1 Receptor Agonists and Diverse Patient Needs
John L. Leahy, MD
  Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent
 
(A): Knowledge of subject

1     2     3     4     5    
 
(B): Presentation was orderly and understandable

1     2     3     4     5    
 
(C): Use of audiovisual and discussion were effective in helping me learn

1     2     3     4     5    

7. Was all data reported objectively and with appropriate referencing?
Yes
No

8. Was the overall content of this educational activity presented objectively and free of bias?
Yes
No

9. If you answered 'No' to question 7 or 8, please explain:
 

10. FACULTY AND CONTENT
How Do I Successfully Use These Agents for My Patients?
Geralyn Spollett, MSN, ANP-CS, CDE
  Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent
 
(A): Knowledge of subject

1     2     3     4     5    
 
(B): Presentation was orderly and understandable

1     2     3     4     5    
 
(C): Use of audiovisual and discussion were effective in helping me learn

1     2     3     4     5    

11. Was all data reported objectively and with appropriate referencing?
Yes
No

12. Was the overall content of this educational activity presented objectively and free of bias?
Yes
No

13. If you answered 'No' to question 11 or 12, please explain:
 

14. FACULTY AND CONTENT
Roundtable Discussion
Faculty Panel – facilitated by John L. Leahy, MD
  Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent
 
(A): Knowledge of subject

1     2     3     4     5    
 
(B): Roundtable discussion was orderly and understandable

1     2     3     4     5    
 
(C): Format of discussion was effective in helping me learn

1     2     3     4     5    

15. LEARNING OBJECTIVES
Please evaluate how well the following learning objectives were met:
  Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent
 
(A): Analyze data from clinical trials that demonstrate the effects of GLP-1 receptor agonists on glycemic control for patients at different stages of disease progression

1     2     3     4     5    
 
(B): Recognize nonglycemic effects of GLP-1 receptor agonists that may contribute to disease management in patients with type 2 diabetes

1     2     3     4     5    
 
(C): Evaluate safety and tolerability considerations with regard to GLP-1 receptor agonists

1     2     3     4     5    
 
(D): Identify approaches to promote successful implementation of therapy with GLP-1 receptor agonists

1     2     3     4     5    

16. Was the subject matter relevant to your clinical practice?
Yes
No

17. Was the educational format an effective learning method?
Yes
No

18. Was the environment conducive to learning?
Yes
No

19. If you answered 'No' to question 16, 17 or 18, please explain:
 

20. What one question remains unanswered after having participated in this activity?
 

21. Cite one new piece of information learned from this activity.
 

22. What related topics would you like to have offered as future continuing education (CE) activities?
 

23. What are your preferred learning methods? (Check as many as applicable)
Live conferences
CD-ROM
Print materials (eg, monographs)
Internet/Web-based
Podcasts/MP3 audio
PDA/Windows Mobile®/iPhone™
  Other

24. Additional Comments:
 

25. I want to receive further information regarding Caring for Diabetes activities
Yes
No

26. CONTINUING EDUCATION CREDIT ATTESTATION
The Institute for Medical and Nursing Education, Inc (IMNE) designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

IMNE designates this educational activity for 1.5 contact hours (0.15 CEUs) of continuing nursing education credit as a designated provider of the ANCC.

I certify that I completed this CME activity. The actual amount of time I spent in this activity was:
 
 hours     minutes  (Not to exceed 1 hr(s) 30 mins)

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