NAVAL SCHOOL OF HEALTH SCIENCES PORTSMOUTH VIRGINIA
CME/CEU CRITIQUE FORM
Please complete this evaluation form. Your constructive feedback will assist with the assessment of the CME program at Naval School of Health Sciences, Portsmouth.
TITLE OF COURSE: Operational Obstetrics & Gynecology, Non-Resident Training Course No. 13109-A
DATE OF COMPLETION OF COURSE: ________________________
Please rate the program using numerical values given below:
1 = POOR 2 = FAIR 3 = AVERAGE 4 = VERY GOOD 5 = OUTSTANDING
CONTENT: Appropriateness of topic for your educational needs? [___]
MANUAL: Usefulness? [___] Clear? [___] Enough detail? [___]
Comments:_______________________________________________________________________________________
TEST: Was it fair? [___] Did it help insure careful reading of the text? [___] Was it understandable? [___]
Comments:_______________________________________________________________________________________
OBJECTIVES: How well did the course meet the educational objectives? [___]
OVERALL impression of the course? [___]
OVERALL Comments:_____________________________________________________________________________
[___] PHYSICIAN
[___] PHYSICIAN ASSISTANT
[___] NURSE
[___] NURSE PRACTITIONER
[___] NURSE MIDWIFE
[___] NURSE PRACTITIONER
[___] HOSPITAL CORPSMAN
[___] INDEPENDENT DUTY CORPSMAN
[___] OTHER____________________________________________
Name____________________________________