First Name
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Phone
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Email
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Course Date
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What is your professional role?
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1. Please rate the course itself by choosing the number that best describes your opinion on the following questions:
Flow of course outline
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Poor
Excellent
Course materials enhanced your learning
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Poor
Excellent
Supplemental readings enhanced your learning
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Poor
Excellent
Course content applicable to your practice
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Poor
Excellent
Course case studies applicable to your practice
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Poor
Excellent
Instructors are knowledgeable
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Poor
Excellent
Instructors are approachable and helpful
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Poor
Excellent
A variety of teaching methods were used
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Poor
Excellent
Course location
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Poor
Excellent
Room temperature
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Poor
Excellent
Quality of the food and beverages
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Poor
Excellent
Additional Comments:
2. How do you think you will adjust your practice as a result of this program?
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3. How confident are you to apply what you have learned about each of these DMU topics in your practice? Choose High, Medium or Low.
The patient’s experience of living with diabetes:
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Better understand the patient’s experience of living with diabetes
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
The pathophysiology of type 2 diabetes
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Understand the pathophysiology of type 2 diabetesith diabetes
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Actions of diabetes medicines
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Understand actions of diabetes medicines
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Recommend or make medicine changes
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Recommend or make medicine changes
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
The complexity of obesity as a chronic disease beyond "Eat Less, Move More"?
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Understanding the complexity of obesity beyond “eat less move more”
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Use the information gained by testing in pairs or using a continuous glucose monitor (CGM) to inform and guide care and patient next steps
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Patient-centered use of blood sugar monitoring
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Patient-centered use of carbohydrate management
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Patient-centered use of carbohydrate management
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Importance of listening to the patient and the patient feeling heard
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Importance of listening to the patient
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
Use the information gained by testing in pairs or using a continuous glucose monitor (CGM) to inform and guide care and patient next steps
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Understand the benefits testing in pairs to inform and guide care
Low
Medium
High
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Describe any barriers to implement these approaches and any specific additional learning needs you have on this topic:
4. What recommendations do have to improve this program?
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5. What additional information would you like to have on any topic covered?
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6. Please describe any additional diabetes related continuing education needs that you have at this time.
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