Introduction Module Evaluation Survey

Thanks for your participation in this FM Pivot module and for completing this survey.  We are greatly interested in your feedback, as we hope to incorporate it in the development of future modules.

1.  How many years have you been in practice?

2. What region is your practice/institution based in?

3. How would you describe your community of practice?

4. How would you describe your primary type of work?

5. Do you have a leadership or administrative role that takes up more than 25% of your time?

6. Please indicate your level of agreement with the following statements 

Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree
The learning objectives for this module were clear.
The learning objectives were met.
I was easily able to register for and access this module.
The module contents were easy to navigate.
The content was relevant to my clinical practice/teaching.
I feel confident in my ability to apply the content in my practice/teaching.
The resource materials were useful.
The content was balanced and unbiased.
I will be able to apply what I’ve learned to improve health outcomes in my community.
I would recommend this module to a colleague.

7. Please identify which components of the module were most useful to your clinical practice/teaching.

8. Which were least useful?

9. Did you perceive any degree of commercial bias in any part of the module?

10. Do you have any suggestions for future module topics?

11. Do you have any suggestions for additional resource materials?

12. We are hoping to conduct a follow-up evaluation on FM Pivot later in the year.  May we contact you for a brief follow-up questionnaire or interview at this time?  If so, please include your email address here:

13. Any final suggestions/comments?

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