Physicians please help us by filling out our needs Survey

We invite you to share your Continuing Medical Education needs with us so that
we may better serve you. Please fill out the following brief online survey.

Thank you for taking a moment, and answering our survey questions....

INDIVIDUAL PRACTICE PROFILE

This section is intended to gather information on you and your practice.
 

Type of Practice:

Other:

   

Practice Area

Or:

Speciality:

Subspeciality:

   

Do you have an academic appointment?
 
 

Location of your practice

     City:

     State:

   

How often were CME programs that you attended lately presented as :
 

     Didactic Lectures

     Small Group Discussion

     (<15 people)

     Problem based Learning

     Workshops

     Computer-based
   

YOUR LEARNING NEEDS

This section is intended to determine what you personally need to learn.

Do you find you require continuing education to:

     Update existing knowledge

     Update existing skills

     Acquire new knowledge

     Acquire new skills

     Reinforce that you are doing

     things correctly

     Understand technical advances

     Learn about computer use in

     medicine

     Generally keep abreast of

     advances
   

Please rate your anticipated need to learn material relevant to your practice in the following areas:

     Administration/Managment

     Basic science review

     Technology in medicine

     Information resources

     Faculty development

     Pharmaceutical advances

     Patient education/ counseling

     Prevention

     Research ethics

     Speciality needs for primary care

     physicians

     Other
   

About which of the following topics would you close your practice for the day to learn

 
 
Your Preferred Learning Style:
 
if other:

Please rate the following barriers to learning as they apply
to you in your practice:

     Distance to travel

     Cost of course

     Loss of income

     Timing of programs

     Practice responsibilities

     Lack of resources (ie, library)

     Family responsibilities

     Lack of time

     Other:

   

When is the convenient time for you to engage in CME Activities?

     Season:

   

     Day of Week:

     Time of Day:

 

     Length of Session:

 

We thank you for filling out our survey. Please click on the submit button at the botom of the page to conclude the survey.

To receive updates regarding CME Activities, please complete the following form.

Fields with * are required.

  

    *Name:

  

    *E-mail:

  
   

     Preferred Mailing Address:

     Address line 1 :

     Address line 2 :

     City:

     State:

     Zip/Postal Code :

     Country:
   
 

Please send questions or comments to Randy Estes, Associate Director CME ( estesr@uic.edu)
Revised on 01/07/2007.