Pacific AETC
Program Evaluation Form

Thank you for participation in this event.

Event Title:
HIVLN - Effective Communication Skills for Patient Engagement (ARCHIVED)
Date:
30-Jun-19

We collect information from each participant to evaluate our activities using the participant evaluation form (PEF).

You are on our mobile version of the evaluation. Click here to go to the standard page.

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Pacific AETC PEF
Unique ID

Please fill in your PIF Unique ID Number. To create your unique ID number, use the month of your birth, the day of your birth, and the last four digits of your cell phone. For example, a birthday of May 29 and a cell of 201-867-5309 would result in a unique ID of 05295309. Why is this necessary.

Pacific AETC PEF
Program Quality

Use this scale for the following questions

1
Poor
2
Fair
3
Satisfactory
4
Good
5
Excellent
1. How would you rate the overall quality of the program?
2. How well did this program meet the stated learning objectives?

Pacific AETC PEF
Program Quality

Use this scale for the following questions

1
Poor
2
Fair
3
Satisfactory
4
Good
5
Excellent

3. How would you rate your level of knowledge about this content?

BEFORE Training
AFTER Training

Pacific AETC PEF
Program Impact

Use this scale for the following questions

1
Poor
2
Fair
3
Satisfactory
4
Good
5
Excellent

4. How would you rate your overall ability to provide quality HIV care/services?

BEFORE Training
AFTER Training

Pacific AETC PEF
Program Impact

Use this scale for the following questions

1
Poor
2
Fair
3
Satisfactory
4
Good
5
Excellent

5. How would you rate your confidence to provide care/services to persons with HIV/AIDS?

BEFORE Training
AFTER Training

Pacific AETC PEF
Program Impact

6. I can apply the information or skills learned in my practice/service setting.

Pacific AETC PEF

Use this scale for the following questions

1
Poor
2
Fair
3
Satisfactory
4
Good
5
Excellent
9. How would you rate the program content?
10. How would you rate the program format?
11. How would you rate overall quality of the faculty?
12. How would you rate the usefulness of this subject matter to your daily practice?

Pacific AETC PEF

13. Would you recommend this training to your colleagues?
14. Was the material presented in a manner that was free from commercial bias?

Pacific AETC PEF
Learning Objectives

15. Rate your level of knowledge or skill for each Learning Objective (LO) before the training program and after the program. (LPS program managers/faculty need to fill in LOs or guide trainees to LOs.)


LO 1: Recognize opportunities to develop skills for engagement and patient-centered care.
BEFORE Training
AFTER Training
LO 2: Apply motivational interviewing skills and strength-based counseling to engage patients.
BEFORE Training
AFTER Training
LO 3:
BEFORE Training
AFTER Training

Pacific AETC PEF
Comments & Future Programs

Pacific AETC PEF
PIF ID

This program is part of the AIDS Education and Training Center, a federally funded training program. Because of the government funding source, we need to account for every person who receives training, as well as the number of people who attend multiple trainings. Please note that this unique identifier does not allow for identification of individual respondents. As indicated on the form, please create your anonymous PIF unique identification number by entering the month and day of your birth, and the last 4 digits of your Social Security number.

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