Professional Presentees (primarily medical students)

The Heart Truth Evaluation of Professional Materials

The Heart TruthPractictioner_exposed d7

Professional Presentees (primarily medical students)

OMB: 0990-0310

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Heart Truth

Participating Practitioners/Students

Paper/Web

Assessment of The Heart Truth Professional Education Campaign






Welcome to the Assessment of The Heart Truth Professional Education Campaign. This is an important opportunity for you to share your experience with The Heart Truth professional education materials.


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In the past three months, (your institution used materials provided by The Heart Truth Professional Education Campaign in a lecture or presentation)/(you used the Heart Truth interactive Case Based modules on Medscape site to take a course entitled “[Anna: what is the name of the course?]”.



1. Do you recall having seen The Heart Truth professional education materials?


Yes - (Continue)

No - (Skip to #5)






2. Please rate the extent to which you agree or disagree with these statements about The Heart Truth materials.


As a result of viewing The Heart Truth materials, I feel I am better equipped to provide my female patients with the most up-to-date information they need about heart disease


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know


  1. As a result of viewing The Heart Truth materials, I have adopted new preventative procedures into my practice for heart disease with my female patients


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know


  1. When it comes to talking to your female patients about heart disease risks, as a result of viewing The Heart Truth materials, are you?


5 Significantly more likely to discuss heart disease risks

4 Somewhat more likely to discuss heart disease risks

3 Neither more nor less likely to discuss heart disease risks

2 Somewhat less likely to talk about heart disease risks

1 Significantly less likely to talk about heart disease risks







3. Please rate the following statements with regard to The Heart Truth materials you saw


  1. Relevance of the materials to my practice


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know



  1. Helpfulness of the materials in improving the way I communicate with female patients


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know




  1. Level of detail provided in the materials to meet my needs


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know


  1. Level of detail provided in the materials to meet my patient’s needs


5 Strongly Agree

4

3

2

1 Strongly Disagree


6 Don’t Know






4. As a result of viewing The Heart Truth materials, I have incorporated the following techniques into my practice. Please list up to five techniques that you have incorporated, numbering them consecutively starting with the number 1. (Allow 750 characters).






Please mark the best response to each question below.


5. Which of the following best describes your profession?


1 Physician (Skip to #5A)

2 Nurse, Nurse Midwife, Nurse Practitioner (Skip to #5B)

3 Physician’s Assistant (Skip to #5C)

4 Other (Fill in response) (Allow 50 characters) (Skip to #6)





A. Which best describes your area of practice?


1 Family physician

2 General internist

3 Obstetrician/gynecologist

4 Cardiologist

5 Other MD or DO (Fill in response) (Allow 50 characters)


(Skip all to #6)






B. Which best describes your area of practice?


1 Registered Nurse

2 Nurse-midwife

3 Nurse practitioner- general or family practice

4 Nurse practitioner- gynecologic practice

5 Other Nurse practitioner (Fill in response) (Allow 50 characters)

(Skip all to #6)






C. Which best describes your area of practice?


1 Physician assistant-general or family practice

2 Physician assistant-gynecologic practice

3 Physician assistant (Fill in response) (Allow 50 characters)













6. Which of the following best describes your current level of training?


1 Student

2 Intern, resident

3 Fellow

4 Practicing physician, physician assistant, nurse practitioner, nurse

5 Other (Fill in response) (Allow 50 characters)



7. In a typical week, how many female patients do you see?


0 No patients

1 1-25 patients

2 26-50 patients

3 51-75 patients

4 76-99 patients

5 99+ patients


  1. Don’t Know






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That completes the Assessment of The Heart Truth Professional Education Campaign. Your opinion counts! Thank you for your cooperation.


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File Typeapplication/msword
File TitleHeart Truth
AuthorAlison Simon
Last Modified Byanna kindermann
File Modified2006-12-14
File Created2006-12-14

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