ࡱ> RTQo@ v"bjbj p p *@oov$L+8NNNN)))*+,+,+,+,+,+,+$,R.P+#))##P+NNe+A&A&A&#NN*+A&#*+A&zA&')2*N, v6#)v*{+0+*,g/$g/2*g/2*D)+A&w )))P+P+Xd 7& XDoc E Ƶ / Chicago College of Osteopathic Medicine Office of Continuing Medical Education 2005 Physician Continuing Medical Education 1 MINUTE CME NEEDS ASSESSMENT SURVEY Please help us with our need to assess your need for CME. Please return the completed survey to: Brenda Dohman, Office of CME, Ƶ Chicago College of Osteopathic Medicine 20201 South Crawford Ave, Olympia Fields, IL 60461 Phone: 708/747-4000 ext.1097 Fax: 708/747-8532 e-mail:  HYPERLINK "mailto:bdohma@midwestern.edu" bdohma@midwestern.edu Section I DEMOGRAPHIC INFORMATION1. Primary Classification (circle one): Academic Research Private Practice Intern/Resident/Fellow Group Practice Hospitalist Other _____________________________________ 2. Primary Discipline: In what area of medicine do you practice? ________________________________________________ 3. Year/s in Practice: ________________ SECTION II CURRENT ISSUES IN (check areas of interest for CME Programming)Allergy/Immunology Dermatology Geriatrics Lifestyle Topics ____ Skin Testing ____ Rashes ____ Incontinence ____ Nutrition & diet ____ Asthma ____ Skin biopsies ____ Dementia ____ Exercise ____ Allergy ____ Common cutaneous disorders ____ Osteoporosis ____ Alcohol dependence ____ Other: ____ Sexually transmitted diseases ____ Nutrition ____ Smoking cessation Anesthesia ____ Cutan. manifs. of syst. disease ____ Other: ____ Battered patient - ____ Epidural ____ Other: Hematology parent, child, spouse ____ Pain drug Endocrine ____ Lymphoma ____ Drug dependence ____ Other: ____ Impotence ____ Anemias ____ Obesity Cardiovascular ____ Diabetes ____ Hyper-coagl. ____ Other: ____ Preventive cardiology ____ Thyroid, parathyroid ____ Use of blood & blood products ____ Lipid Management ____ Fertility ____ Other: ____ Arrhythmias ____ Other: Infectious Disease Musco-skeletal ____ Hypertension Gastroenterology ____ Travel medicine ____ Phys. exam of joints ____ Myocardial infarction ____ GERD ____ AIDS ____ Rheumatoid arthritis ____ Congestive failure ____ Diarrhea ____ Meningitis ____ Osteoarthritis ____ Congenital abnormalities ____ liver disease ____ Lyme disease ____ Collagen vasc. disease ____ Cardiomyopathies ____ Peptic ulcer ____ Systemic infections ____ Other: ____ Cardiovascular drugs ____ Inflam. bowel disease ____ Upper resp. tract infec. ____ Other: ____ Other: ____ Other: Other/s: _______________________________________________________________________________________________ SECTION III CONTINUING MEDICAL EDUCATION PROGRAMINGFor future programs, identify the topics you would be most interested in learning more about. _____ Targeted program focusing on one or two areas _____ A varied program, with a more diversified menu of offerings _____ Other ____________________________________________________________________________________________ SECTION IV WRITE INWhat do you need help with? What problems do you encounter in practice that you need courses to help you solve? ______________________________________________________________________________________________ ______________________________________________________________________________________________ (Over) Page 1 Section IV CONTINUING MEDICAL EDUCATION APPROACHESPlease rate your interest in the following list of CME topics (circle the appropriate ratings): (1 = very interested, 2 = somewhat interested, 3 = not interested) 1. Evidence Based Medicine Critical reading skills 1 2 3 Mngmt. of common Primary Care dxs 1 2 3 New drug therapies... 1 2 3 Complementary / Alternative Medicine 1 2 3 Other: _______________________________________ 1 2 3 2. Approaches to Psychosocial Issues Domestic Violence... 1 2 3 Anxiety / Depression 1 2 3 Substance Abuse... 1 2 3 Other: _______________________________________ 1 2 3 3. Medical Informatics (e-journals, handheld PCs, etc) 1 2 3 4. Health Promotion / Disease Prevention. 1 2 3 5. Enhancing Teaching Skills Challenging Learners 1 2 3 Assessing Learners Needs. 1 2 3 Teaching On the Fly... 1 2 3 Evaluation and Feedback... 1 2 3 6. Clinical Medical Skills Advanced physical exam skills 1 2 3 Advanced interviewing techniques.. 1 2 3 Behavior modification techniques 1 2 3 Other: _______________________________________ 1 2 3 7. Office Procedure Skills.. 1 2 3 Suggestions: _________________________________ 8. Office Based Quality Improvement Strategies.. 1 2 3 Suggestions: _________________________________ SECTION V CONTINUING MEDICAL EDUCATION DELIVERYIndicate preferences: 1. Course ____ Half Day Courses ____ Full Day Courses _____ Combination Half and Full Day Courses 2. Time Preference ____ Days ____ Evenings 3. Day Preference ____ Weekdays ____ Weekends 4. Programming format/s: (1 = very interested, 2 = somewhat interested, 3 = not interested) Lecture. 1 2 3 Hands on.. 1 2 3 Internet-accessible 1 2 3 Power Point/slide presentation... 1 2 3 Panel. 1 2 3 5. Location Preferences MWU Campus, Downers Grove . 1 2 3 Chicago 1 2 3 Other __________________________________ 1 2 3 6. Have you accessed our website (www.Ƶ.edu) in the past year? _____ Yes _____ No Have you accessed other electronic resources in the past year? _____ Yes _____ No If no, check all that apply: _____ I need further instruction in accessing electronic resources _____ I do not have a PC _____ I am not interested _____ I dont know how to access the site THANK YOU! Page 2 Gnors~' 4 E Z [ j ɽՂxoh`\h-4jh-4U h0o5\h0oh0oCJh0o6>*CJ]h0o6CJ]h-45CJaJh \$5CJaJh \$h \$CJaJh 8$5CJaJh 8$h 8$5CJaJh 8$hH ^5CJaJh 8$h0o5CJaJh \$h0oCJaJ h0oCJh0oh 8$ h0oCJ hCJ hOCJ$Gno' 9 : ` $Ifgd \$$a$gdOv" ! 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C ` d v   x}#*pu,2 % f m "T_x3333333333333333339 - / 8 9 I I {89999"&QVWadrrOP..uxxMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityBDohmanBDohmaAPattodB(^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.dB           2 8$ \$ONjY#[H ^kc0o-4:`a 0 H I :pqI}~x@\=] v@Unknowng: Times New RomanTimes New Roman5SymbolG& : Arialhelvetica"qh ˑFsksk$24d  3QH(?H ^Office of Continuing EducationBDohmanAPatto Oh+'0  ( D P \ ht|Office of Continuing EducationffiBDohmanDohDohNormalAPatto2atMicrosoft Word 10.0@F#@!@>6@>6s՜.+,D՜.+,` hp  ƵSk { Office of Continuing Education TitleHlt _PID_HLINKS_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnceAt4mailto:bdohma@midwestern.edu@L|Updates for CME WebsiteBDohma@midwestern.edueDohman, Brendarohm  "#$%&'(*+,-./0123456789:;<=>?@BCDEFGHJKLMNOPSRoot Entry F 6UData !1Table)w/WordDocument*@SummaryInformation(ADocumentSummaryInformation8ICompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q