Hampton University Preceptor Conference CE Submission Form

Thank you for attending the 2017 HUSOP Preceptor Conference “Preceptor Development.”

Please complete the the CE Submission Form by scrolling below to redeem your continuing education credits.

Deadline to submit CE is December 13, 2017. Late submissions may be subject to additional fees.

CE Evaluation - Hampton University Preceptor Conference

Contact Information
Name*
First Last
Email*
Phone*
NABP e-Profile ID Number*
Date of Birth*
Please select the programs you fully attended.*
- Interprofessional Education
- “Outlining Success”: Preceptor Syllabus Development
- The Art of Precepting: Growing the Profession Now and Later
Interprofessional Education
UAN #: 0278-0000-17-028-L04-P
Rank Each of the Following
Program content*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Practical applicability*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Effectiveness of teaching and learning methods*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker's delivery technique*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 1: Define Interprofessional education.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 2: Describe the four Interprofessional education competencies.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 3: Describe the process of patient centered care.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Handouts*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Relevance to practice*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker presentations were fair, balanced and/or unbiased?*
- Yes
- No
Please explain
The pacing of this program was (please check one):*
- Too fast
- About right
- Too slow
The level of difficulty of this program was (please check one):*
- Too high
- About right
- Too low
Based on the program content, explain how you will apply this information to your practice site:*
“Outlining Success”: Preceptor Syllabus Development
UAN #: 0278-0000-17-029-L04-P
Rank Each of the Following
Program content*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Practical applicability*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Effectiveness of teaching and learning methods*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker's delivery technique*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 1: Define the role of the preceptor in experiential education.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 2: Review the components of the syllabus.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 3: Identify the potential benefits that syllabus development can create for the preceptor.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 4: Discuss the importance of the syllabus in fostering growth and development of the student on clerkship rotations.*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Handouts*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Relevance to practice*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker presentations were fair, balanced and/or unbiased?*
- Yes
- No
Please explain
The pacing of this program was (please check one):*
- Too fast
- About right
- Too slow
The level of difficulty of this program was (please check one):*
- Too high
- About right
- Too low
Based on the program content, explain how you will apply this information to your practice site:*
The Art of Precepting: Growing the Profession Now and Later
UAN #: 0278-0000-17-030-L04-P
Rank Each of the Following
Program content*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Practical applicability*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Effectiveness of teaching and learning methods*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker's delivery technique*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 1: Define the fundamentals of precepting*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 2: Identify the necessary skills of an effective receptor*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 3: Describe successful preceptor-learner relationships*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 4: Recognize cultural differences that could affect learning*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Extent to which the program met Learning Objective 5: Intergrade students into your practice*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Handouts*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Relevance to practice*
- Excellent
- Good
- Satisfactory
- Fair
- Poor
Speaker presentations were fair, balanced and/or unbiased?*
- Yes
- No
Please explain
The pacing of this program was (please check one):*
- Too fast
- About right
- Too slow
The level of difficulty of this program was (please check one):*
- Too high
- About right
- Too low
Based on the program content, explain how you will apply this information to your practice site:*

Hampton University Preceptor Conference CE Submission Form

CE Evaluation - Hampton University Preceptor Conference

Contact Information

Interprofessional Education

Rank Each of the Following

“Outlining Success”: Preceptor Syllabus Development

Rank Each of the Following

The Art of Precepting: Growing the Profession Now and Later

Rank Each of the Following

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