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Weill Cornell Medicine Evaluation form.docx
1. WCM-Q Grand Rounds 'Science and Practice of Low-
carbohydrate Ketogenic Diets'
Weill Cornell Medicine - Qatar is committed to excellence in continuing education. All our CME/CPD
activities are designed to lead to improvement in healthcare professionals’ practice of medicine. We
are required to evaluate the extent to which we have achieved this goal, and ask that you take a
moment to complete this survey. Your opinions are critical to us.
Livestream (Zoom), Doha, QATAR on September 26, 2021 3:30:00 PM
Please complete the following questions and then submit after reviewing your responses. Once you
have completed this evaluation you will be able to print your CME/CPD certificate.
Available Credit Hours and Types: AMA PRA Category 1 Credits™ (1.00 hours), Non-Physician
Attendance (1.00 hours), DHP - Department of Healthcare Professions (1.00 hours)
Please indicate to what degree do you agree with the following statements (where
applicable?):
I have obtained new knowledge as a result of attending this activity:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
This activity will impact my competence (my ability to apply these new skills and/or
strategies):
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
This activity will impact my performance (implementing the new skills, abilities, and/or
strategies into practice):
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
2. The skills, abilities and/or strategies I have obtained from this activity could potentially affect
my patients' outcomes:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Were disclosures of speaker(s), moderator(s), facilitator(s) and/or author(s) clearly displayed
for this activity?
Yes
No
Do you feel the activity had any commercial bias* or influence? *A commercial bias occurs when there is
a current or potential financial interest with any entity Producing, Marketing, Re-Selling, or Distributing healthcare goods or
services consumed by, or used on, Patients
Yes
No
Do you feel the activity was scientifically sound, evidence-based, objective, and balanced?
Yes
No
Was the format of this activity appropriate to the content presented?
Yes
No
Somewhat
The session met the stated objectives:
Describe the low-carbohydrate eating pattern and the rationale behind it
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Summarize weight loss effects of low-carbohydrate eating plans
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
3. Evaluate potential mechanisms of weight loss during low-carbohydrate eating
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Appraise the effects of low-carbohydrate eating on health and risk factors
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Topic: WCM-Q Grand Rounds 'Science and Practice of Low-
carbohydrate Ketogenic Diets'
Please rate the following speaker(s):
William Yancy Jr., MD, Associate Professor
William Yancy Jr., MD, Associate Professor was knowledgeable:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Overall, the session by William Yancy Jr., MD, Associate Professor was beneficial:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Based on your educational needs and/or perceived practice gaps in your specialty, please list
any topics you would like to see addressed in future educational activities.
4. Please rate the following:
Advertising and promotional material:
Excellent
Very Good
Good
Fair
Poor
Registration process:
Excellent
Very Good
Good
Fair
Poor
Venue (Suitability / Convenience):
Excellent
Very Good
Good
Fair
Poor
If you have any other comments or concerns about this activity please describe below:
If the Submit button below (computer) or above (tablet/mobile) is dimmed, you have not fully
completed the evaluation. Please review the form for any required fields (with an asterisk) that you
may have missed.
5. WCM-Q Grand Rounds 'Brugada Syndrome, the New
Silent Killer: What Every Physician Should Know About It'
Weill Cornell Medicine - Qatar is committed to excellence in continuing education. All our CME/CPD
activities are designed to lead to improvement in healthcare professionals’ practice of medicine. We
are required to evaluate the extent to which we have achieved this goal, and ask that you take a
moment to complete this survey. Your opinions are critical to us.
Livestream (Zoom), Doha, QATAR on September 12, 2021 3:30:00 PM
Please complete the following questions and then submit after reviewing your responses. Once you
have completed this evaluation you will be able to print your CME/CPD certificate.
Available Credit Hours and Types: AMA PRA Category 1 Credits™ (1.00 hours), Non-Physician
Attendance (1.00 hours), DHP - Department of Healthcare Professions (1.00 hours)
Please indicate to what degree do you agree with the following statements (where
applicable?):
I have obtained new knowledge as a result of attending this activity:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
This activity will impact my competence (my ability to apply these new skills and/or
strategies):
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
This activity will impact my performance (implementing the new skills, abilities, and/or
strategies into practice):
Strongly Agree
Agree
Neutral
Disagree
6. Strongly Disagree
Not Applicable
The skills, abilities and/or strategies I have obtained from this activity could potentially affect
my patients' outcomes:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Were disclosures of speaker(s), moderator(s), facilitator(s) and/or author(s) clearly displayed
for this activity?
Yes
No
Do you feel the activity had any commercial bias* or influence? *A commercial bias occurs when there is
a current or potential financial interest with any entity Producing, Marketing, Re-Selling, or Distributing healthcare goods or
services consumed by, or used on, Patients
Yes
No
Do you feel the activity was scientifically sound, evidence-based, objective, and balanced?
Yes
No
Was the format of this activity appropriate to the content presented?
Yes
No
Somewhat
The session met the stated objectives:
Identify Brugada ECG
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Outline the diagnostic criteria and differential diagnosis of Brugada syndrome
Strongly Agree
Agree
Neutral
7. Disagree
Strongly Disagree
Outline the typical presentation and evaluation of a patient with Brugada syndrome
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Outline the pharmacological interactions in patients with Brugada Syndrome
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Topic: WCM-Q Grand Rounds 'Brugada Syndrome, the New Silent Killer:
What Every Physician Should Know About It'
Please rate the following speaker(s):
Rasha Kaddoura, PharmD
Rasha Kaddoura, PharmD was knowledgeable:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Overall, the session by Rasha Kaddoura, PharmD was beneficial:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Amar Salam, MBBS
Amar Salam, MBBS was knowledgeable:
Strongly Agree
8. Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Overall, the session by Amar Salam, MBBS was beneficial:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not Applicable
Based on your educational needs and/or perceived practice gaps in your specialty, please list
any topics you would like to see addressed in future educational activities.
Please rate the following:
Advertising and promotional material:
Excellent
Very Good
Good
Fair
Poor
Registration process:
Excellent
Very Good
Good
Fair
Poor
Venue (Suitability / Convenience):
Excellent
Very Good
Good
9. Fair
Poor
If you have any other comments or concerns about this activity please describe below:
If the Submit button below (computer) or above (tablet/mobile) is dimmed, you have not fully
completed the evaluation. Please review the form for any required fields (with an asterisk) that you
may have missed.