STD 101 Evaluation Form



Centers for Disease Control and PreventionNational Network of STD/HIV Prevention Training Centers 2014 National STD Prevention Conference“STD 101 In A Box Workshop”: June 9, 2014Evaluation FormPlease complete this form and return it at the end of the program. Your feedback is important!Name: (optional)_____________________________________________________________________________________________ Job Title:__________________________________________________Degree:_______________(BA, RN, MPH, etc.)Organization: _______________________________________________________________________________________________City: ______________________________________________ State: __________________ Zip Code: _______________________Common STDs Please circle the number that best reflects your opinion ( 5 = strongly agree 3 = neutral 1 = strongly disagree)Information was practical and useful to me54321Speaker demonstrated mastery of subject54321Presentation was clear and well-organized54321Speaker was receptive to questions and discussion54321Learning objectives were met54321Comments_______________________________________________________________________________________________________________________________________________________________________________________________________Current Epidemiology of Selected STDs Please circle the number that best reflects your opinion ( 5 = strongly agree 3 = neutral 1 = strongly disagree)Information was practical and useful to me54321Speakers demonstrated mastery of subject54321Presentation was clear and well-organized54321Speaker was receptive to questions and discussion54321Learning objectives were met54321Comments____________________________________________________________________________________________________________Sex In The City: THE HIV/STD Inter-Relationship Please circle the number that best reflects your opinion ( 5 = strongly agree 3 = neutral 1 = strongly disagree)Information was practical and useful to me54321Speakers demonstrated mastery of subject54321Presentation was clear and well-organized54321Speaker was receptive to questions and discussion54321Learning objectives were met54321Comments_______________________________________________________________________________________________________________________________________________________________________________________________________Expanding Opportunities For STD Prevention Please circle the number that best reflects your opinion ( 5 = strongly agree 3 = neutral 1 = strongly disagree)Information was practical and useful to me54321Speaker demonstrated mastery of subject54321Presentation was clear and well-organized54321Speaker was receptive to questions and discussion54321Learning objectives were met54321Comments_______________________________________________________________________________________________________________________________________________________________________________________________________State and Local STD Prevention ProgramsPlease circle the number that best reflects your opinion ( 5 = strongly agree 3 = neutral 1 = strongly disagree)Information was practical and useful to me54321Speakers demonstrated mastery of subject54321Presentation was clear and well-organized54321Speaker was receptive to questions and discussion54321Learning objectives were met54321Comments_______________________________________________________________________________________________________________________________________________________________________________________________________Overall Program EvaluationPlease circle the number that best reflects your opinion (5 = strongly agree; 3 = neutral; 1 = strongly disagree).This program met my personal objectives54321Overall, content was relevant to objectives54321The knowledge learned in this course will enhance my practice54321The question and discussion periods were well organized54321 Will your participation in this course help you in your own work setting? If so, how?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Please make suggestions to improve the program:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________7. What portion of this program was most helpful to you? Why?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________8. What portion of this program was least helpful to you? Why?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________9. Overall, how would you rate the quality of this activity and its educational content? (Please circle one)Excellent Good Fair PoorThank you for completing this evaluation form! ................
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