Evaluation & credit request form

What best describes your role/degree? (Select one)

What is your area of specialization?

How long have you been in practice?

How many patients with SMA do you see each year?

Please select the extent to which you agree/disagree that the activity supported the achievement of each learning objective:
Develop individualized care plans for treatment and multidisciplinary management of adolescent/adult patients with SMA

Discuss real-world experience on current treatments for adolescent/adult patients with SMA

Define realistic treatment goals in concordance with the patient

Apply appropriate outcome measures to evaluate clinical changes and impact of treatment

Please select the extent to which you agree/disagree that the activity achieved the following:
The faculty were effective in presenting the material

The content was evidence based

The educational material provided useful information for my practice

The activity enhanced my current knowledge base

The activity provided appropriate and effective opportunities for active learning (e.g., case studies, discussion, Q&A, etc.)

The opportunities provided to assess my own learning were appropriate (e.g., questions before, during, or after the activity)

Based upon your participation in this activity, do you intend to change your practice behavior? (Choose only one of the following options)

How often do you plan to do the following:
Apply standardized outcome measures to assess patients with SMA

How often do you plan to do the following:
Consider nusinersen treatment for adult patients with SMA

Which of the following do you anticipate will be the primary barrier to implementing changes?

Did you perceive commercial bias in this activity?

If you perceived commercial bias in this activity, please explain. Otherwise type “NA”:

What was your interest in participating in this activity? (Choose all that apply)

Please explain how the information received in this educational activity will help impact the care of your patients.

Please list any clinical issues/problems/education needs related to this topic that you would like to see addressed in future educational activities: