Needs Assessment Survey

Needs Assessment Survey

Thank you for taking a moment to complete ImproMED's Needs Assessment Survey. Your input will be useful for the planning of future CME activities.

Which of the following best describes your practice setting?

What is your occupation?

What is your specialty/subspecialty?

What sources of CME do you use? (Check all that apply)

	Formal CME programs (Live events)
	Videoconferences
	Printed enduring materials
	Audiotapes
	Videotapes
	CD-ROMs
	Journals and texts
	Online CME

Please rank the following potential reasons you would participate in a CME activity on a scale from 1 to 8, with 1 being the strongest reason you would participate.
Location
Convenience
Subject matter
Reputation of speaker
Reputation of CME sponsor
Cost
Required time commitment
Associated leisure activity

Which approaches do you find most effective in helping you apply your CME learning in your practice?
	Traditional lectures, live or by audio or videoconference
	Online instruction
	Case presentations or simulations with small group discussions
	Panel discussions
	Lectures with feedback mechanisms (eg, audience response systems)
	Multiple session courses that cover a topic in depth over a period of time
	Hands-on learning
	Self study with guidance by a faculty member
	Interactions with experts after a course
	Other:

On average, how many CME credits do you earn each year?

Over the last 2 years, have you changed the way in which you earn your CME credits?
	No
	Yes
If yes, in what way?

What sources do you use to find CME activities?

	Direct mail
	Organizational publications
	Journals
	Internet
	Other:

I use the Internet (Check all that apply):

	To identify CME activities
	To order CME enduring materials
	To participate in CME activities
	To save time
	To access more information
	To facilitate discussions with other physicians
	For cost effectiveness
	For convenience

If you use the Internet for CME activities, how much time do you spend on average in any one sitting?
	Do not use the Internet for CME activities
	Less than 15 minutes
	16–30 minutes
	31–45 minutes
	46 minutes to 1 hour
	More than 1 hour

How are you connected to the Internet?

I am interested in the most up-to-date information about the following topics (Check all that apply):

		Allergies			Arthritis
		Asthma			Cardiology
		Cholesterol			Communicating with Patients
		Depression			Endocrinology
		Gastroenterology			Hematology
		HIV/AIDS			Medical/Scientific Presentation Skills
		Menopause			Mental Health
		Migraine			Obstetrics/Gynecology
		Oncology			Ophthalmology
		Orthopedics			Sports Medicine
		Urology
		Other:

First Name

Last Name

Degree

Other

Affiliation

Address

City

State

Province

ZIP or Postal Code

Country

USA

or Other

Phone

ext.

Fax

Email*

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