HomeSupports for Family DoctorsMental Health, Addictions and Chronic Pain SupportsMental Health, Addictions and Chronic Pain Community of Practice Practising Well CoP Self-Learning Post-Session Evaluation Survey

Practising Well CoP Self-Learning Post-Session Evaluation Survey

Please note: this form is only for Practising Well self-learning activities. If you are submitting self-learning for any other Community of Practice, please use the appropriate form.

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Please complete the following questions. Comments and quotes may be shared for promotional purposes. All comments and quotes shared will be anonymous.

Your comments are greatly appreciated. Thank you!

Attestation: By responding to the following question, I confirm that I have completed the Practising Well CoP self-learning activity (reviewed recording and resources).

Name*

Prefix First Last

Email*

Indicate the number of sessions you are requesting credits for (numerical, i.e., 6) and the dates of the sessions. Please enter date as Month-Day-Year (November 21, 2022). The session dates are found in the description of each past event on the Past Practising Well Communities of Practice page.

Number of session(s) you reviewed: **

Session Date(s):*

Please provide your CFPC number below for direct credit entry.

CFPC Number:

If you have questions(s) after reviewing the Practising Well CoP session material (recording and resources), please ask them below. You are not required to ask a question to earn credits. If you have no questions, please leave this text box blank.

If you have questions, please indicate which session(s) you have questions about.

My Questions:

Please provide your responses to the following questions.

My overall experience was positive.*

The session was relevant and applicable to my practice. As a result, I am motivated to take action.*

On reflection, please share a way that the community of practice sessions have helped you address some of the daily challenges of practice:

Did you perceive any degree of bias in any part of the program?*

If you perceived bias in any part of the program, please explain below:

Please identify your practice model and practice region using the options below.

My Practice Model*

Other Practice Model

My Practice Region **

Thank you for completing session(s) of the Practising Well CoP Self Learning Program.

Certificates of Attendance for the self learning sessions are issued by email once per month, at the beginning of the month following when the self-learning activity is completed. If you provided your CFPC number above, your Mainpro+ credits will be directly entered. These will show up in your account holding area within 4-6 weeks after you receive your certificate.

If you have any questions, please email practisingwell@ocfp.on.ca.

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