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Elevating Excellence: Mentorship Development in Family Medicine Evaluation Survey

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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 Elevating Excellence: Mentorship Development in Family Medicine self-learning activity (reviewed recordings).

Name*

Prefix First Last

Email*

CFPC Number*

Please select the sessions that you are requesting credits for:*

Fundamentals of Human-to-Human Facilitation (33 minutes - 0.5 credits)

The Anatomy of a Facilitated Group Session (30 minutes - 05. credits)

Time Management: Improving the 5p.m. Experience for Family Physicians (57 minutes - 1 credit)

If you have questions(s) after watching the recording(s) 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 content was relevant and applicable to my practice/work. As a result, I am motivated to take action.*

On reflection, please share a way that the session(s) have helped you address some of the daily challenges of practice/work:

Please share any comments on how these sessions could be improved to better help you:

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 this session(s) of the Elevating Excellence: Mentorship Development in Family Medicine 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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