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Program evaluation form

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Please circle your answers and add comments as desired. Please fax this form back to: L J Tan, PhD at (312) 464-5841, or see below for mailing instructions.

1. The primer increased my ability to recognize foodborne illnesses and increased the likelihood that I will consider such illnesses in my patients.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

2. The primer increased my knowledge and skills in the diagnosis and management of foodborne illnesses.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

3. This primer increased my knowledge of the role of public health authorities in the prevention and control of foodborne disease outbreaks.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

4. It is important to talk to my patients about food safety.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

5. As formatted, this primer is a useful physician education tool.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

6. The amount of information presented was appropriate for my needs.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

7. I will recommend this primer to my colleagues.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

8. I would like to receive regular updates of this primer.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment: 

 

9. I would like to see a similar physician education program for other clinical issues.

1. Strongly agree    
2. Agree    
3. Undecided    
4. Disagree    
5. Strongly disagree
Comment:
 

 

10. How long did it take you to work through this primer?

 

Provide any additional comments about this primer, your experiences with foodborne illnesses, and suggestions for future physician education efforts:

 

 

Please fax the completed survey to: L J Tan, PhD at (312) 464-5841 or mail this form (first class postage required) to:

Diagnosis and Management of Foodborne Illnesses
Program Evaluation (c/o L J Tan)
American Medical Association
515 N. State Street
Chicago, Illinois 60610

Thank you.

Diagnosis and Management of Foodborne Illnesses: A Primer for Physicians is produced by

American Medical Association
Centers for Disease Control and Prevention
Center for Food Safety and Applied Nutrition, Food and Drug Administration
Food Safety and Inspection Service, US Department of Agriculture

Last updated:Feb 22, 2008
Content provided by: Infectious Diseases