Syphilis ECHO

Cardea Services

Questions about this evaluation? Email info@cardeaservices.org.

We hope you found this educational offering both interesting and informative. Your anonymous responses will be used to plan future educational activities.

1. Please enter your unique identifying number using your birth month (mm), last two numbers of your cell phone number, and the first letter of your middle name. If you do not have a middle name, please use the first initial of your last name. This number will be used to compare your survey responses while keeping your responses anonymous.

Example: 0389S
Birth Month: March (03)
Phone Number: 012-345-6789
Middle Name: Smith

3. Approximately how many patients do you see in a month?

3. In what type of setting do you work? (Check all that apply)

3. What state is your clinic or organization located?

3. Is your clinic or organization in a rural or urban setting?

3. How satisfied are you with this session?

Very satisfied	Satisfied	Unsatisfied	Very unsatisfied
Very satisfied	Satisfied	Unsatisfied	Very unsatisfied

4. As a result of this session,

Space Cell	Strongly agree	Agree	Disagree	Strongly disagree
I intend to incorporate knowledge learned about treatments for neuro, ocular, and otic syphilis as well as treatment for early and late stages of syphilis into the care of my patients.	I intend to incorporate knowledge learned about treatments for neuro, ocular, and otic syphilis as well as treatment for early and late stages of syphilis into the care of my patients.: Strongly agree	I intend to incorporate knowledge learned about treatments for neuro, ocular, and otic syphilis as well as treatment for early and late stages of syphilis into the care of my patients.: Agree	I intend to incorporate knowledge learned about treatments for neuro, ocular, and otic syphilis as well as treatment for early and late stages of syphilis into the care of my patients.: Disagree	I intend to incorporate knowledge learned about treatments for neuro, ocular, and otic syphilis as well as treatment for early and late stages of syphilis into the care of my patients.: Strongly disagree

4.  As a result of this session, how has your knowledge on syphilis epidemiology/history changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis prevention changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis diagnosis and interpretation changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis manifestations changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis treatment changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on congenital syphilis changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis in special populations changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

4. As a result of this session, how has your knowledge on syphilis response changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse