Sarasota Memorial Health Care System
Center for Nursing Excellence
Summary Evaluation Form
LEARNER-DIRECTED (Independent Study) Activity

Legend:  4 = % Strongly Agree; 3 = % Agree; 2 = % Disagree; 1 = 5 Strongly Disagree

1. The activity objectives were clearly stated:

4
3
2
1
N/A

2. The activity objectives were met:

4
3
2
1
N/A

3. The activity post-test reflected the content of the stated objectives (when post-testing is included as part of the activity):

4
3
2
1
N/A

4. The length of the activity was adequate:

4
3
2
1
N/A

5. The activity objectives and content reflected current practice issues:

4
3
2
1
N/A

6. The content presented was accurate:

4
3
2
1
N/A

7. The teaching methods selected were effective (lecture, demonstration, etc):

4
3
2
1
N/A

8. The activity met your professional needs:

4
3
2
1
N/A

9. The activity educational level was appropriate:

4
3
2
1
N/A

10. Physical environment was comfortable:

4
3
2
1
N/A

11. Overall, this was a worthwhile activity:

4
3
2
1
N/A

12. I would recommend this activity to others:

4
3
2
1
N/A

13. What did you like best about this activity?

14. What did you like least about this activity:

15. Additional Comments:

Your Title:

Enter the date of ... :

-- mm/dd/yy

Check the following options that apply to you:

RN
LPN
CNA/HCT:
Other Discipline