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ANORECTAL MANOMETRY COURSE (00-050) EVALUATION Name: Date: Prior to this course, how many anorectal manometry studies have you done? ____ than 10 procedures ____ 11-25 procedures ____ 25 procedures How well did you achieve the objectives of this activity? Please rate on a scale from 5 (highest) to 1(lowest) Understanding of the protocol and technique of anorectal manometry 5 4 3 2 1 Identify anatomy and physiology of anal canal and rectum 5 4 3 2 1 Developed skills to perform anorectal procedures 5 4 3 2 1 Please rate the presenters: Matt Reveille, M.D.: Expertise: 5 4 3 2 1 Effectiveness of teaching strategies: 5 4 3 2 1 Comments: John Sun, M.D.: Expertise: 5 4 3 2 1 Effectiveness of teaching strategies: 5 4 3 2 1 Comments: Linda Knight, R.N.: Expertise 5 4 3 2 1 Effectiveness of teaching strategies 5 4 3 2 1 Comments: Was the facility conducive to learning? 5 4 3 2 1 Would you like additional courses on manometry? Comments: Post Activity Attendance List Sandhill Scientific ANORECTAL MANOMETRY COURSE SGNA identification no. (00-050) September 18-19, 2000 Participant Name and Address: EVALUATION Anorectal and Pelvic Muscle Anatomy and Physiology How well were you able to achieve the course objectives listed below? Recognize the pelvic floor musculature and neural intervention 4 3 2 1 COMMENTS: Recognize the basic mechanisms necessary for continence and defecation 4 3 2 1 COMMENTS: Recognize disease manifestations of anorectal dysfunction 4 3 2 1 COMMENTS: Was the content consistent with the objectives? 4 3 2 1 COMMENTS: How effective was Dr. Reveille in presenting this content? 4 3 2 1 How effective was Dr. Sun in presenting this content? 4 3 2 1 How effective were the teaching methods? A. Lecture: 4 3 2 1 B. Audio Visuals: 4 3 2