Ambulatory Care Nursing Module Evaluation Form

Consent to use your responses in research

We would like to use these anonymous evaluation responses as part of our educational research on ambulatory care nursing training. We will only include your responses with your consent. Responses will be summarized as a group, not individually. The evaluation is anonymous, and no responses can be linked to you personally. If you have questions at any time, contact Diana Buchanan at dmtaibi@uw.edu.

Do you consent to the use of your responses in educational research? *

Yes
No

If you are a UW student taking this module as part of a course, please enter the course number.

Which module are you evaluating? *

Date on which you completed this module.

Which of the following describes your role (select all that apply)?

If you selected "Other," please describe your role.

With what health care and/or educational organization(s) are you affiliated?

Instructions

Using the understanding that you now have after completing this module, please rate the items below about the training you have received.