Evaluation Form: Motivational Interviewing and the Language of Change with Adolescents (OT107-A) Evaluation – Motivational Interviewing and the Languages of Change with Adolescents Email * Last Name (as you’d like printed on your certificate) * First Name (as you’d like printed on your certificate) * License Number, if applicable (for identity verification purposes) Issuing state/province, if applicable Which of the following best describes you? * Select OnePsychologistSocial WorkerCounselorStudentNone of the above I certify that I am the above-named person completing this form and that the information I submit here is accurate. * I agree 1. How much did you learn as a result of this CE program? 5 = Very much, 1 = Very little * 5 4 3 2 1 2. Rate the quality of the program content 5 = Very High, 1 = Very Low * 5 4 3 2 1 3. Rate how current/relevant the program content is 5 = Very High, 1 = Very Low * 5 4 3 2 1 4. How useful was the content of this CE program for your practice or other professional development? 5 = Extremely Useful, 1 = Not Useful at all * 5 4 3 2 1 5. Rate the instructor’s knowledge and expertise of the subject 5 = Very High, 1 = Very Low * 5 4 3 2 1 6. Rate the instructor’s teaching ability 5 = Very High, 1 = Very Low * 5 4 3 2 1 7.1. Would you agree that learning objective #1 was met? Learning Objective #1: “Identify the four components that make up the ‘MI Spirit,'” 5 = Strongly agree, 1 = Strongly disagree * 5 4 3 2 1 7.2. Would you agree that learning objective #2 was met? Learning Objective #2: “Distinguish between the four motivational interviewing micro-skills,” 5 = Strongly agree, 1 = Strongly disagree * 5 4 3 2 1 7.3. Would you agree that learning objective #3 was met? Learning Objective #3: “Explain the factors that increase the risk that a person will be subject to further allegations of abuse,” 5 = Strongly agree, 1 = Strongly disagree * 5 4 3 2 1 8. Rate how well the program met your expectations (according to the promotional materials) 5 = Very well, 1 = Not well at all * 5 4 3 2 1 9. Rate the quality of the provided course materials 5 = Very High, 1 = Very Low * 5 4 3 2 1 10. Rate the quality of the facilities (in-person) or technology (online). 5 = Very High, 1 = Very Low * 5 4 3 2 1 11. Rate how well disability accommodations were met, if requested. 5 = Very High, 1 = Very Low * 5 4 3 2 1 12. Rate the ease of the registration process 5 = Very Easy, 1 = Very Difficult * 5 4 3 2 1 13. Rate the instructor(s) responsiveness to questions 5 = Very High, 1 = Very Low * 5 4 3 2 1 14. Rate the program staff’s responsiveness to questions 5 = Very High, 1 = Very Low * 5 4 3 2 1 15. How will the information from this program be useful to you in the future? * 16. What did the program (or presenter/s) do particularly well that helped you understand the material? * 17. What, if anything, could the program (or presenter/s) have done differently to help you understand the material better? * 18. About how long did it take you to complete this course (including completing this form)? * 19. OPTIONAL: How did you learn about this training? 20. OPTIONAL: Do you have any additional thoughts or comments you’d like to share with us? Submit If you are human, leave this field blank. Δ