GC 400 – Course Evaluation Form

AMERICAN INSTITUTE OF HEALTH CARE PROFESSIONALS, INC.

Thank you for completing your Continuing Education Course and Congratulations! The final step is your completion of the GC 400 – Course Evaluation. This will take a few minutes of your time. You must complete the following course evaluation to receive your credit hours and your certificate of course completion.

Please complete the evaluation below and be sure to complete all required information. When finished, be sure to click the submit button. Your score and credits will be recorded once your completed evaluation is received. We will then prepare your CE certificate and e-mailed to you in a PDF format.

Keep in mind when filling out the evaluation to list your first and last name in the appropriate blank because that is how your name will be listed on the certificate for the course. We do not list titles, or degrees on any of our certificates but only the first and last name. If any errors occur on the certificate due to improper listing on this form then it is the student’s responsibility for a new certificate. A $5 fee to process a new certificate will be charged in these cases for a new certificate. So please make sure your name is correct and the postal address is accurate and up to date.

Once correctly submitted you will see a “thank you” note below this line:

"*" indicates required fields

Name*
Email*
Please input your student ID Number
Date Completed*
Enter the date you completed the course
Address*
Please rate questions 1 through 12 using this rating scale: 5 = Excellent, 4 = Very Good, 3 = Good, 2 = Fair, 1 = Poor.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 5.
Please enter a number from 1 to 999.
Please enter a number from 1 to 5.
Question 13 Rating Scale: Please rate the following statement using this rating scale: 5 = Great, 4 = Some, 3 = Neutral, 2 = Little, 1 = Very Little.
Please enter a number from 1 to 5.
Question 14 Rating Scale: Please rate the following statements using this rating scale: 5 = Extremely Useful, 4 = Somewhat Useful, 3 = Useful, 2 = Slightly Useful, 1 = Not Useful.
Please enter a number from 1 to 5.
Questions 15 Through 20: Please respond with a "Yes" or "No."
Question 15 - Was The Course Content Free Of Bias?:*
Question 16 - Before Completing The Course Did You Identify The Necessity For Education On The Topic/Subject To Improve Or Enhance Your Professional Practice?:*
Question 17 - Has What You Think Or Feel About This Topic/Subject Changed?*
Question 18 - I Would Recommend This Course To Other Professionals:*
Question 19 - Are You More Confident In Providing Patient Care After Completing This Course?:*
Question 20 - Was Self-Paced Learning Effective For You:?*
Please read the section below and answer the following questions.
Question 21 - Are You A Licensed Health Care Professional In Any Of The Following States That Report CE’s Through CE Broker (Www.Cebroker.Com) In Which The Course You Have Taken From AIHCP Is Listed As An Approved Course For You For CE Credits?*
Question 22 - Are You A Licensed RN/LPN/APN In Any State in the United States (including DC)?*
Question 23 - Are You a Licensed RN/LPN/APN in the State of Florida or the District of Columbia (Washington DC)?*
Question 24 - Are You a Licensed RN/LPN/APN in Any of the Following States That Report CE's to CE Broker - AK, GA, KY, NM, SC, or WV*
If you answered (Yes) to any of the above questions, or if you Report CE’s Through CE Broker (Www.Cebroker.Com) please provide your nursing or professional license number as well as your state you are licensed in. You must provide your license number in the area provided below. This is mandated by the Nursing Boards that have given us our CE Approved Provider Status. We cannot issue you a CE certificate or CE hours unless you provide your license number below. Thank you.
Instructions: Using the scale below, please respond to the following evaluation statements.
A- Agree Strongly, B – Agree Somewhat, C – Disagree Somewhat, D –Disagree Strongly.
OBJECTIVES: After completing this course, I am able to:
Discuss the concept of invisible death and the attitudes and behaviors around it.*
Explain an historical perspective of current death practices.*
Discuss demographic, psychological, sociological and economic factors which contribute to how death is dealt with and processed.*
Discuss statistics and trend patterns in death occurrence.*
Explain the application of the dying trajectories concept.*
Discuss how age, stress and culture influence death.*
Discuss theories of death and dying, stages and cycles.*
Describe near death experiences and interpretations of them.*
Describe the final step in the living/dying process.*
Discuss grief, loss and mourning and reactions that people experience.*
Identify and discuss emotions experienced in coping with loss.*
Use developmental frameworks to assess children’s and adolescent’s ability to perceive death*
Identify the needs of terminally ill children.*
Assess the needs of children who are terminally ill or grieving the death of others.*
Discuss issues of death and dying related to natural disasters, murder, accidents.*
Discuss suicide and attempted suicide among the youth.*
Discuss the meaning of death of the adult’s parent.*
Describe the experience of loss of a child to parent and family.*
Analyze impending death of the aged from developmental frameworks.*
Explain the impact of death of spouse, children or pets to elderly persons.*
Identify the social effects of aging.*
Discuss practical procedures and tasks concerning death.*
Discuss ethical and medical-legal concepts regarding the right to die.*
Discuss historical views of how people bury the dead.*
Describe religious and secular practices regarding burial of the dead.*
ATTESTATION: I certify that I have read/studied the course materials and any additional course assignments and I have personally completed the final examination based on the materials presented.*
In the area above please feel free to make recommendations for future CE courses provided by AIHCP.
Comment Usage:
May We Use Your Comments As A Post On Our Website Regarding Your Experiences With This Course?
Thank you for completing this course and the course evaluation. All evaluations are reviewed carefully by our staff and board. Your participation is appreciated.