Essentials in Multiple Sclerosis Care - A Comprehensive Curriculum for MS Nurses

ACTIVITY EVALUATION/ATTESTATION

Essentials in Multiple Sclerosis Care: A Comprehensive Curriculum for MS Nurses
Attestation of time spent on activity:
- I participated in the entire activity and claim 5.0 hours of continuing education credit.
- I participated in only part of the activity and will claim partial continuing education credit.
How many hours of continuing education credit do you claim?*
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How many hours of continuing education credit do you claim?
1. Type of credit you are requesting:*
- NCPD
- Certificate of Completion
- None
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NABP Profile ID
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Your Birthday
MM slash DD slash YYYY
- 2. Which of the following best describes you?*
  - Advanced Practice Nurse/NP
  - RN/BSN
- 3. What is your area of specialization?*
  - Multiple Sclerosis
  - Neurology
  - Primary Care
- 4. How many patients with MS do you treat per week?*
  - 1 to 10 patients
  - 11 to 20 patients
  - More than 20 patients
  - I do not treat patients with MS
5. Please select the extent to which you agree/disagree that the activity supported the achievement of each learning objective:
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Discuss advances in the understanding of MS and the benefits of early diagnosis and treatment
- Strongly Agree
- Agree
- Neutral
- Disagree
- Strongly Disagree
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Review information on current therapies and its relevance to the development of individualized management strategies for patients with MS
- Strongly Agree
- Agree
- Neutral
- Disagree
- Strongly Disagree
5. Please select the extent to which you agree/disagree with the statements about our faculty:
- The content was well organized and clearly presented.*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- The presenter was effective in delivering the material.*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
6. Please select the extent to which you agree/disagree that the activity achieved the following:
- The content was evidence-based, objective, balanced, and free of bias.*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- The content was relevant to my area of professional practice.*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
7. Please select the extent to which you agree/disagree with the following statement.

The activity supported the learning objective, and as a result, my knowledge of the following has increased:
- Advances in the understanding of MS and the benefits of early diagnosis and treatment*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Information on current therapies and its relevance to the development of individualized management strategies for patients with MS*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Strategies to address common MS symptoms (primary, secondary, tertiary)*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Invisible symptoms of MS and strategies to recognize, assess, and manage these in individual patients*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Rehab modalities and their role in the management and care of patients living with MS*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Approaches to address diversity, equity, and inclusion in MS care*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Evidence related to the treatment and care of MS patients who are pregnant or breastfeeding*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
- Apply nursing interventions that incorporate best practices and evidence-based approaches to the care of patients with MS*
  - Strongly Agree
  - Agree
  - Neutral
  - Disagree
  - Strongly Disagree
8. Please select the extent to which you agree/disagree with the following statement.

The activity supported the learning objective, and as a result, my competence and/or confidence in the following has increased:
Applying nursing interventions that incorporate best practices and evidence-based approaches to the care of patients with MS*
- Strongly Agree
- Agree
- Neutral
- Disagree
- Strongly Disagree
9. Please select the extent to which you agree/disagree with the following statements.

The activity supported the learning objective, and as a result, my performance in the following will improve:
Application of evidence-based nursing interventions to improve earlier diagnosis, monitoring, treatment, and management of patients living with MS*
- Strongly Agree
- Agree
- Neutral
- Disagree
- Strongly Disagree
10. Based upon your participation in this activity, what type of changes do you anticipate you will implement? (Check all that apply)*
- Change in approach to evaluation of patients with symptoms of possible MS
- Change in approach to treating MS or managing its symptoms
- Increased consideration of invisible symptoms of MS
- Increased referral to rehabilitation services for patients with MS
- Increased effort to provide equitable and inclusive care through consideration of the needs and preferences of diverse populations
- Change in approach to management or counseling patients with MS regarding pregnancy and/or breastfeeding
- None; this activity validates my current practice
- N/A; I don’t practice
- Other, please specify
If other:*
11. Please note one specific change you anticipate making:
- 12. How confident are you that you will be able to make your intended changes?*
  - Very confident
  - Somewhat confident
  - Unsure
  - Not very confident
  - N/A (do not see patients)
- 13. Please indicate any barriers you anticipate in implementing these changes. (Check all that apply)*
  - Time constraints
  - Cultural or language barriers
  - Formulary restrictions
  - Patient safety/risk
  - Patient adherence/compliance
  - Cost/reimbursement/insurance issues
  - Organizational/institutional
  - No barriers
  - N/A (do not see patients)
  - Other
- If other:*
14. Do you employ a team-based model in your professional practice?*
- Yes
- No
15. What changes will you make in your role on the health care team as a result of this activity? (Check all that apply)*
- Share specific information I learned in this activity with suggestions for implementation within our practice setting
- Provide feedback to other members of my team about resources and information I learned in this activity in the team member’s area of expertise
- Seek feedback/information from other team members on my own performance on the team in areas where our roles intersect
- Improve my efforts to create a safe, respectful, collaborative environment for all members of my health care team
- Not applicable
16. What new team-based patient care strategies do you anticipate implementing as a result of information from this activity? (Check all that apply)*
- Share information that will assist in our efforts to provide a supportive environment for our unique patient population
- Implement strategies to improve both written and verbal communication with other team members
- Better align communication with my patients to be consistent with messaging from other members of the health care team
- Improve referral process both with other clinicians within my health care team and with those outside of my team
- Not applicable
- Were you provided with disclosure of relevant financial relationships of all persons affecting the content of this activity?*
  - Yes
  - No
- Were the commercial supporters of this activity acknowledged in course materials?*
  - Yes
  - No
- Were product names avoided in this activity, or if used, were all products referenced by their generic name?*
  - Yes
  - No
Please complete the required information below.
Your Name*
First Last Degree
Affiliation:*
Your Address*
Street Address City State ZIP Code
- Email Address (your certificate will be emailed here if claiming credit)*

ACTIVITY EVALUATION/ATTESTATION

Essentials in Multiple Sclerosis Care: A Comprehensive Curriculum for MS Nurses