“PEPP-2” Faculty Evaluation Form Maryland Enhanced PEPP Program
ALS & BLS Provider PEPP Course
Date: ___________ Location: _____________________ Please circle your response: Strongly Disagree 1 Disagree Agree 2 3 Strongly Agree 4 Not Used x
1.
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4.
The PEPP Student Manual provided adequate clinical information to teach the PEPP course. The PEPP Resource Manual provided adequate information for conducting the Lectures. The PEPP Resource Manual provided adequate information on conducting the Skills Stations. The PEPP Resource Manual provided adequate information on conducting the Scenarios.
1
2
3
4
x
1
2
3
4
x
1
2
3
4
x
5.The amount of time allotted for each of the sessions was (please circle your response):
Too Short Course Content About Right Too Long Did Not Teach This Portion
PEPP Video – Assessment PEPP Video - Skills LECTURE Cardiovascular Emergencies Child Assessment: Applying the Pediatric Assessment Triangle Children with Special Health Care Needs Emergency Delivery and Newborn Stabilization Medical Emergencies Respiratory Emergencies SIDS/ALTE Toxicology Trauma
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
x x x x x x x x x x x
12/2005
“PEPP-2” Faculty Evaluation Form Maryland Enhanced PEPP Program
SCENARIOS Cardiovascular Emergencies Child and Family Interaction Children with Special Health Care Needs Medical Emergencies Emergency Delivery and Newborn Stabilization Trauma SKILLS STATIONS BLS Skills Station 1: Airway BLS Skills Station 2: Spinal Immobilization ALS Skills Station 1: Airway Management ALS Skills Station 2: Vascular Access ALS Skills Station 3: Spinal Immobilization 6.
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
x x x x x x x x x x x
Is there anything else that should be added to the content of the PEPP course? If yes, please list content areas: YES NO If yes, please list:
7.
Did any of the content presented in the PEPP course conflict with your regional standard of practice? YES NO If yes, please list areas of conflict
8.
Comments
Thank you for your feedback. This information will be shared with the Maryland State Pediatric Emergency Advisory Committee (PEMAC) and the Maryland PEPP Steering Committee for planning future PEPP Courses. Thank you for your commitment to the emergency care of children in Maryland.
12/2005