DO NOT WRITE YOUR NAME ON THIS SURVEY

 

PLEASE PRINT LEGIBLY

 

Human Trafficking in the Emergency Department: The Evaluation

 

  1. Date ____________
  2. Institution (circle one):             Rhode Island            The Miriam
  3. provider type (check one):     p attending    p EM resident                           

p physician assistant              p nurse practitioner  p registered nurse    

p  “moonlighter”       p  “traveling nurse” p other___________________

  1. years in this role (check one):             p <1           p 1-3           p 4-5          ; p 6-10           p >10
  2. years working in the emergency dept (any ED; check one): 

p <1           p 1-3           p 4-5           p 6-10           p >10

  1. Before this session, did you know what human trafficking was? (circle one)

p Yes                        p No

  1. After this session, can you comfortably define human trafficking? (circle one)

Very confident………….Confident…………..Hesitant…………....Not Confident

1                                          2                                          3                                          4

  1. After this session, how confident are you in your ability to identify a trafficked person in the E.D.? (circle one)

Very confident………….Confident…………..Hesitant…………....Not Confident

1                                          2                                          3                                          4

  1. After this session, how confident are you in your ability to correctly treat a trafficked person in the E.D.? (circle one)

Very confident……..…..Confident……..……..Hesitant…….……..Not Confident

1                                          2                                          3                                          4

  1.  I found this session (check all that apply):

p useful                           p purely educational               p not at all educational          

p well organized              p adequately organized           p poorly organized

p thorough                      p tedious                                p incomplete               

p well timed                    p adequately timed                 p poorly timed            

p motivating                   p interesting                             p boring          

              

PLEASE INCLUDE COMMENTS ON REVERSE

 

 

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THANK YOU FOR YOUR TIME