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Pediatric Palliative Care Music Therapy: the Heartsongs of Care Survey

Name *

First

Last

CBMT Number (Required to receive CMTE Certificate)

Please select "yes" or "no" to indicate whether or not, in your opinion, the specific learning objectives for this opportunity were met:

Identify clinical needs of terminally ill children and their families *

Yes
No

Recognize ethical dilemmas and ethical practices guiding care for pediatrics *

Yes
No

State music therapy interventions meeting clinical needs and identify ways to provide multi-generational and multicultural music therapy sessions *

Yes
No

Recognize risks of compassion fatigue and incorporate self-care as an essential practice *

Yes
No

Please select "yes" or "no" to answer the following questions:

Was physicial environment conducive to learning? *

Yes
No

Was the length of the program appropriate? *

Yes
No

Was the amount of material presented sufficient? *

Yes
No

Were my educational needs and expectations met? *

Yes
No

Instructor: Dr. Russell Hilliard, PhD, LCSW, LCAT, MT-BC
Rating Scale: Excellent = 4, Good = 3, Fair = 2, Poor = 1

Presentation style *

4
3
2
1

Knowledge of subject and clarity *

4
3
2
1

Interaction with participants (Leave blank if no interaction occurred during this opportunity)

4
3
2
1

Please rate the CMTE content:

Quality of relevant information *

4
3
2
1

Quantity of relevant information *

4
3
2
1

Organization of material *

4
3
2
1

Instructor: Kayla Zuckerman, MA, SCMT, MT-BC
Rating Scale: Excellent = 4, Good = 3, Fair = 2, Poor = 1

Presentation style *

4
3
2
1

Knowledge of subject and clarity *

4
3
2
1

Interaction with participants (Leave blank if no interaction occurred during this opportunity)

4
3
2
1

Instructor: Amanda Maestro-Scherer, MA, MT-BC
Rating Scale: Excellent = 4, Good = 3, Fair = 2, Poor = 1

Presentation style *

4
3
2
1

Knowledge of subject and clarity *

4
3
2
1

Interaction with participants (Leave blank if no interaction occurred during this opportunity)

4
3
2
1

Instructor: Jessica Sturgeon, MT-BC
Rating Scale: Excellent = 4, Good = 3, Fair = 2, Poor = 1

Presentation style *

4
3
2
1

Knowledge of subject and clarity *

4
3
2
1

Interaction with participants (Leave blank if no interaction occurred during this opportunity)

4
3
2
1

Please rate the CMTE content:

Quality of relevant information *

4
3
2
1

Quantity of relevant information *

4
3
2
1

Organization of material *

4
3
2
1

What information presented in this CMTE opportunity was most useful to your practice? *

This CMTE opportunity could be improved by: *

Please suggest topics for future CMTE opportunities. *

Phone

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