Name
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First Name
Last Name
Email
*
Degree (MD, DO, NP, etc)
*
Credit Type
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AMA PRA Category 1
ADA-CERP
ANCC-NCPD
ACPE
CPE
AAPA
APA
ASWB-ACE
CDR
IPCE
Practice Setting (hospital, private practice, etc)
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Specialty
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Level of Training
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Still in Training
1-5 Years Out
6-10 Years Out
11-15 Years Out
16+ Years Out
Size of Practice
<20 people
21-40 people
>41 people
not actively practicing
still in training
industry/other expert
Academic Affiliation (if applicable)
Instagram Handle
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
This activity improved my knowledge base and competency as it relates to my profession.
*
Agree
Disagree
Neutral
This activity helped with a new skill set which I will employ to become a better leader in my healthcare team.
*
Agree
Disagree
Neutral
This activity will change/improve my performance within my practice.
*
Agree
Disagree
Neutral
This activity was free from commercial bias
*
Reflect on a recent clinical or professional challenge. What type of support (mentorship, innovation, social media presence, resilience strategies, or courageous communication) would have most improved the outcome, and how might you strengthen your “bench” of resources moving forward?
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Identify a recurring patient care challenge or misconception you encounter in your practice. How could innovation, media relationships, or more effective patient/professional communication help you address this issue and improve outcomes?
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Consider how your own resilience, authenticity, and leadership style influence your clinical decision-making and team dynamics. What specific change will you commit to implementing in your daily practice as a result of this activity?
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