After attending this course, have you implemented or started to implement a change in your practice by any of the following? *

[YES] Integrating knowledge gained at a didactic session.

[YES] Incorporating updates to discussions with the heart team at my practice about patient selection/approaches in coronary artery surgery.

[YES] Using improved interpersonal communication skills based on what I learned at an educational session.

[NO] I have not made any changes.

Other, please explain:

After attending this course, have you implemented or started to implement a change in your practice by any of the following? Other, please explain:

[NO] Why haven’t you implemented any changes in your practice?

The meeting reinforced what I am already doing in practice.

It is not applicable to my practice situation.

Systems-related barriers, please explain*

No practices changes were recommended.

Other, please explain*

[NO] *Describe any systems-related barriers or specify other reasons why not.

Please describe how the change(s) you made as a result of attending the course have had an impact on your patient outcomes. *

How many years have you been in practice? (Please note if you are still in training.) *

Please indicate your profession. *

Anesthesiologist

Cardiologist

Cardiothoracic Surgeon

Cardiothoracic Surgery Resident

Fellow

General Surgery Resident

Interventional Pulmonologist

Non-RN Data Manager

Nurse

Nurse Practitioner

Perfusionist

PhD/Research Scientist

Physician (Other)

Physician Assistant

Practice Administrator

RN-Data Manager

Vascular Surgeon

Other:

Please indicate your profession. Other:

Which best describes your practice? *

Salaried – academic medicine with an ACGME CT surgery residency program

Salaried – academic medicine (medical school or university)

Salaried – government (national health service, military, VA)

Salaried – hospital employed

Salaried – HMO employed (e.g., Kaiser)

Private Practice – small (1-3 CT surgeons)

Private Practice – large (4 or more CT surgeons)

Other, please explain:

Which best describes your practice? Other, please explain:

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