Survey : Questions

	Topic: Cultural Sensitivity in MS Nursing Presenter: Toni Saldana-King, BSN, RN, MSCN Date: May 9, 2012

Rate the following questions.

	Agree strongly	Agree	Neutral	Disagree	Disagree strongly
1. The speaker for this discussion was informative and the material covered was relevant to my practice.
2. The speaker presented at a level that was appropriate for my practice.
3. The audio and moderator format was clear and easy to follow.
4. I plan to change my practice due to the presentation and discussion.
5. I would recommend this activity to a peer.

Tell us about yourself.

How many MS patients do you see in a month?

1 - 25

26 - 50

51 - 100

more than 100

What is your primary practice setting?

Hospital

Outpatient University Practice

Private Practice

Hospital Outpatient Specialty Clinic

Rehabilitation Setting

Pharmaceutical Support Program

Other

What is your role in your practice?

RN

NP

Research Coordinator

Medical Assistant

LPN

PA

Other

Are you a Multiple Sclerosis Certified Nurse (MSCN)?

Yes

No

How long have you been in practice?

1 - 5 years

6 - 10 years

more than 10 years

How long have you working in MS?

1 - 5 years

6 - 10 years

more than 10 years