CE Request Form. Please return your evaluation and this form along with your payment details below to ISONG. $15.00 fee to process the CE s.

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1 CE Request Form Please return your evaluation and this form along with your payment details below to ISONG. $15.00 fee to process the CE s. Answer Sheet: Participant s Name: Home Address: City: State/Province: Postal Code: Phone: PAYMENT: (payable in US Funds only) Please print clearly. $15.00 Visa MasterCard Check enclosed # Expiration / (CVV / CID) (CVV/CID is the 3-digit number from the back of your card immediately following the account number. This is required to process a card which is not physically present at ISONG headquarters.) Signature: Billing info/address for credit card, if different than mailing address provided above: Name: Billing Address: City: State/Province: Postal Code: Phone:

2 University of Pittsburgh School of Nursing Continuing Nursing Education Evaluation Tool Please assist in the evaluation of this educational activity and the planning of future activities by completing this evaluation form. Thank you! Disclosure regarding Conflict of Interest(s): The provider of the activity has disclosed in writing or verbally the conflict of interest or lack thereof declared by the planners and presenters/content specialists. YES X NO Objectives Please use the following rating scale to evaluate the objectives by circling the corresponding number below. To a Great Extent = 4 To a Moderate Extent = 3 To a Slight Extent = 2 Not at All = 1 I have achieved the following objectives as a result of this educational activity: Objective # 1: Discuss techniques to present genetic/genomics content to MSN students in a single genetic/genomic focused course. Objective # 2: Discuss techniques to present genetic/genomics content to MSN students in multiple courses over a MSN program. Objective # 3: State examples of teaching methods to facilitate MSN student learning. Presenters/Content Specialists Please use the following rating scale to rate the teaching effectiveness of each presenter using Excellent = 4 Good = 3 Fair = 2 Poor = 1 Presenter/Content Specialist: Lauri Linder Appropriateness of teaching strategies used (i.e., lecture, Power Point slides) Presenter/Content

3 Specialist: Marsha Tadje Appropriateness of teaching strategies used (i.e., lecture, Power Point slides) Content Integrity: The content was presented without bias of any commercial product or drug. Yes No Is there more that you would like to learn about this topic? Yes If yes, please identify: No What additional information related to this topic do you need to learn to make it useful in your practice? Please explain: Additional Comments:

4 POST TEST Presentation Title: Incorporating Genetic/Genomic Content into MSN Curriculum; Master s Essential I: Background for Practice from Sciences and Humanities. Presenters: Lauri Linder, Marsha Tadje 1. Genetic/Genomic content fits into which of the following coursework for MSN students? a. Pharmacology b. Bioethics c. Pathophysiology 2. MSN students can take a Genetics course in the Human Genetics department to meet the requirements of Essential I. a. True b. False 3. Content for a course in Genetics should include: a. Nutritional therapy b. Exercise therapy c. Family history 4. To meet the MSN Essential I requirement, genetic/genomic content can be offered as an elective course, open to interested students, in a MSN curriculum. a. True b. False 5. Which of the following is one focus of pharmacogenetic content appropriate for the MSN student? a. Genetic/genomic variation as a source of variable response to common medications. b. Blood pressure measurement to monitor for efficacy of anti-hypertensives. c. Teaching patients to monitor their blood glucose levels after insulin administration. d. Teaching patients about genetic testing so they can interpret their own genetic test results. 6. Which of the following is an appropriate teaching strategy for genetic/genomic content? a. Online or on-site lecture(s) b. Case studies c. Required reading of genetic focused journal articles

5 7. Case presentations on genetic content should include which of the following content? a. Vital signs. b. Biological function of the gene, and how the mutation leads to altered physiologic function/response to therapy. c. A list of genes near the mutated gene that do not impact the disease or response to therapy.. 8. When taking a family history, which of the following should be included? a. Dietary history. b. Exercise history. c. A 3 generation pedigree chart. d. None of the above. 9. Warfarin is an excellent drug to study Pharmacogenetics because: a. There is one mutation that impacts its function. b. Genetic testing can be used to determine optimal dosing. c. There are a large number of people taking this drug. d. It is the only drug known to be metabolized differently in people with genetic mutations. 10. Which of the following are appropriate resources for faculty developing a course on genetic/genomic content for MSN level students? a. The DNA Learning Center. b. The National Coalition for Health Professional Education in Genetics. c. The Genetic Information Non-discrimination Act of