Final Survey

Please return to this section after you have completed your mini audit.In order to have your RACGP CPD hours recorded please complete the reflection and evaluation below. The information you need to complete this reflection is available in the SUMMARY tab of your Auditing Tool spreadsheet. ASHM will then submit your CPD hours to RACGP on your behalf. Your feedback is welcomed and will help us to improve this activity.

About You

1. Name(Required)

First Last

2. Email(Required)

3. What is the postcode of your main place of practice? (Required)

4. Which of the following best describes your main role?

GP Registrar 

Sexual health registrar 

Medical Officer/Senior Medical Officer 

International Medical Graduate 

Nurse Practitioner 

Nurse   

Aboriginal Health Worker 

Other

5. How would you best describe your main service setting?  

General practice 

Aboriginal Medical Service/Aboriginal Community-Controlled Health Organisation 

Correctional setting 

Drug and alcohol service (hospital/non-hospital) 

Sexual/reproductive health service

Other primary health (e.g. community health centre) 

Other hospital setting 

Other

6. For which of the following reason(s) did you participate in this activity? Please select all that apply.

I see patients who may be at risk

Interest in the area

Third Choice

As a Quality Improvement initiative

I wish to increase my skills and abilities in Sexual Health

To receive RACGP CPD points

Other

7. On a scale of 1 to 5, how satisfied were you with the following Syphilis QI activities?

	1. Not at all satisfied	2. Not very satisfied	3. Neither satisfied nor dissatisfied	4. Quite satisfied	5. Very satisfied
Syphilis Decision-Making Tool
Short-form videos
Auditing Tool
Overall activity design

8. Please use this space if you would like to elaborate on any of the above responses

RACGP CPD submission

Please complete this section to enable ASHM to submit for CPD hours on your behalf. We record RACGP number for verification. All other data is de-identified and reported in aggregate for your privacy.  

9. RACGP number(Required)

10. In the month prior to undertaking the mini audit how many syphilis tests did you offer (estimate)?(Required)

11. In your audit please state the number of Syphilis tests conducted (use auditing tool summary page for this question)(Required)

12.In your audit please state the number of positive Syphilis test results (use auditing tool summary page for this question)(Required)

13. In your audit please state the Number of Public Health Unit Syphilis Notification forms completed (use auditing tool summary page for this question)(Required)

14. Reflection – Please write a few sentences reflecting on your experience with this activity. Eg. Has this increased your uptake of Syphilis screening/testing? Was the auditing tool helpful in collecting the correct information? Was this training package helpful in improving the management of syphilis notifications in your practice?(Required)

15. Please rate to what degree the learning outcomes of the program were met:(Required)

	Not met	Partially me	Mostly met	Entirely met
Increase confidence in managing a diagnosis of syphilis
Demonstrate how to accurately record sexual history relating to a Syphilis diagnosis
Examine processes for identification, recall and management of patients with Syphilis.

16. Please rate to what degree this CPD activity met your expectations about(Required)

	Not met	Partially me	Mostly met	Entirely met
Content: Current, contemporary, evidence-based, and relevant to general practice
Delivery: Engaging/interactive, e.g., with opportunity for questions and feedback

17. Would you likely change anything in your practice as a result of this CPD activity? Please describe.(Required)

18. Would you likely recommend this CPD activity to a colleague? Please describe why/why not.(Required)