Example Slides 1 and 2  should have all fields completed.  The remaining slides are intended only  as guidance.  See written Executive Summary Guidance for more details Outcome Report (label as Interim or Final) Program Title BMS grant # Educational Provider and Collaborator(s) Primary contact name & email Date Submitted (data as of DATE)

Program Title & BMS Grant # Outcome Report-Summary Slide (this slide must have all fields completed) Program Title & BMS Grant # ACTIVITY SUMMARY PARTICIPATION XXXX (n)  Total Actual Unique Learners Provider and Educational Partner(s) Start and End Date(s) for each modality Live (if applicable) Enduring material(s) (if applicable) Links:  Total Cost of Activity (if multi-supported): $ BMS Support: $ BMS Cost per Learner: $xxxxx/xxxxx TOTAL Learners MDs/DO NP/PA PharmD Other XXXX % (n) Total Learners as of DATE Breakdown of Physician Learners (if available) TOTAL Physician Learners Specialists Subspecialists PCP XXXX % (n) EDUCATIONAL GAINS (aligned with learning objectives) REMAINING  PRACTICE GAPS AND EDUCATIONAL NEEDS (e.g., from responses to evaluation questions, cases, etc.,) XX% (n) Overall increase in knowledge, competence, confidence & performance (pre-post activity) Gain #1 Gap # 1 Description / justification 5% Gain # 2 6% 8% Gap # 2 Description / justification 8% 43% XXXXX # of patients impacted Gain # 3 18% 22% Gap # 3 Description / justification 18%

Executive Summary Slides BMS- Example of an Outcome Report

Gaps and Learning Objectives Educational Purpose: briefly describe the professional practice gap(s) the activity was intended to fill. Learning objectives: 1. 2. 3. 4. Target Audience(s): BMS- Example of an Outcome Report

Educational Activity Details Live Activity (if applicable): Date(s): Location(s): Number and types of credits offered: Enduring Activities (if applicable): Type(s): e.g., webcast, podcast, print, etc. Links for each modality: Maximum number and type of credits offered for each modality: Dates Posted and Expiration for each modality:

Faculty Name Affiliation(s) Name Affiliation(s) Name Name

BMS- Example of an Outcome Report Outcomes Summary Demographics and Participation Educational Impact Planned practice changes and barriers to change Key practice gaps remaining Testimonials from participants BMS- Example of an Outcome Report

Demographics and Participation Total Actual Unique Learners XXXX (n) TOTAL Learners MDs/DO NP/PA PharmD Other XXXX % (n) Total Learners as of DATE Breakdown of Physician Learners (if available) TOTAL Physician Learners Specialists Subspecialists PCP XXXX % (n) BMS- Example of an Outcome Report

Knowledge, Confidence, Competence and Performance Outcomes (pre-post activity)

Educational Impact: HCPs & Patients HCP Educational Impact XX% Overall increase in knowledge, competence, confidence & performance(pre-post activity) XX% gain in Knowledge XX% gain in Competence XX% gain in Confidence XX% improvement in performance Describe the key highlights of the educational impact and overall increase in knowledge, competence, confidence and performance. Patient Impact Potential number of patients with [disease or condition covered in the activity] seen per week by participants, who are more likely to receive evidence-based care than those seen by non-participants. XXXXX # of patients impacted

There was a XX% increase in knowledge regarding xxxx State the Knowledge question(s) showing gains pre-post activity Repeat slide with questions showing gains in Confidence, Competence and Performance There was a XX% increase in knowledge regarding xxxx P=.001

Learners’ Planned Changes to Practice & Barriers (post-activity) xxxxx (n) xxxxx (n) xxxxx (n) xxxxx (n) Describe the Barriers to Change

Learners’ Remaining Practice Gaps Description Justification Gap #1 Gap #2 Gap #3

Testimonials and Comments from Participants (categorize them and list below) 1. 2. 3. 4. 5.

Participant Satisfaction

Participant Satisfaction (overall % ratings from good to excellent) Overall quality of education Overall effective format Faculty were knowledgeable N=xxx N=xxx N=xxx N=xxx N=xxx N=xxx