Optional Teledementia Manual Health Professional Survey

Audience: GRECC Connect Webinar Attendees

Subject: Tele-dementia for older adults manual

Question Title

* 1. Please indicate your clinical background (select one)

Geriatric Medicine Physician

Geriatric Medicine APRN/PA

Primary care Physician

Primary care Physician/APRN/PA

Geriatric Psychiatry/Psychiatry

Pharmacy

Nursing

Psychology/Neuropsychology

Social Work

Rehab (Physical Therapy, Occupational Therapy, Speech therapy)

Medical subspecialty

Other (please specify)

Question Title

* 2. Are you currently a trainee?

yes

Question Title

* 3. If yes, please specify level of training

Question Title

* 4. How many years have you been practicing?

0-5 years

6-10 years

11-20 years

21-30 years

More than 30 years

N/A

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* 5. How long have you been practicing via telemedicine?

0-3 years (since COVID-19 pandemic started)

4-6 years

7-9 years

10+ years

N/A

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* 6. Do you use telemedicine for patients with dementia?

Yes

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* 7. Approximately what % of your patients are rural?

None

Less than 25%

25%-50%

50%-75%

75%+

N/A

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* 8. Approximately what % of your patients have difficulty accessing dementia specialists?

None

Less than 25%

25%-50%

50%-75%

75%+

N/A

Question Title

* 9. Approximately what % of your patients do you see via telemedicine?

None

Less than 25%

25%-50%

50%-75%

75%+

N/A

Question Title

* 10. Approximately what % of your patients are >65 years old?

None

Less than 25%

25%-50%

50%-75%

75%+

N/A

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* 11. Please indicate the zip code of the facility you practice out of. If multiple facilities, please indicate the zip code of the facility you spend the most time at:

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* 12. I learned about the tele-dementia for older adults manual through:

Reviewing the document only

Webinar + reviewing the document

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* 13. Who have you shared or plan to share this manual with (select all that apply)?

Colleagues at the VA

Colleagues outside the VA

Your organization at large (via email lists/listservs, TEAMs channels, educational webinars etc.)

Trainees

Other (please specify)

None of the above, I don't plan to share it

Question Title

* 14. How likely are you to recommend this manual to a colleague in the future?

Very likely

Likely

Unlikely

Very unlikely

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* 15. How do you plan to use this manual? (check all that apply)

Personal education

Educating trainees

As a part of creating a clinical care plan for telemedicine encounters

As a part of creating a clinical care plan for all dementia encounters

Other (please specify)

None of the above, I don't plan to use it

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* 16. Any other comments about this tele-dementia manual for older adults?

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* 17. Are there any aspects of tele-dementia care that you hoped to learn about that isn’t included?

Question Title

* 18. What is your email address? We would love to contact you for an optional follow up survey about your experience using this tele-dementia for older adults manual.

Optional Teledementia Manual Health Professional Survey

Audience: GRECC Connect Webinar AttendeesSubject: Tele-dementia for older adults manual

Question Title

* 1. Please indicate your clinical background (select one)

Question Title

* 2. Are you currently a trainee?

Question Title

* 3. If yes, please specify level of training

Question Title

* 4. How many years have you been practicing?

Question Title

* 5. How long have you been practicing via telemedicine?

Question Title

* 6. Do you use telemedicine for patients with dementia?

Question Title

* 7. Approximately what % of your patients are rural?

Question Title

* 8. Approximately what % of your patients have difficulty accessing dementia specialists?

Question Title

* 9. Approximately what % of your patients do you see via telemedicine?

Question Title

* 10. Approximately what % of your patients are >65 years old?

Question Title

* 11. Please indicate the zip code of the facility you practice out of. If multiple facilities, please indicate the zip code of the facility you spend the most time at:

Question Title

* 12. I learned about the tele-dementia for older adults manual through:

Question Title

* 13. Who have you shared or plan to share this manual with (select all that apply)?

Question Title

* 14. How likely are you to recommend this manual to a colleague in the future?

Question Title

* 15. How do you plan to use this manual? (check all that apply)

Question Title

* 16. Any other comments about this tele-dementia manual for older adults?

Question Title

* 17. Are there any aspects of tele-dementia care that you hoped to learn about that isn’t included?

Question Title

* 18. What is your email address? We would love to contact you for an optional follow up survey about your experience using this tele-dementia for older adults manual.

Audience: GRECC Connect Webinar Attendees

Subject: Tele-dementia for older adults manual