Feb 21 – Montana First Nation Site Visit – Feedback Form

Name *

First

Last

PRIOR to this event, how would you rate your awareness of Indigenous populations in Canada? *

Excellent
Good
Fair
Poor

AFTER attending this event, how would you rate your awareness of Indigenous populations in Canada? *

Excellent
Good
Fair
Poor

AFTER attending this event, would you say your empathy towards indigenous communies has... *

Greatly increased
Increased
Stayed the same
Decreased

AFTER attending today's site visit, how comfortable do you feel working with indigenous patients moving forward? *

Very comfortable
Comfortable
Somewhat comfortable
Uncomfortable

What other courses have you taken related to Indigenous healthcare and culture? *

University of Alberta Indigenous Course
Alberta Health Services Indigenous Modules
A workshop through AIMGA
Other
I have not taken any specific courses prior to our Montana First Nation visit

What other course(s) have you taken? *

Given that this is an ongoing partnership between AIMGA and Montana First Nation, how would you like to support in the future? *

Deliver an educational workshop through AIMGA
Offer on-site support
Work as a Clinical Assistant if positions become available
Work as a Physician (for those who are PRA eligible)
Complete an observership placement (note: you would have to arrange your own transport to and from site)
Unsure

Please provide further details on the areas of support selected above or specific supports that you would like to assist with. *

I am: *

Employed
Unemployed, not seeking work
Unemployed, seeking work

What is your current job title? *

Did your visit to Montana First Nation change your perspective in engaging with Indigenous patients moving forward? *

To a great extent
Somewhat
Very little
Not at all

Are you interested in attending an event at Montana First Nation on March 1st (8:00-5:00pm, including travel time)? *

Yes
No

What topic(s) are you comfortable providing health education on? Select all that apply.

Which of these areas do you have particular medical/professional experience in (if applicable)? Please explain.

Please provide your overall impressions of your site visit to Montana First Nation with AIMGA. (E.g., is there anything that we could have improved upon? Are there suggestions for next steps to further your knowledge and awareness? Are there other topics related to Indigenous healthcare and culture that you would like to learn more about?) *