interactive-ceu-workshop-template

Session Evaluation & CEU Credit Verification

📝 Instructions

This is a low-tech, plain-text evaluation document optimized for markdown submission. Please copy the raw content of this file, populate the text fields below, and email it directly to `` with the subject line CEU Verification: .

👤 Section 1: Attendee Metadata

Full Name:
Professional License Number / State:
Email Address:
Session Date Attended:

🧠 Section 2: Critical Reflection Prompts (Praxis Audit)

Prompt 1: Systemic vs Individual Failures

In your own words, summarize how the theoretical framework of critical pedagogy reframes professional burnout and isolation as a systemic or institutional failure rather than an individual worker deficiency.

Your Response:

Prompt 2: Interleaved Pacing Assessment

This session abandoned the traditional continuous lecture format in favor of a 15-minute staggered pacing strategy interleaved with peer-level dialogue.固定 Analyze how this shift impacted your processing of the empirical data presented.

Your Response:

Prompt 3: Actionable Institutional Policy

Identify one concrete Micro, Mezzo, or Macro policy change you will propose to your current organization based on the structural solutions discussed during the interactive segments.

Your Response:

📊 Section 3: Structural Session Ratings

Please input a score from 1 (Strongly Disagree) to 5 (Strongly Agree) inside the brackets.

The learning objectives were explicitly stated and clearly addressed during the 90-minute runtime.
The presenter successfully demonstrated critical pedagogy principles by engaging in activities on a peer level.
The single-column Markdown layout was easily readable and accessible on my mobile device browser.
The content maintained clear alignment with the NASW Code of Ethics standard of professional competence.

🔒 Presenter Disclosures & Attestation

By submitting this form, you attest that you were actively present for the full 60 minutes of presentation delivery and the 30 minutes of interactive group dialogue.

CEU Course Provider Code:
Course Tracking Number:

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