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Post-circuit evaluation by Country Brand Leads (CBLs)
Speaker:
*
Country
*
[Please select a country]
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahrain
Bangladesh
Belgium
Bolivia
Bosnia
Botswana
Brazil
Brunei
Bulgaria
Cambodia
Canada
Chile
China
Colombia
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Ecuador
Egypt
Estonia
Finland
France
Georgia
Germany
Greece
Guam
Hong Kong
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Japan
Jordan
Kazakhstan
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lithuania
Luxembourg
Macedonia
Malaysia
Malta
Mexico
Morocco
Myanmar
Netherlands
New Zealand
Niger
Norway
Pakistan
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Saudi Arabia
Serbia
Singapore
Slovakia
Slovenia
South Africa
South Korea
Spain
Sudan
Suriname
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Tunisia
Turkey
Uganda
UK
Ukraine
United Arab Emirates
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
Period:
Start date:
*
End date:
*
Completed by:
*
Completed by_country
*
[Please select a country]
Hong Kong
India
Indonesia
Malaysia
Pakistan
Philippines
Singapore
Taiwan
Thailand
Vietnam
A
Speaker quality
1. 
Is this speaker considered a renowned KOL, or one that your local customers would be excited to meet?
(10 – most positive/strongly believe/agree)
1. Is this speaker considered a renowned KOL, or one that your local customers would be excited to meet? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
a. 
For what reason is this KOL considered renowned or highly desirable in your local environment?
Please list all reasons: e.g. involved in trials, involved in guidelines, professional accolades, good presentation style, etc.
a. For what reason is this KOL considered renowned or highly desirable in your local environment? Please list all reasons: e.g. involved in trials, involved in guidelines, professional accolades, good presentation style, etc.
*
2. 
Can the speaker grasp and digest the local market information (through briefing call/relevant local data & articles shared) and deliver lectures that are able to address the local situation/needs?
(10 – most positive/strongly believe/agree)
2. Can the speaker grasp and digest the local market information (through briefing call/relevant local data & articles shared) and deliver lectures that are able to address the local situation/needs? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
3. 
Is the speaker able to analyse and summarize data/guidelines and present in a precise and concise manner?
(10 – most positive/strongly believe/agree)
3. Is the speaker able to analyse and summarize data/guidelines and present in a precise and concise manner? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
B
Presentations/slides quality
4. 
Was the speaker’s data/information presented up-to-date?
(10 – most positive/strongly believe/agree)
4. Was the speaker’s data/information presented up-to-date? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
5. 
Were the lectures and messages delivered by the speaker relevant and useful to your customers’ clinical practice?
(10 – most positive/strongly believe/agree)
5. Were the lectures and messages delivered by the speaker relevant and useful to your customers’ clinical practice? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
6. 
Was the speaker easy to work with and well prepared for the lectures?
(10 – most positive/strongly believe/agree)
6. Was the speaker easy to work with and well prepared for the lectures? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
7. 
Were the speaker’s presentations aligned to your current brand campaign messages?
(10 – most positive/strongly believe/agree)
7. Were the speaker’s presentations aligned to your current brand campaign messages? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
C
Speaker expertise
8. 
For which patient subgroups/conditions does the speaker show particularly strong knowledge?
(can be more than one answer)
8. For which patient subgroups/conditions does the speaker show particularly strong knowledge? (can be more than one answer)
*
Elderly patients
Patients with comorbid renal conditions
Patients who have previously bled
Post-stroke patients
Others (Please specify)
8. Other
*
9. 
Which specialty/sub-specialty of physicians would benefit most from seeing this speaker present?
(can be more than one answer)
9. Which specialty/sub-specialty of physicians would benefit most from seeing this speaker present? (can be more than one answer)
*
Electrophysiologists
General practitioners
Internal medicine
Interventional cardiologists
Neurologists
Others (Please specify)
9. Other
*
10. 
From your understanding/observation, how does the speaker position the use of different NOACs?
(1 – most preferred option; 4 – least preferred option; N/A – not applicable)
Apixaban
*
[Please select a rate]
1
2
3
4
N/A
Dabigatran
*
[Please select a rate]
1
2
3
4
N/A
Edoxaban
*
[Please select a rate]
1
2
3
4
N/A
Rivaroxaban
*
[Please select a rate]
1
2
3
4
N/A
10. N/A
N/A
D
Future planning
11. 
To what extent would you recommend this speaker for other countries?
(10 – most positive/strongly believe/agree)
11. To what extent would you recommend this speaker for other countries?
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
12. 
To what extent would you like to engage this speaker again for another virtual initiative with a presentation in your country?
(10 – most positive/strongly believe/agree)
12. To what extent would you like to engage this speaker again for another virtual initiative with a presentation in your country? (10 – most positive/strongly believe/agree)
*
[Please select a rate]
10
9
8
7
6
5
4
3
2
1
0
13. What additional topics would this speaker be particularly well-suited to cover in future virtual initiative?
*
For these questions, please consider the logistics arrangements, MAPP approval process, agency support, and any other such factors supporting the virtual initiative
14. What elements of the virtual initiative were done particularly well?
*
15. Which elements of the virtual initiative could have been done better?
*
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