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[date name="variable_1" default="today"]...
[checkbox name="Q2" value="Residency Goals"]
[conditional field="Q2" condition="(Q2).is('Residency Goals')"] What specifically are you trying to accomplish? [textarea default=""]
Do you have a good grasp of how your goal(s) will fit into your training and future practice? [textarea default=""]
How do you feel you are progressing in your training? [textarea default=""]
What are your near-term goals? [textarea default=""]
[/conditional]
[checkbox name="Q3" value="Challenges"]
[conditional field="Q3" condition="(Q3).is('Challenges')"]Describe any unusual or unanticipated challenges you experienced this semester in trying to accomplish your goals. [textarea default=""]
What actions have you taken to meet these challenges? [textarea default=""]
How can your advisor help you? [textarea default=""]
[/conditional]
[checkbox name="Q4" value="Additional training"][conditional field="Q4" condition="(Q4).is('Additional training')"]
What program requirements do you still need to complete and what is your plan to fulfill them? [textarea name="comment_1"]
What fellowships are you applying to and have you sought guidance? [textarea default=""]
What CME conferences have you gone to and how have they enhanced your learning? [textarea default=""]
[/conditional]
[checkbox name="Q5" value="Academic Skills"]
[conditional field="Q5" condition="(Q5).is('Academic Skills')"] Trainee will target these skills for this year: [checkbox name="X1" value="*Background knowledge|**Critical reading of scientific literature|***Experimental design|****Interpretation of data|*****Creativity and innovation|*****Understanding of systems|****Identifying and seeking advice|***Working with constructive criticism|**Supervision of learners|*Time management."] COMMENTS: [textarea default=""]
[/conditional]
[checkbox name="Q6" value="Mentors"]
[conditional field="Q6" condition="(Q6).is('Mentors')"] Faculty mentor: [text default="name"]. How often do you meet? [text default=""]. Is this sufficient? [select name="variable_1" value="yes|no"].
Peer mentor: [text default="name"]. How often do you meet? [text default=""]. Is this sufficient? [select name="variable_1" value="yes|no"].
Personal mentor: [text default="name"]. How often do you meet? [text default=""]. Is this sufficient? [select name="variable_2" value="yes|no"].
Comments regarding mentors:[textarea default=""][/conditional]

[checkbox name="Q8" value="Trainee is concerned about developing burnout."][conditional field="Q8" condition="(Q8).is('Trainee is concerned about developing burnout.')"] Mitigation strategies discussed include the following: [textarea name="burnout" default=""][/conditional]

[checkbox name="Q1" value="Professional Goals"]
[conditional field="Q1" condition="(Q1).is('Professional Goals')"] Do you have a plan after graduation? [textarea default=""]
What are your current longterm career goals? [textarea default=""]
What features of your relationships with colleagues are most helpful and supportive to your personal development? [textarea default=""]
Are there any factors/relationships that negatively affect your career decisions? [textarea default=""]
[/conditional]
[comment memo="Free text area"]
[textarea name="comment" default=""]
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