Form FEMA-95-20 National Fire Academy Course Evaluation Form

Emergency Preparedness and Response/Department of Homeland Security

National Fire Academy

Course Evaluation Form

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DIRECTIONS FOR COMPLETING THIS FORM. Using a pen or pencil, please complete the course evaluation form by completely darkening the appropriate bubble for each item. Please fill the bubbles in. Do not sign or put your name on the form. All responses are confidential and will be reported ONLY in aggregate form, so no one will know what you specifically have said.

Part I

Course Evaluation Data

Indicate the course information for this training and complete the bubble grid to indicate the course number for this training.

Course Code Number

Course Dates: ___/___/___ to ___/___/___ 1 2 3 4 5 6 7 8 9 0

Course Title: __________________________________________ 1 2 3 4 5 6 7 8 9 0

Course Type: (check one) ___Resident __Regional Delivery ___Off-Campus Hazmat 1 2 3 4 5 6 7 8 9 0

___Direct Delivery __State Weekend

To what extent do you agree with each of the following? Strongly Agree Unsure Disagree Strongly NA

The course… Agree disagree

1. increased my knowledge of this topic ___ ___ ___ ___ ___ ___

2. allowed sufficient time to prepare in and out of class assignments ___ ___ ___ ___ ___ ___

3. was well organized ___ ___ ___ ___ ___ ___

4. contained sufficient practical “hands-on” opportunities ___ ___ ___ ___ ___ ___

5. fostered appropriate “team-building” skills ___ ___ ___ ___ ___ ___

6. used effective teaching techniques (lecture, AVs, scenarios, web) ___ ___ ___ ___ ___ ___

7. provided a balance of individual and group based teaching techniques ___ ___ ___ ___ ___ ___

8. helped me clarify my goals and professional expectations ___ ___ ___ ___ ___ ___

9. provided up to date information ___ ___ ___ ___ ___ ___

10. included useful web resources for the material ___ ___ ___ ___ ___ ___

11. met expectations I had from the catalog description ___ ___ ___ ___ ___ ___

The printed and audiovisual (AV) materials for this course…

1. were clear and easily readable ___ ___ ___ ___ ___ ___

2. supported class discussion ___ ___ ___ ___ ___ ___

3. were of good technical quality ___ ___ ___ ___ ___ ___

4. will be a useful reference when I get back on the job ___ ___ ___ ___ ___ ___

5. supplemented other teaching aids used in the course

(lecture, AVs, scenarios, web) ___ ___ ___ ___ ___ ___

The computer resources for this course… (Check NA if not applicable)

1. were user friendly ___ ___ ___ ___ ___ ___

2. were available when I needed them ___ ___ ___ ___ ___ ___

3. supplemented other teaching aids used in the course

(lecture, AVs, scenarios, web) ___ ___ ___ ___ ___ ___

Have you taken other NFA classes? To what extent did this course require you to use…

Some A lot Not at all

On campus: ___Yes ___No WEB & Internet resources ____ ___ ____

Off campus ___Yes ___No NFIRS data ____ ___ ____

Federal, local or state resources ____ ___ ____

GIS data ____ ___ ____

How might this class be improved?____________________________________________________________________________

______________________________________________________________________________________________________

Before taking this class, was this material… How do you access information about NFA classes?

(check all that apply)

___ completely new to you? ___ printed catalog ___world wide web ___ somewhat familiar to you? ___ other students ___local departments

___ very familiar to you? ___ information at conferences

Part II

Course Instructors/Overall Training

As you consider the instructor(s) for this course, to what extent do you agree that…

Strongly Strongly Not

Agree Agree Unsure Disagree Disagree Applicable

Instructor 1…Name:_________________________________________

1. knew the material well ___ ___ ___ ___ ___ ___

2. regularly clarified course and assignment expectations ___ ___ ___ ___ ___ ___

3. encouraged independent thinking from students ___ ___ ___ ___ ___ ___

4. fostered a collaborative “team-based” learning experience ___ ___ ___ ___ ___ ___

5. supplemented course with helpful experience ___ ___ ___ ___ ___ ___

6. answered students’ questions clearly ___ ___ ___ ___ ___ ____

7. presented engaging lectures ___ ___ ___ ___ ___ ___

8. led the learning process without dominating it ___ ___ ___ ___ ___ ___

9. exhibited a positive attitude toward students ___ ___ ___ ___ ___ ___

10. conducted the class in a professional manner ___ ___ ___ ___ ___ ___

11. worked well with co-instructor ___ ___ ___ ___ ___ ___

12. is worth recommending to others ___ ___ ___ ___ ___ ___

Is there particular feedback you have regarding this instructor?__________________________________________________________

_____________________________________________________________________________________________________________________________________

(PLEASE SKIP TO THE TRAINING EXPERIENCE SECTION BELOW IF THERE WAS ONLY ONE INSTRUCTOR IN THE COURSE.)

To what extent do you agree with each of the following? Strongly Strongly Not

Agree Agree Unsure Disagree Disagree Applicable

Instructor 2…Name:_________________________________________

1. knew the material well ___ ___ ___ ___ ___ ___

2. regularly clarified course and assignment expectations ___ ___ ___ ___ ___ ___

3. encouraged independent thinking from students ___ ___ ___ ___ ___ ___

4. fostered a collaborative “team-based” learning experience ___ ___ ___ ___ ___ ___

5. supplemented course with helpful experience ___ ___ ___ ___ ___ ___

6. answered students’ questions clearly ___ ___ ___ ___ ___ ___

7. presented engaging lectures ___ ___ ___ ___ ___ ___

8. led the learning process without dominating it ___ ___ ___ ___ ___ ___

9. exhibited a positive attitude toward students ___ ___ ___ ___ ___ ___

10. conducted the class in a professional manner ___ ___ ___ ___ ___ ___

11. worked well with co-instructor ___ ___ ___ ___ ___ ___

12. is worth recommending to others ___ ___ ___ ___ ___ ___

Is there particular feedback you have regarding this instructor?___________________________________________________________

_________________________________________________________________________________________________________

Considering the training overall, to what extent do you agree that… Strongly Strongly

Agree Agree Unsure Disagree Disagree

This training experience…

1. will help me do my current job better ___ ___ ___ ___ ___

2. was consistent with my department’s training expectations ___ ___ ___ ___ ___

3. will be useful for a department the size of mine ___ ___ ___ ___ ___

4. will be applicable to my future work ___ ___ ___ ___ ___

5. included material helpful to my department’s prevention efforts ___ ___ ___ ___ ___

6. will help reduce the fire-related risks in my community ___ ___ ___ ___ ___

7. provided sufficient opportunities for networking ___ ___ ___ ___ ___

8. provided information my department can use when responding

to an all-hazards and/or terrorist event ___ ___ ___ ___ ___

9. is worth recommending to others ___ ___ ___ ___ ___

Answer each of the following items as they apply to the class you have just completed. Otherwise, mark them as “Not Applicable”

Satisfactory Unsatisfactory Not Applicable

1. classroom and learning facilities _____ _____ ____

2. LRC _____ _____ ____

3. dormitory rooms _____ _____ ____

4. student center facilities _____ _____ ____

5. dining facilities _____ _____ ____

6. course registration and administrative details _____ _____ ____

7. workout/weight room facilities _____ _____ ____

Part III

Training Benefits

How do you think this course will help you in your job? (Check all that apply and note other ways as needed.)

General: ___gave me material I will use daily ___showed how to increase my efficiency ___will help me use dept resources better ___gave better idea of Federal, State, local resources ___increased my confidence, self understanding ___gave me the big picture, brought me up to speed ___gave info for continued learning after training is over ___showed value of brainstorming ___showed how to use public data sources ___showed value of identifying stakeholders ___helped to build/increase my professional network Leadership/Management ___provided new people skills ___will help me set department goals ___will make me a better manager ___gave skills for interacting with subordinates ___will help with labor negotiations ___taught me to delegate ___gave better idea of politics of department ___identified my leadership style(s) ___improved my administrative skills ___gave tools for handling departmental conflict ___contributed to my marketing skills ___will help with writing proposals ___increased my ability to see and set task priorities ___gave me a vision for my department ___contributed to my understanding of professional ethics ___showed how to prioritize my work ___gave tools to prepare SOPs ___showed how to use data (e.g., NFIRS/GIS) for department planning ___gave clear idea of organizational culture ___gave tools for performance appraisals ___gave information on budget preparation & negotiation ___improved my writing skills ___improved my speaking skills OTHER:_______________________________________ ________________________________________________

Technical ___prepared me for handling hazmat ___gave useful info on toxicology ___gave new info on product/containers ___gave better understanding of regulations ___will help with handling chemicals ___gave tools for response at “all hazards”or terrorist events ___clarified role as training manager ___gave tools to design training/classes ___gave tools to manage training ___will help in developing a marketing plan ___increased my investigative skills ___will help with report writing ___gave tools for better court preparation ___showed me how to interpret codes ___showed me how to inspect alarms ___increased my knowledge of health and fire safety issues ___increased my knowledge of fire/EMS issues ___gave tools to identify risk audiences ___gave tools to reach risk audiences ___increased my presentational skills ___identified goals for public education ___showed ways to develop interagency cooperation ___will help with budget preparation & program justification ___introduced me to coalition building ___provided model public education programs ___will help in adapting for small departments & communities ___showed how to develop risk analysis matrix for performance based design ___showed how to identify community health risks ___gave knowledge of managed care health risks ___showed the prevention side of EMS ___provided information for pre-incident planning ___gave tools for scene size-up ___will help with EOC/ICS integration at “all hazards” or terrorist events ___provided tools for incident documentation OTHER:_______________________________________ ________________________________________________

Which training delivery modes do you prefer?

___Resident ___VIP delivery ___Technology Mediated Distance Education

___Regional Delivery ___State Weekend Delivery ___Some combination of the above

Which training delivery modes do you find most helpful as you consider your training needs? (Check all that apply)

___ Self Study (CD ROM) ___ traditional face-to-face classrooms ___ paper-based course download

___ Self-Study (Internet) ___ video-teleconferencing ___other:_______________________

How likely are you to re-apply to NFA for future training?

___Very likely ___Somewhat Likely ___Not Sure/Can’t say ___Not likely to re-apply

Additional comments?_________________________________________________________________________________________

__________________________________________________________________________________________________________

Part IV

Student and Department Demographics

Location: Department/Organization. Please refer to the numerical codes listed below to indicate your Department or Organizational Location in the Location: Department/Organization Grid. For example, if your state is Maryland, which is code 24, fill in bubble number“2” in the first row and bubble number“4” in the second. If it is Alaska, fill in the bubble under the “0” for the first row and the bubble under the “1” for the second row.

Location: Department/Organization 0 1 2 3 4 5 6 7 8 9

(First digit of your state code) _ _ _ _ _ _ _ _ _ _

(Second digit of your state code) _ _ _ _ _ _ _ _ _ _

01___Alaska 11___Delaware 21___ Kentucky 31___North Carolina 41___Oregon 51___Virginia

02___Alabama 12___Florida 22___Louisana 32___North Dakota 42___Pennsylvania 52___Virgin Islands

03___Arkansas 13___Georgia 23___Massachusetts 33___Nebraska 43___Puerto Rico 53___Vermont

04___Am. Samoa 14___Guam 24___Maryland 34___New Hampshire 44___Rhode Island 54___Washington

05___Arizona 15___Hawaii 25___Maine 35___New Jersey 45___South Carolina 55___Wisconsin

06___California 16___Iowa 26___Michigan 36___New Mexico 46___South Dakota 56___West Virginia

07___Colorado 17___Idaho 27___Minnesota 37___Nevada 47___Tennessee 57___Wyoming

08___Connecticut 18___Illinois 28___Missouri 38___New York 48___Trust Territories 58___Other

09___Canal Zone 19___Indiana 29___Mississippi 39___Ohio 49___Texas

10___District of Columbia 20___Kansas 30___Montana 40___Oklahoma 50___Utah

(1) Are you attending course as… __Career ___Volunteer ___Other ( 2) If you know it, please tell us your FDID#. _______(Bubble grid) 0 0 0 0 0 1 1 1 1 1 2 2 2 2 2 (3) Years of experience in 3 3 3 3 3 subject area related to course: 4 4 4 4 4 etc through 9 ___less than one year in boxed area ___one to five years ___six to ten years ___more than ten years (4) Population currently served by your organization: __under 2,500 __10,000-24,999 __2,500-4,999 __25,000-49,999 __5,000-9,999 __50,000-99,000 __100,000 or more (5) Years of formal education: ___less than 9 ___AA degree ___HS graduation or equivalency ___Bachelor’s degree ___Some college ___ Master’s degree (6) Are you a fire instructor in your local jurisdiction? ___yes ___no

(7) What is your present position? __Firefighter __Bureau Chief __Driver/operator __Division Chief __Specialist/technician __Deputy Chief __Paramedic/EMT __Assistant Chief __Sergeant __Chief of Department __Lieutenant __Civilian Employee __Captain __Allied Professional __Battalion Chief __Other:____________ (8) What is your primary responsibility? __Command __Fire Prevention __Fire Suppression __Communications __EMS __Data Processing __Hazardous Materials __Public Education __Training/Instruction __Equipment Maint. __Investigation __Admin. Service __Inspection/Enforcement __Other:___________ (9) How long have you been in Fire and Emergency Services ___less than one year ___six to ten years ___one to five years ___more than ten years (10) What percent of your department are volunteer personnel? ___ none ___51-75% ___ 1-25% ___76-99% ___26-50% ___100%

Please answer the following questions: Are you: __male How old were you on your last birthday? 1 2 3 4 5 6 7 8 9 0 __female (First digit of your age) __ __ __ __ __ __ __ __ __ __ (Second digit of your age) __ __ __ __ __ __ __ __ __ __ Please check the ethnicity Are you one or more that best applies to you: ___Hispanic or Latino/Latina of the following: ___American Indian or Alaska Native ___Not Hispanic or Latino/Latina ___Asian ___Black or African American ___Native Hawaiian or Pacific slander ___White

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FEMA FORM 95-20