Sample Report 1660-NEW Level 1 Assessment Form

Sample Report

Course Name: TERT 99-11

Number of Students: 30

SECTION 1

Primary Discipline	Number	Primary Discipline	Number
1. Emergency Management	2	7. Government Administrative
2. Fire Service	12	8. Healthcare (non-EMS)	3
3. HAZMAT	1	9. Public Health
4. Law Enforcement	10	10. Public Works
5. Public Safety Communications		11. Other
6. Emergency Medical Services (EMS)	2

SECTION 2

Level of Expertise	Number
Expert (SME)	5
Intermediate	8
Basic	17

SECTION 3

Module:	Quality of Instruction Average of Responses	Knowledge Increase Average of Responses	Confidence Increase Average of Responses
1. Terrorist Threat	4.53	4.28	4.86
2. Incident Command and Response Actions	3.87	3.45	4.23
3. Chemical Hazards	3.63	3.78	3.26
4. Biological Agents	3.01	4.20	3.45
5. Radiological Hazards	4.52	4.35	4.67

SECTION 3 (Cont.)

Module (Lane/Exercise)	Quality of Facilitation	Increase in Skill	Increase in Confidence
6. 1 Lane Principles of Mass Causality Response	4.78	4.30	4.99
6. 2 Decontamination and PPE Level B	4.69	4. 50	3.76
6. 3 Scene Survey and Safety	4.79	4.89	4.67
6. 4 Survey and Monitoring and PPE Level C	4.83	4.98	4.68
7. Practical Exercise (COBRA)	4.97	4.89	4.93

SECTION 4

The course (Overall)

Item	Average Response
a. employed a variety of instructional methods	4.63
b. was an appropriate length for the material covered	5.00
c. is worth recommending to others	4.68

SECTION 5

The Instructors (Overall)

Item	Average Response
a. answered questions thoroughly	4.93
b. encouraged student participation	4.00
c. covered all course learning objectives	4.98
d. conducted themselves in a professional manner	5.00

IMPLEMENTATION SCHEDULE

February14, Through April 30, 2011

February 14	February28	March 21
1. TERT	16. ERHM	29. FFC
2. HT	17. FFE	30. FRAME
3. IC	18. EMO	March 28
4. AgERT	19. HOT-I	31. RP
5. HERT	20. HCL	April 4
6. HERT TtT	March 7
7. ICS TtT	21. HEC	April 11
8. EHTER	22. ITC	32. ICS 300
February 21	23. P3	33. FLO
9. HARM	MARCH 14	April 18
10. FFO	24. LEPM
11. SAAT	25.ILERSBA
12. ICS 400	26. LERA
13. HOT	27. RAD TtT
14. SAT	28.APIOHHE
15. ICR