Word Version ODS_Practicum Eval_Final Survey_03202012

OMB Control #0925-0648
Expiration Date: 01/31/2015

Office of Dietary Supplements

National Institutes of Health

Dietary Supplement Research Practicum Participant Survey

The staff of the Office of Dietary Supplements of the National Institutes of Health/U.S. Department of Health and Human Services appreciates your willingness to complete this survey and provide feedback on the annual Dietary Supplement Research Practicum that you attended. The goal of this survey is to determine how well the practicum met attendees’ needs and contributed to their research, clinical practice, and/or education on dietary supplements. 

Public reporting burden for the collection of information is estimated to be no more than 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not return the completed form to this address.

Thank you for your valuable feedback. 

1. Please indicate the type of institution you were employed with when participating in the practicum and for which you are currently employed. (Select all that apply.)

   Institutional Affiliation	During Practicum	Current
   Academic institution		
   Research institution		
   Company/business		
   Clinical practice (as MD)		
   Clinical practice (other health care provider)		
   Government agency		
   Other (specify):_________________________		
   Other (specify):_________________________		

2. Please indicate your position when you were participating in the practicum and now. (Select all that apply.)

Position	During Practicum	Current
Dentist		
Doctor of Osteopathy		
Masters or Doctoral Student		
Post-doctoral Student/Fellow		
Medical Doctor		
Nurse		
Nutritionist		
Pharmacist		
Physical Therapist, Physical Trainer, Kinesiologist		
Research Scientist		
University/College Faculty		
Other Health Practitioner (specify):	__________	____________
Other Professional (specify):	__________	____________

3. How did you first hear about the practicum? (Select one.)

1. Department chair

2. Professor

3. Colleagues

4. Professional meeting

5. Workplace/institution

6. The Office of Dietary Supplements website

7. Direct notification from the Office of Dietary Supplements

8. Other (please specify): ______________________________________________________

4. Thinking back to when you first were interested in participating in the practicum, why were you interested in this opportunity to learn about dietary supplements? (Select all that apply.)

1. For teaching purposes

2. For research purposes

3. For your practice as a health care provider

4. For future career choices

5. Opportunity to network with other professionals interested in dietary supplement research

6. Other (please specify): ________________________________________________________

5. How valuable did you find the practicum during your participation and what is your perception of its value now?

	Very Valuable	Valuable	Somewhat Valuable	Not Valuable
While attending practicum				
Currently				

If you answer that your current perception of the practicum is “not valuable,” skip to question 7.

6. How have you benefited from participating in the practicum? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Did you find the meeting binder helpful to have during the time of the practicum?

   1. Yes.

   2. No—Please specify why not:

_____________________________________________________________

8. Have you used the binder materials since participating in the practicum?

   1. No

   2. Yes—Please specify how you used the materials:

____________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________

9. Have you used the knowledge gained during the practicum to create new resources or to enhance existing ones at your workplace?

   1. No—Skip to question 11

   2. Yes—Please complete the following table. (Select all that apply.)

	Enhanced Existing Resources	Created New Resources
Curriculum for existing courses		
New courses		
New research grant application		
Research methods		
Research agenda		
Nonacademic educational materials on dietary supplements		
Other (specify):	___________	____________

10. Are there other ways you have used the practicum or it has influenced your research/practice?

    1. No

    2. Yes—please specify: ___________________________________________________________________________

___________________________________________________________________________

11. Have you worked with other practicum participants in activities or projects as a result of your practicum experience?

    1. No

    2. Yes—please specify: ___________________________________________________________________________

___________________________________________________________________________

12. Do you have any plans you have not yet implemented that you would attribute to your practicum participation?

    1. No

    2. Yes—please specify: ___________________________________________________________________________

___________________________________________________________________________

13. Have you faced any barriers to implementing new activities on dietary supplements?

    1. No

    2. Yes—please specify: ___________________________________________________________________________

___________________________________________________________________________

14. In your department or institution, are there courses or course modules offered on dietary supplements?

    1. No, we don’t have any

    2. Yes—please specify course name and department: ___________________________________

    3. Does not apply; I am not working in an academic setting.

15. In your department or institution, is any research currently being done on dietary supplements?

    1. No.

    2. Yes—please specify research grant, principal investigator, and department: ______________________

_________________________________________________________________________________

3. Does not apply; I am not working in an academic setting or research institution.

16. Do you have any suggestions of professional groups that the Office of Dietary Supplements (ODS) should recruit for the practicum?

    1. No

    2. Yes—please specify: ___________________________________________________________________________

___________________________________________________________________________

17. ODS is considering developing some type of networking group or activity. Please indicate whether you would be interested in participating in any of the following (Select all that apply.):

    1. Read a newsletter.

    2. Actively contribute to an online community to share resources, ideas, etc.

    3. Attend a networking session at a national conference.

    4. Attend a workshop at a national conference.

    5. Other ideas (please specify): ________________________________________________

    6. I am not interested in participating.

18. If there is any other information that you would like to share with ODS regarding the practicum?

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

If you have material that you would like to share with ODS, please send to:

Office of Dietary Supplements

National Institutes of Health

6100 Executive Boulevard, Room 3B01, MSC 7517

Bethesda, MD 20892-7517

Tel: 301-435-2920

E-mail: [email protected]

Thank you for your time and effort in helping us improve our practicum program.

Please provide your email address if you are willing to have us contact you if we have questions about your responses to this survey:

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ODS Practicum Evaluation Survey