Form 10-0439 Learner's Perception survey

200X Learners' Perceptions Survey Date shown solely to prevent confusion.
Why take the survey? We value and need your input! The information you provide will help us to improve the educational experience for you and your fellow trainees at your VA facility. Please take the time to complete this survey. Thank you!	This is a confidential survey. If you have any questions about how to complete the survey, please call 1-888-877-9869 or e-mail the Help Desk.
OMB Control Number 2900-0691 Estimated Burden: 15 minutes Public Reporting Burden Statement
The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. The public reporting burden for this collection of information is estimated to average 15 minutes per response. No person will be penalized for failing to furnish this information if it does not display a currently valid OMB control number. The collection of information is sponsored by the Department of Veterans Affairs (VA) and is collected in accordance with Title 38 Sections 527 and 7302. The information you supply will be confidential and protected by the Privacy Act of 1974 (5 U.S.C. 522a) and the VA’s confidentiality statute (38 U.S.C. 5701 as implemented by 38 CFR 1.526(a) and 38 CFR 1.576(b). Disclosure of information involves release of statistical data and other non-identifying data for the improvement of the clinical training that takes place at VA medical centers. Response to this survey is voluntary and failure to respond will have no effect on your future employment or any claim you may file with the Department of Veterans Affairs.

200X Learners' Perceptions Survey
(Physician Residents/Fellows, Medical Students, and VA Physician)

1. Please select and complete one of the following Learners' Perceptions Surveys that is appropriate to your Clinical Training:

___ Physician Residents/Fellows, Medical Students, and VA Physician

Special Fellows

___ Associated/Allied Health Professions including Dentistry,
Optometry & Podiatry

2. Please indicate the level of training of the most recent program at the VA medical facility you identified for this survey.

Medical Student - 1st year

Medical Student - 2nd year

Medical Student - 3rd year

Medical Student - 4th year

Residency/Fellowship - PGY1

Residency/Fellowship - PGY2

Residency/Fellowship - PGY3

Residency/Fellowship - PGY4

Residency/Fellowship - PGY5

Residency/Fellowship - PGY6

Residency/Fellowship - PGY7

Post-residency Physician in a VA Special Fellowship

3. PHYSICIAN RESIDENTS (PGY 1 to PGY 7) - Please indicate your Residency Specialty by selecting from the list below.

Obstetrics and gynecology

Oncology

Ophthalmology

Orthopaedic surgery

Otolaryngology

Pain medicine-Anesthesiology (APM)

Pain medicine-Neurology (PMN)

Pain medicine-PM&R (PPM)

Pain medicine-Psychiatry (PPN)

Pathology – anatomic and clinical

Physical medicine and rehabilitation

Plastic surgery

Preventive medicine

Psychiatry

Psychosomatic medicine-Psychiatry (PYM)

Pulmonary disease

Pulmonary disease and critical care medicine

Radiation oncology

Radiology-diagnostic

Rheumatology

Sleep medicine

Spinal cord injury medicine

Surgery-general

Surgical critical care

Thoracic surgery

Urology

Vascular and interventional radiology

Vascular surgery

Other

4. If you are a VA POST-RESIDENCY SPECIAL FELLOW - Please indicate your Fellowship Training Program by selecting from the list below.

5. Are you rotating at this facility now?

Yes ___ No ___

6. What PERCENT of the time in your current clinical training program/experience has been spent at THIS VA facility?

_____ %

7. Please rate your satisfaction with your CLINICAL FACULTY/PRECEPTORS at the VA facility as a group in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Clinical skills
Teaching ability
Interest in teaching
Research mentoring
Accessibility/Availability
Approachability/Openness
Timeliness of feedback
Fairness in evaluation
Being role models
Mentoring by faculty
Patient-oriented
Quality of faculty
Evidence-based clinical practice
OVERALL SATISFACTION WITH CLINICAL FACULTY/ PRECEPTORS

8. Please rate your satisfaction with the LEARNING ENVIRONMENT at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Time working with patients
Degree of supervision
Degree of autonomy
Amount of non-educational (''scut'') work
Interdisciplinary approach
Preparation for clinical practice
Preparation for future training
Preparation for business aspects of clinical practice
Time for learning
Access to specialty expertise
Teaching conferences
Quality of care
Culture of patient safety
Spectrum of patient problems
Diversity of patients
OVERALL SATISFACTION WITH THE LEARNING ENVIRONMENT

9. Please rate your satisfaction with the WORKING ENVIRONMENT at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Faculty/preceptor morale
Ancillary/support staff morale
Peer group morale
Laboratory services
Radiology services
Ancillary/support staff
Call Schedule
Computerized Patient Record System (CPRS)
Orientation program
Library services
Computer access
Internet access
Workspace
OVERALL SATISFACTION WITH THE WORKING ENVIRONMENT

10. Please rate your satisfaction with the CLINICAL ENVIRONMENT at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Hours at work
Number of inpatients admitted for your care
Number of outpatients/clinic patients seen
Timely availability of outpatient appointments
Timely performance of necessary procedures/surgeries
Admitting patients in a timely fashion
Ability to use emerging therapies/pharmaceuticals
How well physicians and nurses work together
How well physicians and ancillary staff work together
Getting tests done in a timely fashion on weekdays
Getting tests done in a timely fashion on nights and weekends
Ease of getting patient records
Backup system for electronic medical records
Amount of ''paper work''
Ability to work within the system to get the best care for your patients
OVERALL SATISFACTION WITH THE CLINICAL ENVIRONMENT

11. Please rate your satisfaction with the AVAILABILITY & TIMELINESS of STAFF AND SERVICES at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Attending/supervisory staff: weekdays
Attending/supervisory staff: nights and weekends
Outpatient nursing staff: weekdays
Inpatient nursing staff: weekdays
Inpatient nursing staff: nights and weekends
Ancillary/support staff: weekdays
Ancillary/support staff: nights and weekends
Pharmacy services: weekdays
Pharmacy services: nights and weekends
Radiology services: weekdays
Radiology services: nights and weekends
Laboratory services: weekdays
Laboratory services: nights and weekends
OVERALL SATISFACTION WITH AVAILABILITY AND TIMELINESS OF STAFF AND SERVICES

12. Please rate your satisfaction in the following areas with the QUALITY of STAFF & SERVICES when available at the VA facility.

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Attending/supervisory staff
Nursing staff
Ancillary/support staff
Pharmacy services
Radiology services
Laboratory services
OVERALL SATISFACTION WITH QUALITY OF STAFF AND SERVICES

13. Please rate your satisfaction with the following SYSTEMS AND PROCESSES dealing with medical errors at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Prevent/reduce medical errors
Assure medication safety
Report medical/medication errors
Assure confidentiality of error reporting
Facilitate discussion of medical/medication errors
Facilitate analysis of medical/medication errors as a learning experience
OVERALL SATISFACTION WITH SYSTEMS AND PROCESSES DEALING WITH MEDICAL ERRORS

14. What level of patient care quality did you expect to find at the VA facility BEFORE starting your residency?

Excellent ___ Very Good ___ Good ___ Fair ___ Poor ___

15. How do you rate the quality of patient care at the VA facility NOW, based on your actual experience?

Excellent ___ Very Good ___ Good ___ Fair ___ Poor ___

16. Please rate your satisfaction with the PHYSICAL ENVIRONMENT at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Convenience of facility location
Parking
Personal safety
Availability of phones
Availability of needed equipment
Maintenance of equipment
Facility maintenance/upkeep
Lighting
Heating and air conditioning
Facility cleanliness/housekeeping
Call rooms
Availability of food at the medical center when on call
OVERALL SATISFACTION WITH THE PHYSICAL ENVIRONMENT

17. Please rate your satisfaction with YOUR PERSONAL EXPERIENCE at the VA facility in the following areas:

	Very satisfied	Somewhat satisfied	Neither	Somewhat dissatisfied	Very dissatisfied	Not applicable
Personal support from colleagues
Personal reward from work
Relationship with patients
Appreciation of your work by faculty
Appreciation of your work by patients
Balance of personal and professional life
Enjoyment of your work
Level of job stress
Level of fatigue
Continuity of relationship with patients
Ownership/personal responsibility for your patients' care
Quality of care your patients receive
Enhancement of your clinical knowledge and skills
OVERALL SATISFACTION WITH YOUR PERSONAL EXPERIENCE

18. In July 2003, the Accreditation Council for Graduate Medical Education instituted changes in requirements in DUTY HOURS/SCHEDULING for resident education.
In your opinion, what effect have these changes had on your educational experience at the VA facility in the following areas:

	Very positive effect	Somewhat positive effect	Had no effect	Somewhat negative effect	Very negative effect	Not applicable
Personal support from colleagues
Personal reward from work
Relationship with patients
Appreciation of your work by faculty
Appreciation of your work by patients
Balance of personal and professional life
Enjoyment of your work
Level of job stress
Level of fatigue
Continuity of relationship with patients
Ownership/personal responsibility for your patients' care
Quality of care your patients receive
Enhancement of your clinical knowledge and skills
OVERALL EFFECT OF CHANGES IN REQUIREMENTS IN DUTY HOURS/SCHEDULING

ANSWER THIS QUESTION IF YOU ARE A PGY3 OR ABOVE...

19. Compared to previous years, how have the duty hours/schedule changes affected your OVERALL educational experience?

Made a lot better ___ Made somewhat better ___ Had no effect___
Made somewhat worse___ Made a lot worse___ Unable to judge ___

20. Approximately what percent of the patients you see in an average WEEK, at the VA facility, fall into each of the following categories?

	Less than 10%	10- 24%	25- 49%	50- 74%	75- 89%	90- 100%
Age 65 or older
Chronic mental illness
Chronic medical illness
Multiple medical illnesses
Alcohol/substance dependent
Low income/socio-economic status
Lack of social/family support

21. Have you ever had a clinical training experience at the same or equivalent level as your most recent VA training at a community or university hospital or other setting outside the VA?

Yes ___ No ___ If NO Skip to question 24.

22. How would you compare your most recent VA clinical training experience to other NON-VA clinical training experiences you have had at the same or equivalent level?

	VA a lot better	VA somewhat better	VA about the same	VA somewhat worse	VA a lot worse	Not applicable
VA clinical faculty and preceptors
VA facility staff
VA learning environment
VA working environment
VA physical environment
Degree of autonomy
Degree of supervision
Quality of care
Usefulness of what you learned
OVERALL EXPERIENCE AT VA COMPARED TO NON-VA

23. On a scale of 0 to 100, where 100 is a perfect score and 70 is a passing score, what NUMERICAL SCORE would you give the NON-VA clinical training you have had?

Non-VA Score ___

24. How would you RATE THE VALUE of your MOST RECENT CLINICAL TRAINING EXPERIENCE at this VA facility?

Excellent ___ Very Good ___ Adequate ___ Fair ___ Poor ___

25. Based on your experience to date, if you had a choice, how likely would you be to CHOOSE THIS TRAINING EXPERIENCE AGAIN?

___ Definitely would choose this clinical experience again

___ Probably would choose this clinical experience again

___ Probably would not choose this clinical experience again

___ Definitely would not choose this clinical experience again

26. Would you RECOMMEND this VA CLINICAL TRAINING EXPERIENCE TO OTHER LEARNERS in your discipline of study?

Yes___ No ___

27. On a scale of 0 to 100, where 100 is a perfect score and 70 is a passing score, what NUMERICAL SCORE would you give your MOST RECENT VA clinical training experience?

VA Score ____

28. BEFORE this clinical training experience, how likely were you to consider a future employment opportunity at a VA medical facility?

Very likely ___ Somewhat likely ___ Had not thought about it ___

Somewhat unlikely ___ Very unlikely ___

29. AS A RESULT of this clinical training experience, how likely would you be to consider a future employment opportunity at a VA medical facility?

A lot more likely ___ Somewhat more likely ___ No difference ___

Somewhat less likely ___ A lot less likely ___

30. Would you consider the VA as a future employer?

Yes___ No ___

31. What is your gender?

Male___ Female ___

32. In what year did you/will you graduate from medical school?

1995 OR Earlier

1995

1996…

…

2010 or later

33. Did you/will you graduate from a medical school in the United States?

Yes___ No ___