Form 1 BTCG Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIAID)

Survey Instrument-BTCG 2013

Evaluation Form for the Bridging the Career Gap for Underrepresented Minority Scientists workshop

OMB: 0925-0668

Document [doc]
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OMB Control #: 0925-0668

Expiration Date: 1/31/2016

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Overall Evaluation Form


SECTION I (Please circle your answer.) (4=Strongly Agree 3=Agree 2=Disagree 1=Strongly Disagree)

  1. Attending this Workshop increased my knowledge/understanding of NIH/NIAID

mission, career options, peer review process 4 3 2 1

  1. The Workshop offered information that was relevant to my research career 4 3 2 1

  2. I received new information that was not available to me prior to the Workshop 4 3 2 1

  3. The Workshop materials were valuable 4 3 2 1

  4. The number of breakout sessions was appropriate 4 3 2 1

  5. The topics addressed during the Workshop were appropriate 4 3 2 1

  6. I would recommend this Workshop to my colleagues 4 3 2 1

S ECTION II (Please circle your answer) (4=Excellent 3=Good 2=Fair 1=Poor)


8. How relevant was each of the following Workshop presentations to increasing your

knowledge base in future research and career options

a. NIH/NIAID Scientific Mission 4 3 2 1

b. Keys to Success 4 3 2 1

c. Experiences from the Front Line – Post Doc Panel 4 3 2 1

d. Funding Sources 4 3 2 1

e. Mentoring Presentation 4 3 2 1

f. Overview of Career Choices 4 3 2 1

g. Speaker Event with NIAID 4 3 2 1

h. NIH Grant System & Peer Review 4 3 2 1

i. Mock Study Section 4 3 2 1

j. Strategies for Success: Perspectives from Grantees and Reviewers 4 3 2 1

k. Role of Program Staff 4 3 2 1

l. Budget proposal pre-Post Award 4 3 2 1

m. Breakout Groups 4 3 2 1

(Please indicate which breakout group you were in) _____________________________________________

9. Please rate the Workshop arrangements and facilities. (4=Excellent 3=Good 2=Fair 1=Poor)

(Please circle "NA " if you did not use the service.)

a. Convenience of site/date/time (NA) 4 3 2 1

b. On-site registration process (NA) 4 3 2 1

c. Meeting facility (NA) 4 3 2

e. Hotel accommodations (i.e., lodging room) (NA) 4 3 2 1


10. Overall, the Workshop was (4=Excellent 3=Good 2=Fair 1=Poor) 4 3 2 1

S ECTION III

11. What were the strengths of this Workshop?

1 2. What suggestions do you have for improving this Workshop?

1 3. Which portion (s) of the workshop did you find most beneficial to your individual needs?

1 4. Additional Comments:








Name (optional):

( Please Print)


Check all boxes that apply:


Predoctorate □ Postdoctorate

  • Diversity Supplement □ nF32 grantee

  • PSA (Kll) grantee

Division of Intramural Research

IRTA □ Clinical Associate

Staff Fellow Visiting Fellow

Other (specify)___________________________________________________________________________________


Thank you for your participation!

File Typeapplication/msword
File TitleBridging The Career Gap for Underrepresented Minority Research Scientists Sponsored by National Institute of Allergy and Infecti
AuthorValued Gateway Client
Last Modified ByWashington, Dione (NIH/NIAID) [E]
File Modified2013-10-28
File Created2013-10-28

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