Learner's Perception (LP) Survey

Forms and Documents

Document Name	Status
Form 10-0439 Learner's Perception (LP) Survey Form	Unchanged
TOC_Response note from Michael Kashner_VHACO.docx Justification for No Material/Nonsubstantive Change	2012-05-16
Kashner_Henley_Golden_Effects ACGME duty hours on Resident Satisfaction_2010.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Kaminetzky_Keitz_Kashner_LPS subspecialty fellows_2011.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Cannon_Keitz_Holland_Factors satisfaction med student resident LPS_2008.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Lam_O'Toole_Arola_Factors associated dental residents_in press (2).pdf Justification for No Material/Nonsubstantive Change	2012-05-16
LPS Instructions_2012_05.docx Justification for No Material/Nonsubstantive Change	2012-05-16
4944_001.pdf Supplementary Document	2011-02-28
(LPS) Poster.pdf Supplementary Document	2009-09-23
postcard reminder.JPG Supplementary Document	2009-09-23
2013 letter to trainees[1].doc Supplementary Document	2012-12-06
2900-0691 JustificationB.DOC Supporting Statement B	2009-12-09
2900-0691 Justification 4-2013.doc Supporting Statement A	2013-04-18

IC Document Collections

IC ID	Document Title	Status
44140	Learner's Perception (LP) Survey Form	Unchanged

ICR Details

OMB Control No: 2900-0691	ICR Reference No: 201212-2900-006
Status: Historical Active	Previous ICR Reference No: 201205-2900-006
Agency/Subagency: VA	Agency Tracking No: 2900-0691
Title: Learner's Perception (LP) Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/23/2013
	Date Received in OIRA: 03/11/2013
Terms of Clearance: This is approved as an extension without change. VA is reminded to submit collections under the correct "ICR Type."

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved	04/30/2013
Responses	14,000	0	14,000
Time Burden (Hours)	3,500	0	3,500
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of the LP Survey is to assist in identifying strengths and opportunities for improvement in the clinical training experience thus allowing continuous assessment of VA's teaching mission.

---

Authorizing Statute(s): US Code: 38 USC Section 7302 Name of Law: Functions of Veterans Health Administration: healthcare personnel education and training programs.
   US Code: 38 USC Section 527 Name of Law: Evaluation and data collection
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 240	12/13/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 34	02/20/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Learner's Perception (LP) Survey	10-0439	Learner's Perception survey

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	14,000	14,000	0	0	0	0
Annual Time Burden (Hours)	3,500	3,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $32,657

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/11/2013

---