Form 1 Attachment A: Workshop Pre-Training Survey

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

Survey #1: Pre-Training Survey

(Pen or Paper Survey Administered to Primary Trainees Immediately Prior to the Training)

Demographic Questions

1. What type of health care practitioner best describes you?

 Administrator/Clinical manager

 Care manager/Case manager

 Clinical nurse specialist

 Clinical psychologist

 Clinical social worker

 Dentist

 Diabetes educator/Diabetes management nurse

 Health care navigator/Patient navigator

 Medical assistant

 Certified nurse midwife

 Nurse

 Nurse practitioner

 Occupational therapist

 Patient health educator/Certified health education specialist (CHES)

 Pharmacist

 Physician assistant

 Physician

 Psychiatrist

 Quality improvement manager

 Registered dietitian

 Respiratory therapist

 Other _____________ (please specify)

2. In what kind of setting do you practice most of the time?

 Academic institution

 Ambulatory/office-based care setting

 Behavioral health care setting

 Community health care setting

 Correctional facility

 Emergency department

 Federally qualified health center or other public health center

 Home care

 Hospice and/or palliative care setting

 Hospital based setting

 Long-term care facility

 Migrant worker health center

Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

 Pharmacy setting

 Rehabilitation center

 Specialty clinic

 Substance use/abuse treatment center

 University health care/hospital setting

 Urgent care setting

 Veteran or military health care center/hospital

 Other _______________ (please specify)

3. Which of the following best describes where your practice setting is located?

 Rural area

 Small or commuter town

 Suburban area

 Urban area

4. How many years have you been working in your current occupation?

 2 years or less

 3-9 years

 10-19 years

 20-25 years

 26+ years

5. To what extent do you work as part of an interdisciplinary patient care team?

 To a great extent

 Somewhat

 Not at all

6. Is the organization you work for recognized as a patient-centered medical home or patient-centered specialty practice (PCMH/PCSP)?

 Yes

 No, but in the process of becoming recognized as one

 No

 I don’t know

7. Is the organization you work for an accredited Accountable Care Organization (ACO)?

 Yes

 No, but in the process of becoming an accredited ACO

 No

 I don’t know

8. Please briefly describe any other accreditation, certifications, distinctions, or recognitions that your organization maintains.

Pre-Training Knowledge

9. Which of the following statements most accurately defines comparative effectiveness research (CER), also sometimes called patient-centered outcomes research (PCOR)?

   	CER/PCOR is the process by which health professionals and others impart information to patients and their caregivers that will alter their health behaviors or improve their health status.
   	CER/PCOR is an interdisciplinary approach to clinical practice that has been gaining ground following its formal introduction in 1992.
   	CER/PCOR is research that compares the available evidence on the effectiveness, benefits, and harms of different treatments and interventions for specific health conditions. CER/PCOR takes into consideration outcomes that matter to patients, such as mortality and quality of life.
   	CER/PCOR is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
   	All of the above
   	None of the above

10. Which of the following statements accurately describes the purpose of the Agency for Healthcare Research and Quality’s (AHRQ’s) Effective Health Care Program?

    	AHRQ’s Effective Health Care Program funds individual researchers, research centers, and academic organizations to produce effectiveness and comparative effectiveness research for clinicians, consumers, and policymakers.
    	AHRQ’s Effective Health Care Program funds individual researchers, research centers, and academic organizations to protect America from health and safety threats. Whether diseases start at home or abroad, are chronic or acute, are curable or preventable, or are based on human error or deliberate attack, AHRQ fights diseases and supports communities and citizens to do the same.
    	AHRQ’s Effective Health Care Program funds individual researchers, research centers, and academic organizations to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.
    	All of the above
    	None of the above

11. Which of the following statements accurately describes a process that is critical for conducting shared decisionmaking (SDM)?

    	The clinician makes a treatment recommendation to the patient and then carefully explains why the option is the best for the patient.
    	The clinician weighs the evidence of available treatment options and selects the most appropriate option for the patient to minimize risks and costs for the patient.
    	The clinician engages the patient and/or their caregivers to clarify the patient’s values or preferences for treatment.
    	The clinician discusses the pros/cons (benefits/risks/costs) of available treatment options with the patient and/or their caregivers and then selects the option with the lowest cost or risk.
    	All of the above
    	None of the above

12. Which of the following definitions best describes the purpose of patient decision aids (DAs)?

	Patient DAs are tools that help people become involved in decisionmaking by making explicit the decision that needs to be made, providing information about the options and outcomes, and by clarifying personal values.
	Patient DAs describe where and why choice exists and they provide information about options, including the option of taking no action.
	Patient DAs help people deliberate, independently or in collaboration with others, about their options by considering how they might feel about short, intermediate, and long-term outcomes which have relevant consequences.
	Patient DAs are designed for patients with certain conditions to help them think about what is important to them when talking with their clinician about treatment options.
	All of the above
	None of the above

Pre-Training Baseline for EHC Program Product Use

13. How often have you used the following AHRQ Effective Health Care (EHC) Program tools/resources in the past 6 months?

	Daily or almost daily	At least once a week	Two to three times a month	About once a month	A couple of times in the past 6 months	Never
AHRQ EHC Program Web site
Patient/consumer summaries – shared with patient and/or family members
Patient decision aids – shared with patient and/or family members
Spanish-language consumer summaries – shared with patient and/or family members
Mobile access to the AHRQ EHC Web site
Clinician summaries (for my own ongoing learning)
PCOR continuing education modules (CME/CE/CEU)
Faculty slide decks
Research reviews or syntheses
An EHC Web conference
Webcasts

Pre-Training Self-Efficacy Questions

14. Please rate how important you believe the following topics are in providing patient care:

	Very confident	Moderately confident	Slightly confident	Not at all confident
Locating trusted CER/PCOR resources.
Using CER/PCOR to facilitate health care decisionmaking.
Sharing CER/PCOR decision aids with patients.
Discussing risks and benefits about health care options with patients
Engaging patients to learn their preferences and values for their health care. options
Including patients in decisionmaking if they want to be involved.

15. Please rate your confidence in training others on the following topics:

	Very confident	Moderately confident	Slightly confident	Not at all confident
Locating trusted CER/PCOR resources.
Using CER/PCOR to facilitate health care decisionmaking.
Sharing CER/PCOR decision aids with patients.
Discussing risks and benefits about health care options with patients
Engaging patients to learn their preferences and values for their health care. options
Including patients in decisionmaking if they want to be involved.

Prior Training Experience

16. Have you previously received formal training related to any of the following?

    	Yes	No	I don’t know
    CER/PCOR
    SDM

17. Have you ever trained other health care professionals on concepts related to any of the following?

	Yes	No	I don’t know
CER/PCOR
SDM

18. Please describe your previous teaching experience using the following methods, on any topic (not just CER/PCOR):

    	Substantial	Some	Little	None
    Teaching in a lecture-based class setting
    Teaching in continuing education programs
    Teaching in a workshop or conference setting

19. How many years of experience do you have in training other health care professionals?

 1 year or less

 2 to 3 years

 4 to 5 years

 6 to 10 years

 More than 10 years

20. What methods of delivery do you prefer for receiving training? (Please check all that apply.)

 Computer/Web-based training

 In-person training

 Lecture-based training

 Hands-on, interactive

 From your own personal reading

ATTACHMENT A - AHRQ EtE -- Survey 1 – Pre Training Survey 10