Form 1 Short Course Survey for Pilot

Attachment 1: NHGRI Short Course Survey – Students and Faculty

OMB No.: 0925-XXXX

Expiration Date: xx/xx/20xx

Collection of this information is authorized by The Public Health Service Act, Section 410 (42 USC 285). Rights of participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not participating or withdrawing from the study at any time. The information collected in this study will be kept private to the extent provided by law. Names and other identifiers will not appear in any report of the study. Information provided will be combined for all participants and reported as summaries. You are being contacted by email to complete this survey as part of an outcome evaluation of the National Human Genome Research Institute (NHGRI) Summer Workshop in Genomics (Short Course).

Public reporting burden for this collection of information is estimated to average 30 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-XXXX). Do not return the completed form to this address.

Participant Information

Historical Information

This first set of questions focuses on verifying or gathering information as it stood at the time of your attendance to the Short Course; we will ask for updated information next.

Select your role during your participation in the Short Course (All Attendees)

1. Faculty Attendee

2. Student Attendee

3. Nursing Faculty Attendee

[Skip logic: If Student Attendee] What degree program were you enrolled in when you attended the Short Course?

1. Bachelor of Science (BS)

2. Bachelor of Arts (BA)

3. Master of Science (MS)

4. Master of Arts (MA)

5. Master of Public Health (MPH)

6. Doctor of Philosophy (PhD)

7. Doctor of Medicine (MD)

8. Dual degree (MD & PhD)

9. Registered Nurse (RN)

10. Other, please specify: ____________

[Skip logic: If Faculty or Nurse Faculty Attendee] What was your primary Position or Occupation Title at the time of your attendance to the Short Course?

1. Researcher

2. Adjunct Instructor/Professor

3. Assistant Professor

4. Associate Professor

5. Professor

6. Distinguished and/or Endowed Professor and/or Emeritus

7. Other, please specify: ____________

[Skip logic: If Faculty or Nurse Faculty Attendee] Was this a tenure or non-tenure track position?

1. Tenure track

2. Non-Tenure track

Did you hold a teaching appointment at the time of your attendance to the Short Course? (Faculty/Nursing Faculty Only)

1. Yes

2. No

[Skip logic: If Yes] Out of 100 percent, what best represented your teaching/research ratio at the time?

• Teaching __________

• Research __________

• Other, please specify __________

Current Information

This section will capture change or updates to your professional or academic profile since your attendance to the Short Course.

Are you still with _____________________________________(prepopulate with Institutional name)? (All Attendees)

1. Yes

2. No

[Skip logic: If No] Please list your current institution or organizational affiliation.

Has your Position or Occupation Title changed from INSERT PIPED ANSWER since the time of your attendance in the Short Course? (Faculty/Nursing Faculty Only)

1. Yes

2. No

[Skip logic: If Yes] What is your current primary Position or Occupation Title?

1. Researcher

2. Adjunct Instructor/Professor

3. Assistant Professor

4. Associate Professor

5. Professor

6. Distinguished and/or Endowed Professor and/or Emeritus

7. Administrator

8. Other, please specify __________

[Skip logic: If Yes] Please specify whether this is a tenure or non-tenure track position

1. Tenure-track

2. Non-Tenure-track

What is your current primary Position or Occupation Title? (Student Attendee Only)

1. Student

2. Trainee

3. Clinician

4. Educator (K-12)

5. Researcher

6. Administrator

7. Instructor or Professor

8. Other, please specify __________

1. [Skip Logic: If Student] What type of degree program are you enrolled in?

   1. MS

   2. MPH

   3. PhD

   4. MD

   5. MD/PhD

   6. RN

   7. Other, please specify __________

2. [Skip logic: If Trainee] Please specify trainee type:

   1. Predoctoral

   2. Postdoctoral

   3. Clinical

   4. Other, please specify __________

3. [Skip Logic: If Instructor/Professor] Please specify the type of instructor or professor position.

   1. Researcher

   2. Adjunct Instructor/Professor

   3. Assistant Professor

   4. Associate Professor

   5. Professor

   6. Distinguished and/or Endowed Professor and/or Emeritus

   7. Administrator

   8. Other, please specify __________

4. [Skip Logic: If Instructor/Professor] Please specify whether this is a tenure or non-tenure track position.

   1. Tenure-track

   2. Non Tenure-track

Does your current position involve teaching genetics or genomics? (Student Attendee Only)

1. Yes

2. No

[Skip Logic: If Yes) Select the content areas you teach: (Select all that apply).

1. Biology of genetics and genomics

2. Biology of human genetics

3. Molecular/cellular genetics

4. Genetics and genomics of common diseases

5. Genetic and genomic technology

6. Pharmacogenetics and genomics

7. Ethical, legal and social implications of genetics/genomics

8. Resources for genetic/genomic education

9. Career resources (e.g., grant writing)

10. Other, please specify: __________

[Skip Logic: If Yes) Out of 100 percent, what percentage of your time is dedicated to teaching? (Student Attendee Only) ______

Which of the following best describes your primary field of work? (All Attendees)

1. Academia

2. Government

3. Clinical

4. Clinical/Government

5. Industry

6. Non-profit

7. Other, please specify: __________

Please identify any additional credentials or degrees you have received or pursued since the Short Course. (Select all that apply). (All Attendees)

1. None received or pursued

2. BS/BA

3. MS/MA

4. MPH

5. PhD

6. MD/PhD

7. MD

8. RN

9. Other, please specify: _____________

[Skip logic: If received or pursuing] Have you completed the credential or degree(s)?

1. Yes

2. No

3. Other, please specify: ______________

[Skip logic: If received or pursuing] What discipline(s) is your credential or degree associated with?

The Short Course Program

The next set of questions focuses on your professional activities since the Short Course.

Teaching Appointment

Out of 100 percent, what best represents your current teaching/research ratio? (Faculty/Nursing Faculty Only)

• Teaching __________

• Research __________

• Other __________

[Skip logic: If Yes] To what degree did your experience at the Short Course influence your teaching to research ratio? (Faculty/Nursing Faculty Only)

1. No influence

2. Some influence

3. Moderate influence

4. Great influence

How many year(s) have you been engaged in teaching? (Faculty/Nursing Faculty Only)

Integration of Short Course Knowledge

Please indicate whether you agree or disagree with the following statement: I was able to update my curriculum as a result of my participation in the Short Course. (Faculty/Nursing Faculty Only)

Yes, I made substantial changes

Yes, I made some changes

Yes, I made minor changes

No, I did not make any changes

[Skip logic: If Yes or variant of Yes] I was able to update my genetics or genomics curriculum and teaching materials in the following ways: (Select all that apply)

1. Informal/unplanned integration (e.g., anecdotal narratives, spontaneous examples)

2. Added content to my lecture materials

3. Added assignments to my courses

4. Removed other content to make way for new information

5. Developed new teaching objectives for my existing courses

6. Created new lab experiments

7. Developed a new course

8. Shared teaching material with other faculty

9. Other, please specify: __________

[Skip logic: If Yes or variant of Yes] I was able to update my curriculum and teaching materials in the following content areas: (Select all that apply)

11. Biology of genetics and genomics

12. Biology of human genetics

13. Molecular/cellular genetics

14. Genetics and genomics of common diseases

15. Genetic and genomic technology

16. Pharmacogenetics and genomics

17. Ethical, legal and social implications of genetics/genomics

18. Resources for genetic/genomic education

19. Career resources (e.g., grant writing)

20. Other, please specify: __________

[Skip logic: If Yes or variant of Yes] How much time was required to update your curriculum and teaching materials after participating in the Short Course?

1. Less than 3 months

2. Between 3 and 6 months

3. Between 6 months and 1 year

4. Between 1 and 2 years

5. Between 2 and 5 years

6. More than 5 years

Beyond curriculum integration, in what other ways did you disseminate information from the Short Course to students? If you did not disseminate information beyond curriculum integration, please write “Did not disseminate further.” (Faculty/Nursing Faculty Only)

Please rate how much you think the following institutional factors influenced your ability to transfer your knowledge to students following participation in the Short Course. (Faculty/Nursing Faculty Only)

	No Influence	Minor Influence	Moderate Influence	Great Influence	Not Applicable
Time and space to accommodate or integrate new information into existing curriculum	❏	❏	❏	❏	❏
Relevant course(s) not available	❏	❏	❏	❏	❏
Process for changing curriculum	❏	❏	❏	❏	❏
Support of colleagues	❏	❏	❏	❏	❏
Support by supervisor or leadership	❏	❏	❏	❏	❏
Institutional awareness about the importance of genetic and genomic content	❏	❏	❏	❏	❏
Curriculum committee support	❏	❏	❏	❏	❏
Incentive (financial or recognition/praise)	❏	❏	❏	❏	❏
Institutional funding or resources	❏	❏	❏	❏	❏
Ability to secure external funding or resources	❏	❏	❏	❏	❏
Protected time to develop content	❏	❏	❏	❏	❏

Please rate how much you think the following student-related factors influenced your efforts to transfer your knowledge to students. (Faculty/Nursing Faculty Only)

	No Influence	Some influence	Moderate influence	Great influence	Not applicable
Student preparedness (e.g., students’ prerequisite knowledge)	❏	❏	❏	❏	❏
Student perception around applicability of information to their career	❏	❏	❏	❏	❏
Student awareness about the importance of genetic and genomic content	❏	❏	❏	❏	❏
Students’ interest	❏	❏	❏	❏	❏
Students’ self-confidence	❏	❏	❏	❏	❏

Did the Short Course influence your research? (All Attendees)

1. Yes

2. No

[Skip logic: If Yes] Please describe how your experience at the Short Course influenced your research.

To what degree did your experience at the Short Course influence your decision to engage in the following activities? (All Attendees)

	No Influence	Some influence	Moderate influence	Great influence	Not applicable
Presentations at scientific meeting	❏	❏	❏	❏	❏
Attendance at scientific meeting	❏	❏	❏	❏	❏
Involvement in professional organizations	❏	❏	❏	❏	❏
Took additional classes on genetics/genomics	❏	❏	❏	❏	❏
Attended seminars/events on genetics/genomics	❏	❏	❏	❏	❏
Informal genetics/genomics chats	❏	❏	❏	❏	❏
Engaged a mentor in the genetics/genomics field	❏	❏	❏	❏	❏
Became involved in a research group related to genetics/genomics	❏	❏	❏	❏	❏
Conducted research in genetics/genomics	❏	❏	❏	❏	❏
Attended professional meetings related to genetics/genomics	❏	❏	❏	❏	❏
Presented material at various events related to genetics/genomics	❏	❏	❏	❏	❏
Published findings related to genetics/genomics	❏	❏	❏	❏	❏

To what degree did your experience at the Short Course influence your decision to pursue new career or educational options? (All Attendees)

1. No influence

2. Some influence

3. Moderate influence

4. Great influence

5. Not applicable – I did not pursue new career or educational options

[Skip logic: If Yes or variant of Yes] Please describe how the Short Course influenced your decision to pursue new career or educational options.

Since the Short Course, have you been involved with Short Course attendees, NIH or NHGRI? (All Attendees)

1. Yes

2. No

[Skip logic: If Yes] Please indicate the ways you have been involved with Short Course attendees, NIH or NHGRI since attending the program. (Select all that apply)

1. Communications with fellow attendees

2. Additional contact with presenter(s)

3. Additional contact with NIH or NHGRI staff

4. Pursued other training or educational opportunities at NIH

5. Pursued other training opportunities at NHGRI

6. Used NHGRI online resources

7. Involved in writing NIH grant-application

8. Awarded NIH grant

9. Joined NIH Listserv(s) or other forms of communication

10. Other, please specify: _____________

Background Information

This section is focused on demographic information.

What year were you born? (All Attendees)

1. 1999

2. 1998

3. 1997

4. 1996

5. 1995

6. 1994

7. 1993

8. 1992

9. 1991

10. 1990

11. 1989

12. 1988

13. 1987

14. 1986

15. 1985

16. 1984

17. 1983

18. 1982

19. 1981

20. 1980

21. 1979

22. 1978

23. 1977

24. 1976

25. 1975

26. 1974

27. 1973

28. 1972

29. 1971

30. 1970

31. 1969

32. 1968

33. 1967

34. 1966

35. 1965

36. 1964

37. 1963

38. 1962

39. 1961

40. 1960

41. 1959

42. 1958

43. 1957

44. 1956

45. 1955

46. 1954

47. 1953

48. 1952

49. 1951

50. 1950

51. 1949

52. 1948

53. 1947

54. 1946

55. 1945

56. 1944

57. 1943

58. 1942

59. 1941

60. 1940

61. 1939

62. 1938

63. 1937

64. 1936

65. 1935

66. 1934

67. 1933

68. 1932

69. 1931

70. 1930

71. 1929

72. 1928

73. 1927

74. 1926

75. 1925

76. 1924

77. 1923

78. 1922

79. 1921

80. 1920

81. 1919

82. 1918

83. 1917

84. 1916

85. 1915

86. 1914

87. 1913

88. 1912

89. 1911

90. 1910

91. 1909

92. 1908

93. 1907

94. 1906

95. 1905

96. 1904

97. 1903

98. 1902

99. 1901

100. Do not wish to provide

What is your sex? (All Attendees)

1. Male

2. Female

3. Do not wish to provide

What is your ethnicity? (All Attendees)

1. Hispanic or Latino

2. Not Hispanic or Latino

3. Do not wish to provide

What race do you consider yourself? (Select all that apply) (All Attendees)

1. White or Caucasian

2. Black or African American

3. Asian

4. American Indian/Alaska Native

5. Native Hawaiian or other Pacific Islander

6. Do not wish to answer

Do/did you have a disadvantaged background, which can be defined either as coming from a family with an annual income below established low-income thresholds, or coming from an educational environment such as that found in certain rural or inner-city environments that have demonstrably and directly inhibited you from obtaining the knowledge, skills, and abilities necessary to develop and participate in a research career? (All Attendees)

1. Yes

2. No

3. Do not wish to answer

Please enter any other comments you would like to share with us about the Short Course and your experiences since attending the program. If you have no additional comments, please hit the next button. (All Attendees)

This is the end of the survey, thank you for your time, we appreciate your input.

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