Survey Modifications

Attachment 4 Details of Survey Modifications.pdf

Impact of Clinical Research Training and Medical Education at the Clinical Center on Physician Careers in Academia and Clinical Research

Survey Modifications

OMB: 0925-0602

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Previous NIH-Duke Master’s Program Alumni Survey

Updated NIH-Duke Master’s Program Alumni Survey.
The updated survey models the current existing CRTP/MRSP Alumni Survey already approved by OMB.
New questions are highlighted.

NIH-Duke Master’s Program in Clinical
Research

OMB #0925-0602; expires 3/31/2016

Mentor
Tutor

Project Title
Secondary Project Title

Previous Introduction to the Principles and Practice of Clinical Research Alumni Survey
This alumni survey is being discontinued. No questions from this survey will be transferred to the replacement
survey which is an end of course evaluation.

Introduction to the Principles and Practice of Clinical Research (IPPCR) Al...
Please take a few minutes to complete the survey below, which invites you to retrospectively evaluate the IPPCR Course. 
OMB #0925­0602. Expires 8/31/2012. 
­question survey, the NIH Office of Clinical Research Training and Medical Education (OCRTME) 
seeks to (a) identify opportunities that will enhance the clinical research training we provide and (b) stay better connected 
with you and other participants. 
Please note that the information you share with us will only be accessible to authorized OCRTME staff. When reported 
external to the office as part of our quality improvement process, all feedback will be anonymous and reported in the 
aggregate. 
Thank you for helping us to improve and stay connected. 

Burden Disclosure Statement: Public reporting burden for this collection of information is estimated to average 20 
minutes per survey, 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 20892­7974, ATTN: PRA (0925­0602). Do not return the completed form to this address. 
Privacy Act Notification Statement: This is not a government website or application. The agency’s Privacy Policy does 
not apply. The agency’s Privacy Policy is located at http://www.nih.gov/about/privacy.htm 
This website is operated by a third party to engage with the public on behalf of the National Institutes of Health (NIH) 
Office of Clinical Research Training & Medical Education. Collection of this information is authorized under 42 U.S.C. 282
(b) (13), 284(b)(1)(C), 241, 242l, 282(b)(10), 284(b)(1)(K), 42 CFR Part 63, and 42 CFR Part 61, Subpart A. The primary 
use of this information is for evaluation of clinical and research training at the National Institutes of Health. The personally 
identifiable information collected via the SurveyMonkey website is used and maintained by NIH. Information is not shared 
with external parties. Additional disclosures may be made to law enforcement agencies concerning violations of law or 
regulation. Information provided is voluntary; however, in order for us to complete the evaluation process, you must 
complete the required fields.  
Information about clinical and research training is available on the NIH website at http://www.cc.nih.gov/training/ 
Questions pertaining to information collected from this website may be sent to mailto:cc­od­[email protected] 

Page 1

IPPCR Alumni Survey - One Year

*1. Which term did you take the NIH Principals and Practice of Clinical Research Course?
j 2010 ­ 2011
k
l
m
n
j 2011 ­ 2012
k
l
m
n
j 2012 ­ 2013
k
l
m
n
j 2013 ­ 2014
k
l
m
n
j 2014 ­ 2015
k
l
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n
j 2015 ­ 2016
k
l
m
n

*2. What is your preferred e­mail address?
3. Do you have an alternate e­mail address?
5
6

*4. What professional degree do you hold?
c M.D.
d
e
f
g
c Ph.D.
d
e
f
g
c J.D.
d
e
f
g
c Master's
d
e
f
g
c Other (please specify)
d
e
f
g

*5. What is the name of your current employer/institution?
5
6

Page 2

IPPCR Alumni Survey - One Year

*6. Employer/Institution type
j Academic
k
l
m
n
j NIH
k
l
m
n
j Government regulatory agency
k
l
m
n
j Pharmaceutical
k
l
m
n
j Other research
k
l
m
n
j Private Practice
k
l
m
n
j Other (please specify)
k
l
m
n

*7. Are you currently performing clinical and/or translational research?
j Yes
k
l
m
n
j No
k
l
m
n

*8. What is the overall degree of impact the IPPCR course has on your professional

career?

j No Impact
k
l
m
n
j Little Impact
k
l
m
n
j Some Impact
k
l
m
n
j Much Impact
k
l
m
n
j Considerable Impact
k
l
m
n

*9. What degree of impact did the IPPCR course have on your ability to:
Perform successfully in an 

No Impact

Little Impact

Some Impact

Much Impact

Considerable Impact

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
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m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

academic or research 
setting
Perform successfuly in a 
non­academic or non­
research setting

*10. What were the best parts of the IPPCR course?
5
6

Page 3

IPPCR Alumni Survey - One Year

*11. What was missing from or could be improved about the IPPCR course?
5
6

*12. How likely are you to recommend the IPPCR course to prospective research­

oriented applicants?
j Unlikely
k
l
m
n
j Somewhat Likely
k
l
m
n
j Likely
k
l
m
n
If "Unlikely" please explain 

*13. Please provide any additional comments about the IPPCR course or research

training at the NIH.

5
6

Page 4

Introduction to the Principles and Practice of Clinical Research Course Evaluation
This course evaluation is replacing the above alumni survey to receive feedback about the
course to make improvements for future participants. No questions from the previous alumni
survey are included in this course evaluation.

OMB #0925-0602 Expires 3/31/2016

Previous Principles of Clinical Pharmacology Alumni Survey
This alumni survey is being discontinued. No questions from this survey will be transferred to the
replacement survey which is an end of course evaluation.

Principles of Clinical Pharmacology Course Evaluation
This course evaluation is replacing the above alumni survey to receive feedback about the course to
make improvements for future participants. No questions from the previous alumni survey are included
in this course evaluation.

OMB #0925-0602 Expires 3/31/2016


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Authorsimmonsjn
File Modified2016-08-24
File Created2016-08-24

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