Form 0920-1009 Course Specific Evaluation Questions

Attachment 1. Course Specific Evaluation Questions

Continuing Education Proposal Packet Live Educational Activity and Enduring Materials Course Evaluation

Activity title:

BULLYING PREVENTION ONLINE COURSE

Activity #:

WB2585

Proposed start/release date: (MM/DD/YYYY)

OMB Control No. 0920-1009

Exp. Date 02/29/2020

The public reporting burden of this collection of information is estimated to average 3 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 - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-1009)

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Please take a moment to give us your feedback and write your comments in the boxes provided.

Activity Specific

Very knowledgeable

Knowledgeable

Somewhat knowledgeable

Not at all knowledgeable

Before this training, I was very knowledgeable overall about the issue of bullying and best practices in bullying prevention.

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After this training, I consider myself very knowledgeable overall about the issue of bullying and best practices in bullying prevention and response.

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After this training, I will…

Very likely

Likely

Unlikely

Very Unlikely

Acquaint colleagues/staff about bullying

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Conduct bullying awareness workshop at regional or national conferences

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Hold a bullying awareness workshop for a local chapter/association/meeting of colleagues (single sector)

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Organize a multi-agency/discipline group to convene a town hall or community event to raise awareness

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Organize a multi-agency/discipline group to convene a community event and facilitate action plans for prevention responses

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What profession/sector do you represent?

1.       Education 2.       Healthcare Provider 3.       Safety, First-response, and Law Enforcement 4.       Child Care, After-School & Out-of-School Care 5.       Faith-Based 6.       Private Corporation or Business 7.       Mental Health & Social Service 8.       Parents & Caregivers 9.       Youth Leaders Organizations 10.   City/County Recreation 11.   Policy Maker 12.   Public Health 13.   Other, please specify:__________________

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Please rate how satisfied you are overall with the bullying prevention continuing education online course.

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Strongly Agree

Agree

Neither / Undecided

Disagree

Strongly Disagree

N/A

Overall, the quality of the course was excellent.

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The course met my expectations for the topic.

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I will recommend this course to others.

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What did you like most about the training?

(open-ended)

What aspects of the training could be improved?

(open-ended)

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