OBGYN Telecom Training Survey

Form Approved

OMB No. 0920XXXX

Exp. Date xx/xx/20xx

CDC estimates the average public reporting burden for this collection of information as 5 minutes per survey, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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 Information Collection Review Office, 1600 Clifton Road NE, MS D74,

Atlanta, Georgia 30333; ATTN: PRA

(0920XXXX).

OBGYN Telecom Training Satisfaction Survey (TTS)

Please indicate the extent to which you agree with each of the following statements.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
This training mode provided a realistic provider-patient interaction.	1	2	3	4	5
Experiencing the standardized patient’s voice and facial expressions were helpful in this interaction.	1	2	3	4	5
It was just as easy to talk with the patient about substance use in this interactive environment as it would be in real-world training.	1	2	3	4	5
This mode of interacting was distracting from the content of the conversation.	1	2	3	4	5
I noticed a delay in response time while using this method of communicating.	1	2	3	4	5
The standardized patient was skillful and natural in the patient role.	1	2	3	4	5
Feedback from the standardized patient was informative and useful to me.	1	2	3	4	5
I prefer this method of training to real life role plays or simulations.	1	2	3	4	5
Getting set up and started with this technology for training was easy enough.	1	2	3	4	5
This mode of experiential training is an expedient method for learning how to conduct a good intervention.	1	2	3	4	5
I plan to utilize what I’ve learned from this training in my clinical practice.	1	2	3	4	5
Overall, the training met or exceeded my expectations.	1	2	3	4	5

13. What did you like best about this training?
    
    
    
    

14. What suggestions do you have for improving the training?

Thanks for your participation and feedback!

1/22/2021 14:33 a1/p1