TA Feedback Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

tafeedbackform.final.1.18

TA Feedback Form

OMB: 1880-0542

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U.S. Department of Education

Technical Assistance (TA) Participant Feedback



TA feedback form development guidelines: To maximize flexibility with utilizing this collection, any question on the Technical Assistance Participant Feedback Form below may be substituted with a question from the bank of Optional Close-Ended, and Open-Ended, Questions. (See page 3).

Additionally, Likert-scale response options (presented as Strong Disagree, Disagree, Agree, Strongly Agree in the table below) can be revised as necessary to capture data most relevant to the evaluator. The final TA feedback form, however, must be no longer than the front and back of one page or 20 questions, whichever is shorter, with a burden of no more than 5 minutes per respondent.


Technical Assistance Participant Feedback Form

The U.S. Department of Education and the <insert TA program/project title (e.g. State Support Network)> are committed to providing quality technical assistance (TA) services. Please take a few minutes to provide feedback about your experience to help us improve future TA and understand how TA benefits each <state/district/grantee (list one or more of these as appropriate)>. The valid OMB control number for this information collection is 1880-0542.


Title of< TA support, session, webinar, or convening>: <insert appropriate information>


TA Date/Location: <insert appropriate information, including descriptor for virtual or online events>


Please select your affiliation (optional):

  • State educational agency

  • Local educational agency

  • Individual school

  • TA provider or education organization

  • Other (please specify):


Goals and Anticipated Outcomes of TA:

  • <insert appropriate information about the stated goals and outcomes>


Please indicate the extent to which you agree with the following statements regarding this TA.

Strongly Disagree

Disagree

Agree

Strongly Agree

  1. The expertise of <insert name of subject-matter expert> was appropriate for the goals of this <insert appropriate descriptor (e.g., TA support, webinar, convening)>. (repeat for up to 4 experts, if needed) <optional item, to be used only for TA events that feature subject-matter experts>

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  1. As a result of my participation in this <insert appropriate descriptor <TA support / webinar / convening>, I am able to <insert goal #1>. (repeat for up to 4 concrete goals)

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  1. The content of this <TA support / webinar / convening> was directly relevant to meeting the <TA goals and anticipated outcomes >.

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  1. The <knowledge / information / skills / tools > I acquired through this <TA support / webinar / convening> are directly applicable to my work.

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  1. The format of the <insert appropriate descriptor > TA provided ample opportunity for participants to engage meaningfully with others.

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  1. I will share the <knowledge / information / skills / tools > I acquired in this <TA support / webinar / convening> with others.

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  1. As a result of my participation in this <TA support / webinar / convening>, I am better prepared to move forward on <insert topic (e.g., education reform)> goals.

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  1. I was satisfied with the overall quality of the TA resources (e.g., handouts, audiovisuals) that were provided.

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  1. I am satisfied with the overall quality of this <TA support / webinar / convening>.

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  1. What aspects of this <TA support / webinar / convening> were most helpful to <goal to be accomplished> and why?



  1. What additional <TA support /webinar/convening> topics would be helpful for you in accomplishing <goal to be accomplished>?



  1. How will you use what you have learned from <TA support/webinar/convening> in your work moving forward?














According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 5 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210-4537 or email [email protected] and reference the OMB Control Number 1880-0542 Note: Please do not return the completed Qualitative Feedback Survey to this address.

The following items are optional statements and questions that can be added to or substituted for similar questions in the generic feedback form to address the specifics of a particular mode of TA being provided. It is expected that each final TA feedback form will be no longer than the front and back of one page or 20 questions, whichever is shorter, with a burden of no more than 5 minutes per respondent.


Open and closed-ended questions focused on quality of a TA support, webinar, or convening:

  1. I was satisfied with the overall quality of the facilitation.


  1. The registration instructions were easy to follow. <Item especially intended for meetings/conferences/convenings.>


  1. The meeting space was appropriate for this <meeting / webinar / convening>. <Item especially intended for meetings/conferences/convenings.>


  1. Technology was used effectively to enhance my participation in this <TA support / webinar / convening> . <Item especially intended for webinars / conference calls.>


  1. The facilitator was effective at engaging all participants.


  1. The facilitator exhibited flexibility while keeping attention focused on the intended outcomes.


  1. The subject-matter expert<s> <was / were> knowledgeable <about the TA topic>.


  1. The subject-matter expert<s> <was / were> helpful in adding to my understanding of this topic.



  1. I was satisfied with the overall <hosting / support> of the <Community of Practice / Working Group / Learning Community / Peer-to-Peer Exchange> facilitated by the <insert name of TA project (e.g, State Support Network)>.


Open and closed-ended questions focused on relevance of a TA or other event:

  1. The format of this <TA support / webinar / convening> was appropriate for meeting the <TA goals and intended outcomes>.



  1. The structure of the <Community of Practice / Working Group / Learning Community / Peer-to-Peer Exchange> activities made my participation not overly burdensome.


  1. The <Community of Practice / Working Group / Learning Community / Peer-to-Peer Exchange> activities were appropriately focused to meeting my desired outcomes for participation.


  1. The <materials / TA resources > were appropriate given my prior level of knowledge.


Open and closed-ended questions focused on usefulness, effectiveness, or impact of a TA or other

event:

  1. The <TA support / webinar / convening> has increased my knowledge about <insert topic>.


  1. The <TA support/ webinar / convening> has increased my practical skills regarding <insert topic>.


  1. As a result of this <TA support / webinar / convening>, I <understand, can identify> <insert learning objective content>.


  1. This interactive format of bringing together multiple stakeholders from my <state / district / school / agency / program> was beneficial for increasing collaboration. <Item especially intended for meetings/conferences/convenings.>


  1. The session entitled <insert name and room location of particular session> was useful to me and my work.


  1. I found the pre-work or materials provided ahead of time to be helpful in preparing me for this <TA support / webinar / convening>.


  1. This <TA/ individualized TA> experience was useful for helping my <state / district / school / agency / project> achieve its <insert topic (e.g., education reform)> goals.


  1. As a result of this <TA / individualized TA>, my <state / district / school / agency / project> has enhanced capacity to continue moving this work forward.


  1. My participation in this <Community of Practice / Working Group / Learning Community / Peer-to-Peer Exchange> was useful for helping my State/project achieve its <insert topic (e.g., education reform)> goals.


  1. As a result of this <TA support / webinar / convening>, I have a better understanding of resources available to support <insert session topic>.


  1. As a result of this <TA support/ webinar / convening>, I have identified new strategies for overcoming potential barriers related to <insert session topic>.


  1. As a result of this <TA support/ webinar / convening>, I have developed specific action steps or plans for moving forward on <insert session topic> with my state, district, or school.


  1. I am likely to extend what I learned <at / in> this <session / event / meeting / series> by exploring specific topics more deeply on my own.


  1. I am likely to extend what I learned <at / in> this <TA support/ webinar / convening> by joining a group <(e.g., State Support Network Community of Practice)> working on this topic.


  1. I am likely to share what I learned <at / in> this <TA support / webinar / convening> through discussions or presentations with my colleagues.


  1. Please rate your understanding of <insert session topic> before participating in the <session/event/meeting>

  • I had no understanding of the information or topic discussed.

  • I had a slight understanding of the information or topic discussed.

  • I had a moderate understanding of the information or topic discussed.

  • I had a good understanding of the information or topic discussed and could explain it to a colleague.


  1. Please rate your understanding of <insert session topic> after participating in the <session/event/meeting>:

  • I have no understanding of the information or topic discussed.

  • I have a slight understanding of the information or topic discussed.

  • I have a moderate understanding of the information or topic discussed.

  • I have a good understanding of the information or topic discussed and could explain it to a colleague.


Open and closed-ended questions for meetings/conferences/convenings that can be added as needed:

  1. What are some examples of action steps that your <state / district / school / agency / program> is planning to implement as a result of this <meeting/conference/convening>?


  1. Which of the following would be most useful at future <convenings/meetings> (check up to three):

    • More time to discuss with our own <State/project> teams.

    • More time to discuss with other <State/project> teams.

    • More time to learn from experts.

    • More time to work on concrete tasks that will help us move our State/project team work forward.

    • More specific topical focus on (please specify):

    • Other:


Open and closed-ended questions for CoP/Working Groups/Learning Communities/Peer-to-Peer Exchanges that can be added as needed:

  1. What are some examples of action steps that your <state / district / school / agency / program> is planning to implement as a result of participation in this <Community of Practice / Working Group / Learning Community / Peer-to-Peer Exchange>?


  1. What other types of activities would be helpful in achieving the goals of the group?


  1. Does the <CoP/Working Group/Learning Community / Peer-to-Peer Exchange> contain an appropriate composition of participants to achieve its intended outcomes?


Open and closed-ended questions for individualized TA that can be added as needed:

  1. What are some examples of action steps that your <state / district / school / agency / program> is planning to implement as a result of participation in this <TA / individualized TA>?


Open and closed-ended questions for resulting activities/changes in practice that can be added as needed:

  1. Have you made progress toward achieving <insert intended outcome> as a result of participating in <TA support/webinar/convening>? If so, how?


  1. I have not yet engaged in any activities related to the <TA support / webinar / convening>, but have made plans to: (insert planned activities)


  1. After <TA support / webinar / convening>, did you utilize references provided by the presenters? If so, how?


  1. After <TA support/ webinar / convening>, I (check all that apply):

  • Reviewed the materials/resources/handouts by the presenters.

  • Looked up references provided by the presenters.

  • Researched additional materials on the topic.

  • Used the information in drafting internal memos/plans/reports.

  • Used the information in developing new processes/projects/programs.

  • Used the information to overcome a barrier or challenge.

  • Made recommendations to agency leadership or staff.





The valid OMB control number for this information collection is 1880-0542.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleThank you for attending this event supported by the Race to the Top TA Network
Author15067
File Modified0000-00-00
File Created2021-01-21

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