Center for Courts CQI Workshops

OMB Control No.: 0970-0484

Expiration Date: XX/XX/XXXX

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, 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.

C QI Workshop Feedback Survey

Please indicate your level of agreement with the following statements.

	Strongly Disagree	2	3	Neither	5	6	Strongly Agree
The materials and information were appropriate for my level of experience and knowledge.	SD	2	3	N	5	6	SA
The CQI Workshop on <<insert topic>> will be helpful in my work.	SD	2	3	N	5	6	SA
Overall, I was satisfied with the CQI Workshop on <<insert topic>>	SD	2	3	N	5	6	SA
The CQI Workshop on <<insert topic>> has increased my knowledge about [Topic 1]. (Insert for each key topic)	SD	2	3	N	5	6	SA
The CQI Workshop on <<insert topic>> has increased my practical skills regarding [Topic 1]. (Insert for each key topic)	SD	2	3	N	5	6	SA
As a result of the [information I learned, knowledge I gained] through the CQI Workshop, I will be a more effective in my work.	SD	2	3	N	5	6	SA
I am confident that I can apply what I have learned in this CQI Workshop to other projects in my state.	SD	2	3	N	5	6	SA

8. Please rate your understanding and/or ability of the following topics both before and after the CQI Workshop on a scale of 1 to 5 (1=Low, 5=High)

Please rate your understanding/ability prior to the CQI Workshop		Please rate your understanding/ability after the CQI Workshop
1 2 3 4 5	General knowledge of << topic>>	1 2 3 4 5
1 2 3 4 5	Understanding of how to measure <<topic>> in practice	1 2 3 4 5
1 2 3 4 5	Ability to develop monitoring/evaluation tool related to << topic>>	1 2 3 4 5
1 2 3 4 5	Ability to incorporate CQI principles into << topic>>	1 2 3 4 5
1 2 3 4 5	Ability to design evaluation/assessment of <<topic>>	1 2 3 4 5

9. What aspects of the CQI Workshop were most relevant and useful for your work?_________________
   __________________________________________________________________________________
   __________________________________________________________________________________

__________________________________________________________________________________

10. Were there ways in which the CQI Workshop could have been more useful to you? (Yes/No)

If yes, please describe how this CQI Workshop could have been more useful? ________________
____________________________________________________________________________________________________________________________________________________________

11. Please provide a specific example of how you plan to apply the information from the CQI Workshop in your work? ________________________________________________________________________
    _________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________

12. Do you have any other comments you would like to share about the CQI Workshop?_______________
    ____________________________________________________________________________________________________________________________________________________________________
    __________________________________________________________________________________