0920-0995 Basic Post Course Evaluation

National Network of Sexually Transmitted Disease Clinical Prevention Training Centers (NNPTC): Evaluation

OMB No. 0920-0995

Attachments 29 & 30

Basic Post-Course Evaluation Instrument

Word version and screenshot

TODAY’S DATE

____________________________

M M D D Y Y

Your confidential ID number is the first two letters of your FIRST name, the first two letters of your LAST name, the MONTH of your birth, and the DAY of your birth.

FN	FN	LN	LN	M	M	D	D

CONFIDENTIAL IDENTIFIER

Basic Post-Course Evaluation

Public reporting burden of this collection of information is estimated to average 2 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 (0920-0995).

S1. How satisfied were you with your overall learning experience?

very unsatisfied











very satisfied

S2. How satisfied were you with the quality of the content?

very unsatisfied











very satisfied

S3. How satisfied were you with the trainer(s)?

very unsatisfied











very satisfied

S4. How satisfied were you with the teaching methods?

very unsatisfied











very satisfied

S5. What could improve this training?

A1. As a result of information presented, do you intend to make changes in your practice or at your worksite

setting?

 Yes

 No

 Not my job

 I already use these practices

 Other reason (please specify)____________________________________

A2. If yes, please list at least one intended change.

CE1 Do you believe this activity was influenced by commercial interests?

 Yes

 No

CE2 Was this presentation evidence-based?

 Yes

 No

K1bef. How much did you know about the topics covered in this session BEFORE this training?

no knowledge











all the knowledge

K1aft. How much do you know AFTER the training?

no knowledge











all the knowledge