National Network of Sexually Transmitted Disease Clinical Prevention Training Centers (NNPTC): Evaluation
OMB No. 0920-0995
Attachments 13 & 14
Practicum 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. |
CONFIDENTIAL IDENTIFIER |
Practicum Post-Course Evaluation
Public reporting burden of this collection of information is estimated to average 4minutes 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 |
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very satisfied |
S2 How satisfied were you with the quality of the content?
very unsatisfied |
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very satisfied |
S3 How satisfied were you with the trainer(s)?
very unsatisfied |
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very satisfied |
S4 How satisfied were you with the teaching methods?
very unsatisfied |
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very satisfied |
S5 What could improve this training?
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CE1 Do you believe this activity was influenced by commercial interests?
Yes
No
CE2 Was this presentation evidence-based?
Yes
No
CE3a Were the learning objectives met?
Yes
No
CE3b If the learning objectives were not met, please explain.
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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.
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SKILLS |
SK2bef How confident were you in your ability to list the steps in the appropriate order for
conducting an STD-oriented male genital exam BEFORE this training?
not at all confident |
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very confident |
SK2aft How confident are you AFTER the training?
not at all confident |
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very confident |
SK3bef How confident were you in your ability to identify the testis, epididymis and spermatic cord by
palpation BEFORE this training?
not at all confident |
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very confident |
SK3aft How confident are you AFTER the training?
not at all confident |
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very confident |
SK4bef How confident were you in your ability to use or direct patients to use the
correct techniques to obtain STD test specimens for male patients BEFORE this training?
not at all confident |
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very confident |
SK4aft How confident are you AFTER the training?
not at all confident |
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very confident |
SK5bef How confident were you in your ability to list the steps in the appropriate order for conducting an
STD-oriented female genital exam BEFORE this training?
not at all confident |
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very confident |
SK5aft How confident are you AFTER the training?
not at all confident |
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very confident |
SK6bef How confident were you in your ability to palpate the uterus and adnexa by bimanual exam BEFORE
this training?
not at all confident |
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very confident |
SK6aft How confident are you AFTER the training?
not at all confident |
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very confident |
SK7bef How confident were you in your ability to use or direct patients to use the correct techniques to
obtain STD test specimens for female patients BEFORE this training?
not at all confident |
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very confident |
SK7aft How confident are you AFTER the training?
not at all confident |
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very confident |
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Course Design and Delivery |
| Author | dreisbach |
| File Modified | 0000-00-00 |
| File Created | 2022-02-24 |