1 Survey

Survey Instrument for the Proper Formatting of OMB Approved Forms

OMB # 0925-0764

Expiration Date: 02/2026

PRINCIPLES OF CLINICAL PHARMACOLOGY LECTURE EVALUATION FORM (ONLINE)

Public reporting burden for this collection of information is estimated to average (5) 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0764). Do not return the completed form to this address.

A. Evaluation of Lecture

1. The faculty was knowledgeable and had expertise on the topic.

   1. Strongly agree

   2. Agree

   3. Neutral

   4. Disagree

   5. Strongly Disagree

2. The faculty communicated clearly and effectively.

   1. Strongly agree

   2. Agree

   3. Neutral

   4. Disagree

   5. Strongly Disagree

3. The lecture was informational and expanded my knowledge base.

   1. Strongly agree

   2. Agree

   3. Neutral

   4. Disagree

   5. Strongly Disagree

B. General Impression

1. Technical level of lecture

   1. Appropriate

   2. Too complex

   3. Easy

2. Length of lecture

   1. Appropriate

   2. Too short

   3. Too long

C. Open-ended Feedback

1. OPTIONAL: What were the major strengths of the lecture (50 words max)?

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2. OPTIONAL: Which aspects of the lecture could be improved (50 words max)?

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