Form 0920-24BS Att A - TCEO PFL Post Training Evaluation Survey Instrum

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

Att A - TCEO PFL Post Training Evaluation Survey Instrument

[NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems

OMB: 0920-1071

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Form Approved

OMB Control No.: 0920-1071

Expiration date: 05/31/2024


CDC Course Evaluation

Live and Enduring Educational Activity


Please take a moment to give us your feedback about this course. Your comments will help us improve future educational activities.

Knowledge, Competence, Practice

How relevant is this course to your current work?

  1. Not at all relevant

  1. Slightly relevant

  1. Moderately relevant

  1. Very relevant

  1. Extremely relevant

Will you use what you learned from this course in your work?

  1. Definitely not

  1. Probably not

  1. Possibly

  1. Probably will

  1. Definitely will

  1. Not applicable, I did not learn anything from this course

How will you use what you learned from this course? I will: (select all that apply)

  1. maintain my competence

  1. increase my competence

  1. improve my performance

  1. provide clinical interventions in practice

  1. develop strategies I can use in practice

  1. other

please specify

  1. not applicable, I did not learn from this course

  1. not applicable, I do not plan to use anything from this course

What do you plan to use from this course?

(if it applies)


How will your team benefit as a result of what you learned?

I will: (select all that apply)

  1. provide better communication across my interprofessional team(s)

  1. share information with colleagues to improve patient education

  1. identify changes needed in practice

  1. increase participation in shared decision making across my interprofessional team(s)

  1. other

please specify

  1. not applicable, I did not learn from the course and/or it will not benefit my team

What factors will keep you from using the content of this course in your work? (select all that apply)

  1. None, I will use this content in my work

  1. I need additional training in the subject matter

  1. I will not have the resources I need

  1. I will not be provided opportunities to use what I learned

  1. I will not have time to use what I learned

  1. My supervisor will not support me in using what I learned

  1. My colleagues will not support me in using what I learned

  1. The course content is not relevant to my current work

  1. Other:

please specify




Presentation


What is your opinion of the balance of lecture and interactivity in this course?

A ) Too much lecture and not enough interactive learning


B ) Right amount of both lecture and interactive learning


C ) Too much interactive learning and not enough lecture


The instructional strategies (lecture, case scenarios, figures, tables, media, etc.) helped me learn.

  1. Strongly disagree


  1. Disagree


  1. Neither/Undecided


  1. Agree


  1. Strongly agree



Strongly disagree


Disagree

Neither/

Undecided


Agree

Strongly

agree


Abigail Carlson presented the content effectively.






Content and Learning Objectives


What part of this course was most helpful to your learning?



How could this course be improved to make it a more effective learning experience?



After completing this course, I can [insert learning objective of the course, i.e., articulate characteristics of COVID-19 that make it a unique healthcare infection control challenge and concern.]

Yes

No


After completing this course, I can [insert learning objectives of the course, i.e., describe how recommended infection control actions work, what each requires to be effective, and the rationale for why they are implemented.]

Yes

No


After completing this course, I can [insert learning objectives of the course, i.e., discuss how to make decisions about my infection control actions, including PPE selection.]

Yes

No


After completing this course, I can [insert learning objectives of the course, i.e., explainhow implementing effective infection prevention and control actions will improve my contribution as a team member.]

Yes

No


Was the content relevant to the learning objectives?

Yes

No


Did the content address an educational need or practice gap?

Yes

No

Not sure


Was the learning environment conducive to learning?

Yes

No


Do you believe this course was influenced by commercial interests?

Yes

No


If yes, please explain.



What are your recommendations for improvements to the CDC’s Training and Continuing Education Online (TCEO) system?






Activity Specific

OMB- Paperwork Reduction Act (PRA) determination is required for any additional questions beyond the standard CE evaluation questions. Also ensured PRA compliance (if determined necessary) by CIO PRA lead.


Form Approved OMB Control #: 0920-1071 Expiration Date: 5/31/2024


Which of the following best describes your professional role? (Select one.)

  1. Physician



  1. Physician assistant



  1. Advanced practice nurse (e.g. nurse practitioner)



  1. Registered nurse (RN)



  1. Licensed practical nurse (LPN)



  1. Nursing/medical assistant

  2. Dentist/dental hygienist



  1. Technician (ex: radiology, surgical, pharmacy, etc.)



  1. Pharmacist



  1. Therapist (ex: physical, occupational, respiratory, etc.)



  1. Environmental/facility services (e.g. EVS staff, facility manager, facility engineers)



  1. Social and community services



  1. Healthcare administrator (e.g. clinic or hospital directors, CEO’s)



  1. Non-clinical staff (e.g. HR personnel, marketing communications, quality/patient safety, clerical)



  1. Emergency medical technician/paramedic



  1. Laboratory staff



  1. Public health professional



  1. None of the above



Which of the following best describes your primary workplace? (Select one.)

  1. Acute care hospital

  1. Critical access hospital

  1. Long-term acute care hospital or inpatient rehabilitation facility

  1. Skilled nursing facility (nursing home)

  1. Assisted living facility

  1. Dialysis facility (outpatient)

  1. Outpatient ambulatory care—not dialysis (e.g. medical, surgical, behavioral health clinic)

  2. Pharmacy

  1. Dental facility

  1. Home health

  1. Health department


i)State health department


ii)Territorial health department



iii)Local health department

iv)Tribal health department


None of the above


What state, territory, or IHS region do you work? You can make up to two selections.

IHS Area – National

IHS Area – Alaska


IHS Area – Albuquerque


IHS Area – Bemidji


IHS Area – Billings


IHS Area – California


IHS Area – Great Plains


IHS Area – Nashville


IHS Area – Navajo


IHS Area – Oklahoma


IHS Area – Phoenix


IHS Area – Portland


IHS Area – Tucson


Alabama


Alaska


American Samoa


Arizona


Arkansas


California


Colorado


Connecticut


Delaware


District of Columbia


Federated States of Micronesia


Florida


Georgia


Guam


Hawaii


Idaho


Illinois


Indiana


Iowa


Kansas


Kentucky


Louisiana


Maine


Marshall Islands


Maryland


Massachusetts


Michigan


Minnesota


Mississippi


Missouri


Montana


Nebraska


Nevada


New Hampshire


New Jersey


New Mexico


New York


North Carolina


North Dakota


Northern Mariana Islands


Ohio


Oklahoma


Oregon


Palau


Pennsylvania


Puerto Rico


Rhode Island


South Carolina


South Dakota


Tennessee


Texas


Utah


Vermont


Virgin Islands


Virginia


Washington


West Virginia


Wisconsin


Wyoming


N/A: Outside of the U.S


Would you recommend this training to others? (Select one.)

Yes

No

Not sure


Has your overall understanding of [insert course topic, i.e.. COVID-19 and infection control] improved after this training?(Select one.)

Yes

No

Not sure









































Public reporting burden of this collection of information is estimated to average 10 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 H21-8, Atlanta, Georgia 30333; ATTN: PRA 0920-1071

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