Form Approved
OMB No. 0920-1163
Expiration Date: 02/28/2026
Attachment 3. 2024 EIS Supervisor Exit Survey
Form
Approved
OMB No. 0920-1163
Expiration Date: 02/28/2026
You are being asked to complete this survey because of your role as a primary supervisor for an Epidemic Intelligence Service (EIS) officer. We appreciate your dedication to training and mentoring your EIS officer. The purpose of this survey is to identify ways to improve the supervisor and host site experience and to assess to what extent your EIS officer has contributed to your host site and public health in general.
Your participation is completely voluntary. Your individual responses will be kept secure and not shared. Only CDC Epidemiology and Laboratory Workforce Branch (including EIS program staff) and CDC Division evaluation staff will have access to your responses. Results from the survey will be reported in aggregate. We ask that this survey be completed by the supervisor who is most familiar with the EIS officer’s work and interactions within the host site. Please email [email protected] if you would like to request a different individual complete the survey for the officer.
We estimate that it will take approximately 20 minutes to complete this survey. This survey link is unique to you, so please don’t forward it to others. You will be able to return to the survey to edit or update your responses at any time prior to the survey closing date on [DATE].
Please contact [email protected] if you have any questions regarding this survey.
Notice: By continuing to the next screen, you consent to complete this survey.
The public reporting burden of this collection of information is estimated to average 20 minutes per response, including 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 ATT: PRA (0920-1163)
Including this EIS officer, how many EIS officers have you supervised as a primary or secondary supervisor? * Open response (numerical)
For the following questions, please consider your experience over the past year. * [Multiple choice]
How frequently did you ________________ |
Nearly every day (4–5 days a week) |
Two or three days a week |
Once a week |
Once every two weeks |
Once a month |
<1 day a month |
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The
following questions are optional. Responses will only be presented in
aggregate, and no identifying information will be linked to
individual responses. These data will be used to better understand
the diversity of our host site supervisors.
What is your race and/or ethnicity? Select all that apply.
American Indian or Alaska Native
For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.
Asian
For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.
Black or African American
For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.
Hispanic or Latino
For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.
Middle Eastern or North African
For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.
Native Hawaiian or Pacific Islander
For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijan, Marshallese, etc.
White
For example, English, German, Irish, Italian, Polish, Scottish, etc.
*Are you: Mark all that apply.
Female
Male
Transgender, non-binary, or other gender
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Strongly Disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly Agree |
Not Applicable |
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If you selected “strongly disagree” or “disagree,” please explain in the space provided below. (Open text)
Please identify any support services or training that you did not receive from the EIS program during the past 2 years that would have improved your experience. * (Open text)
In what topic(s) or skill(s) did your EIS officer need additional training or support (e.g., statistical analysis, leadership development)? (Please list) (Open text)
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Strongly Disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly Agree |
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If
you selected “strongly disagree” or “disagree,”
please explain in the space provided below. (Open
text)
Reflecting on your experience supervising the officer, to what extent do you agree or disagree with the following statement: The EIS officer has been able to contribute to the team/work unit at my host site. *
Strongly disagree (Skip to Page 6)
Disagree (Skip to Page 6)
Neither agree nor disagree (Skip to Page 6)
Agree (Skip to Page 7)
Strongly
agree (Skip
to Page 7)
For the previous question, you selected [strongly disagree, disagree, or neither agree nor disagree]. Please explain your response. * (Open text)
Page skips to Page 8
For the previous question, you selected [strongly agree or agree]. We are interested in learning more about how the EIS officer has contributed to your host site during the fellowship. Describe the EIS officer’s most meaningful contribution to your host site. * (Open text)
Which of the following resulted from the officer’s activities during the fellowship? Select all that apply. *
Include
results where the EIS officer made a meaningful contribution.
Include
direct (e.g., officer drafted
formal guidance) and indirect (e.g., officer's work informed
formal guidance) results from officer’s activities.
Findings, recommendations, tools, or resources shared with others [aware1] [skip to page 9]
Peer-reviewed manuscript(s), including MMWRs [science1]
Non-peer-reviewed report(s) [science2]
Presentation(s) at conference(s) [science3]
Presentation(s) to partners [science4]
New or revised tool(s)/method(s)/technology developed (e.g., R script, algorithm, dashboard) [action2]
New or revised resource(s) developed (e.g., training) [action3]
New or improved partnership(s) or collaboration(s) [action4]
Further studies or analyses are planned or underway (based on the officer’s work) [action5]
Surveillance system(s) improved [change1]
New surveillance system(s) created [change2]
Information system(s) improved [change3]
New information system(s) created [change4]
New or revised public health policies or procedures [change5]
New or revised policies or procedures in the healthcare setting [change6]
New or revised formal public health guidelines or recommendations (e.g., World Health Organization, Advisory Committee on Immunization Practices) [change7]
New or revised public health regulations or laws [change8]
New or increased funding [change9]
New or revised programs or interventions developed [change10]
Increased public health capacity [change11]
Morbidity or mortality reduced or prevented [future1]
Health inequities reduced [future2]
New or revised programs or interventions (e.g., treatment, vaccine, infection control) implemented [future3]
Economic benefits (e.g., hospitals saved money) [future4]
None of the above [skip to page 11]
Other
(describe any other direct
and indirect results from officer’s activities): (Open text)
In the previous question, you indicated that findings, recommendations, tools, or resources were shared with others. Which group(s) were the findings, recommendations, tools, or resources shared with? Select all that apply. *
Public (e.g., presentation to lay audience, public campaign, social media, web, news)
Public health officials (e.g., presentation to STLT/federal health officials, Health Alert Network (HAN) alert)
Healthcare providers
Other partners (e.g., community-based organizations)
Policymakers/decision-makers
Congressional hearing materials
Other (please specify): ______________
Please elaborate on a up to 3 results that you selected in the previous questions.
Example 1
Which result does this example elaborate upon? [Dropdown list from Question 16]
Textbox 1: For this example, include the following information:
What activities and projects did the EIS officer lead or support that led to this result?
What areas of public health did the activities pertain to?
Who did these activities affect? Who did the result affect?
Example 2
Which result does this example elaborate upon? [Dropdown list from Question 16]
Textbox 2: For this example, include the following information:
What activities and projects did the EIS officer lead or support that led to this result?
What areas of public health did the activities pertain to?
Who did these activities affect? Who did the result affect?
Example 3
Which result does this example elaborate upon? [Dropdown list from Question 16]
Textbox 3: For this example, include the following information:
What activities and projects did the EIS officer lead or support that led to this result?
What areas of public health did the activities pertain to?
Who did these activities affect? Who did the result affect?
Do you plan to serve as a supervisor for another EIS officer in the future? *
Yes
No
Undecided
If you selected “No” or “Undecided,” please explain: (Open text)
Would you recommend participation as a host site for other CDC or field sites? *
Yes
No
Undecided
If you selected “no” or “undecided,” please explain: (Open text)
Please comment on anything else you would like the EIS program to know about your experience supervising an EIS officer. (Open text)
Thank you for taking the time to complete the EIS Supervisor Exit Survey. Please click "Done" to submit your responses.
We value your feedback. If you have any questions about this survey, please email [email protected].
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | McColloch, Caitlin (CDC/PHIC/DWD) |
File Modified | 0000-00-00 |
File Created | 2024-11-14 |