Documente Academic
Documente Profesional
Documente Cultură
NAME OF INSTITUTION
The purpose of this survey instrument is to evaluate our program resources. The data compiled will aid
the program in an ongoing process of program improvement.
INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
Comments:
Comments:
Comments:
2
INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
B. CLINICAL INSTRUCTION
1. Students are adequately oriented to assigned clinical
areas, and procedures. 5 4 3 2 1 N/A
2. Clinical instructors are sufficiently knowledgeable to
provide student instruction. 5 4 3 2 1 N/A
3. Clinical instructors direct the students in completing the
assigned objectives. 5 4 3 2 1 N/A
4. Clinical instructors are consistent in their evaluation of
student performance. 5 4 3 2 1 N/A
5. Clinical instructors are readily available to assist
students when needed. 5 4 3 2 1 N/A
Comments:
V. PHYSICIAN INTERACTION
A. Physician/student interaction facilitates the
development of effective communication skills
between physicians and students. 5 4 3 2 1 N/A
Comments:
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VI. ADDITIONAL COMMENTS
OVERALL RATING:
Please rate the OVERALL quality of the resources supporting the program. (Circle one)
Based on your experience, which program resources provided you with the most support?
Please provide comments and suggestions what would help to improve the program's overall
resources.
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PROGRAM PERSONNEL
PROGRAM RESOURCE SURVEY
NAME OF INSTITUTION
The purpose of this survey instrument is to evaluate our program resources. The data compiled will
aid the program in an ongoing process of program improvement. Unless specified, all sections
should be completed by program faculty, Medical Director, and Advisory Committee.
INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
I. PERSONNEL RESOURCES
A. PROGRAM FACULTY (Completed by Medical Directors & Advisory Committee Members)
1. Faculty keep the Advisory Committee informed of
program status. 5 4 3 2 1 N/A
2. Faculty encourage and utilize input from the advisory
board/communities of interest. 5 4 3 2 1 N/A
3. Faculty fosters positive relations with clinical affiliates. 5 4 3 2 1 N/A
4. Faculty encourage student participation in professional
activities. 5 4 3 2 1 N/A
5. Faculty request annual review of goals and standards
by the Advisory Committee. 5 4 3 2 1 N/A
Comments:
II. FACILITIES
A. Classrooms
1. Are adequate in size 5 4 3 2 1 N/A
2. Have adequate lighting 5 4 3 2 1 N/A
3. Contain adequate seating. 5 4 3 2 1 N/A
4. Have adequate ventilation. 5 4 3 2 1 N/A
5. Are provided with appropriate equipment to
support effective instruction. 5 4 3 2 1 N/A
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INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
B. Laboratory
1. Is adequate in size 5 4 3 2 1 N/A
2. Has adequate lighting 5 4 3 2 1 N/A
3. Contains adequate seating 5 4 3 2 1 N/A
4. Has adequate ventilation 5 4 3 2 1 N/A
5. Is accessible to students outside regularly
scheduled class times. 5 4 3 2 1 N/A
Comments:
Comments:
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INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
B. PROGRAM BUDGET
1. Provides for sufficient access to functioning and
up-to-date equipment to achieve classroom and laboratory
competencies. 5 4 3 2 1 N/A
2. Provides for supply purchases necessary to achieve the
program's classroom and laboratory competencies. 5 4 3 2 1 N/A
3. Provides for a sufficient number of faculty for didactic
(classroom) instruction. 5 4 3 2 1 N/A
4. Provides for a sufficient number of faculty for laboratory
and clinical instruction. 5 4 3 2 1 N/A
5. Provides for adequate continuing professional development
of full-time faculty. 5 4 3 2 1 N/A
Comments:
VII.CLINICAL RESOURCES
A. CLINICAL ROTATIONS
1. Facilities
a. The clinical facilities offer an adequate number
of procedures for the student to meet
clinical objectives. 5 4 3 2 1 N/A
b. The clinical facilities offer an adequate
variety of procedures for the student to meet
clinical objectives. 5 4 3 2 1 N/A
c. The clinical facilities provide adequate
exposure to current equipment. 5 4 3 2 1 N/A
2. Experiences
a. Each clinical rotation is of sufficient length
to enable the student to complete clinical
objectives/competencies. 5 4 3 2 1 N/A
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INSTRUCTIONS: Consider each item separately and rate each item independently of all others.
Circle the rating that indicates the extent to which you agree with each statement. Please do not
skip any rating. If you do not know about a particular area, please circle N/A.
5 = Strongly Agree 4 = Generally Agree 3 = Neutral (acceptable) 2 = Generally Disagree 1 = Strongly Disagree N/A = Not Applicable
Comments:
Comments:
OVERALL RATING:
Please rate the OVERALL quality of the resources supporting the program: (Please circle one)
Based on your experience, which program resources provide students with the most support?
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Based on your experience, which program resources could be improved?
Please provide comments and suggestions that would help to improve the program's overall resources.
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RESOURCE ASSESSMENT MATRIX
(TO BE COMPLETED AT LEAST ANNUALLY)
MEASUREMENT DATE(S) OF RESULTS - ANALYSIS
# RESOURCE PURPOSE(S) ACTION PLAN
SYSTEM MEASUREMENT (COMPOSITE SUMMARY)
1 FACULTY
2 MEDICAL
DIRECTOR(S)
3 SUPPORT
PERSONNEL
4 FACILITIES
5 LABORATORY
EQUIPMENT
AND
SUPPLIES
PROGRAM RESOURCE ASSESSMENT MATRIX Continued
7 FINANCIAL
RESOURCES
8 CLINICAL
RESOURCES
9 PHYSICIAN
INPUT
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SAMPLE RESOURCE ASSESSMENT MATRIX
(TO BE COMPLETED AT LEAST ANNUALLY)
MEASURE- DATE(S) OF RESULTS - ANALYSIS
# RESOURCE PURPOSE(S) ACTION PLAN
MENT SYSTEM MEASUREMENT (COMPOSITE SUMMARY)
1 FACULTY To provide effective 1) Student 1) May each year. 1) All students surveyed in 2001 related Continue to monitor.
laboratory, classroom resource 2) May each year. the number of faculty at or above the
and clinical surveys. "cut score" of 3 on a 5 point Likert
instruction to insure 2) Faculty resource scale.
that the program's surveys. 2) All faculty surveyed in 2001 rated
goals and objectives the number of faculty at or above the
are met. "cut score" of 3 on a 5 point Likert
scale.
2 MEDICAL To provide effective 1) Student 1) May each year. 1) All students surveyed in 2001 related Continue to monitor.
DIRECTOR(S) medical direction and resource 2) May each year. the Medical Director at or above the
administration for the surveys. "cut score" of 3 on a 5 point Likert
program to insure 2) Faculty resource scale.
that current standards surveys. 2) All faculty surveyed in 2001 rated
of medical practice the Medical Director at or above the
are met. "cut score" of 3 on a 5 point Likert
scale.
3 SUPPORT To provide clerical 1) College Word 1) May each year. 1) Both full time faculty surveyed in The College is evaluating ways
PERSONNEL support for the Processing Services 2) May each year. 2001 rated all W.P. services to be less to re-allocate the workload of
program. Evaluations. than desirable. the clerical support staff to
2) Faculty resource 2) All faculty surveyed in 2001 rated better serve the faculty and
surveys. support personnel below the "cut score" program needs.
of 3 on a 5 point Likert scale.
4 FACILITIES To provide adequate 1) Student 1) May each year. 1) All students surveyed in 2001 rated Continue to monitor.
classroom, laboratory resource 2) May each year. Facilities at or above the "cut score" of
and office space and surveys. 3 on a 5 point Likert scale.
accommodations to 2) Faculty resource 2) All faculty surveyed in 2001 rated
insure that the surveys. Facilities at or above the "cut score" of
program's goals and 3 on a 5 point Likert scale.
standards are met.
5 LABORATORY To provide students 1) Student 1) May each year. 1) All students surveyed in 2001 rated The faculty has developed a 3-
EQUIPMENT with the equipment resource 2) May each year. lab equipment and supplies below the year financial plan to address
AND SUPPLIES and exercises that surveys. "cut score" of 3 on a 5 point Likert equipment and supply needs.
will adequately 2) Faculty resource scale. We will continue to track the
prepare them for surveys. 2) All faculty surveyed in 2001 rated progress being made.
clinical practice. lab equipment and supplies below the
"cut score" of 3 on a 5 point Likert
scale.
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SAMPLE PROGRAM RESOURCE ASSESSMENT MATRIX Continued
MEASUREMENT DATE(S) OF RESULTS - ANALYSIS
# RESOURCE PURPOSE(S) ACTION PLAN
SYSTEM MEASUREMENT (COMPOSITE SUMMARY)
6 LIBRARY To support student 1) Student resource 1) May each year. 1) All students surveyed in 2001 rated Continue to monitor.
needs for surveys. 2) May each year. the library resources at or above the
supplemental 2) Faculty resource "cut score" of a 3 on a 5 point Likert
reading, electronic surveys. scale.
and print reference 2) All faculty surveyed in 2001 rated
materials, research the library resources 5 on a 5 point
and computing Likert scale.
resources.
7 FINANCIAL To provide 1) Program budget 1) May each year. 1) Operating budgets for the last five Budget Process. Budget
RESOURCES adequate fiscal analysis 2) May each year. years have been adequate. Personnel allocations have been made to
support for the required.2) (instructional) budgets for the last update and expand the
retention of Faculty resource five years have been adequate. laboratory equipment &
personnel and the surveys 2) All faculty surveyed in 2001 rated supply concerns noted above.
acquisition and financial resources above the "cut
maintenance of score" or 3 on a 5 point Likert scale.
equipment and
supplies
8 CLINICAL To provide a 1) Student resource 1) May each year. 1) All students surveyed in 2001 rated Continue to monitor.
RESOURCES sufficient variety surveys. 2) May each year. the clinical resources above the "cut
of tasks and 2) Faculty resource score" of a 3 on a 5 point Likert scale.
procedures for surveys. 2) All faculty surveyed in 2001 rated
instruction to allow the clinical resources 3 on a 5 point
for student mastery Likert scale.
of the program's
required clinical
competencies.
9 PHYSICIAN To assure that 1) Student resource 1) May each year. 1) All students surveyed in 2001 Continue to monitor.
INPUT program graduates surveys. 2) May each year. rated physician instructional input
can communicate 2) Faculty resource above the "cut score" of 3 on a 5
and work surveys. point Likert scale.
effectively with 2) All faculty surveyed in 2001 rated
physicians in a physician instructional input above
confident and the "cut score" of 3 on a 5 point
professional Likert scale.
manner.
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GRADUATE SURVEY
The primary goal of an Anesthesiologist Assistant Education program is to prepare the graduate to function as a competent
Anesthetist. This survey is designed to help the program faculty determine the strengths and areas for improvement for our
program. All data will be kept confidential and will be used for program evaluation purposes only.
BACKGROUND INFORMATION:
Name of Graduate:
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Circle the rating
that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know
about a particular area, please circle N/A.
5=Strongly Agree 4 =Generally Agree 3 =Neutral (acceptable) 2 =Generally Disagree 1 =Strongly Disagree N/A =Not Applicable
Comments:
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Circle the rating
that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know
about a particular area, please circle N/A.
5=Strongly Agree 4 =Generally Agree 3 =Neutral (acceptable) 2 =Generally Disagree 1 =Strongly Disagree N/A =Not Applicable
Cardiac 5 4 3 2 1 N/A
Vascular 5 4 3 2 1 N/A
Peds 5 4 3 2 1 N/A
OB/GYN 5 4 3 2 1 N/A
Thoracic 5 4 3 2 1 N/A
Regional 5 4 3 2 1 N/A
Neuro 5 4 3 2 1 N/A
Trauma 5 4 3 2 1 N/A
ENT 5 4 3 2 1 N/A
Comments:
15
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Circle the rating
that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know
about a particular area, please circle N/A.
5=Strongly Agree 4 =Generally Agree 3 =Neutral (acceptable) 2 =Generally Disagree 1 =Strongly Disagree N/A =Not Applicable
Comments:
Comments:
Please rate and comment on the OVERALL quality of your preparation as an ENTRY-LEVEL Anesthetist.
Comments:
16
VI. ADDITIONAL COMMENTS
Based on your work experience, please identify two or three strengths of the program.
Based on your work experience, please make two or three suggestions to further strengthen the
program.
What qualities/skills (if any) were expected of you upon employment, that were not included in the
program?
Please provide comments and suggestions that would help to better prepare future graduates.
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EMPLOYER SURVEY
The primary goal of an Anesthesiologist Assistant Education program is to prepare the graduate to function as a competent
ENTRY-LEVEL Anesthetist. This survey is designed to help the program faculty determine the strengths and areas for
improvement for our program. All data will be kept confidential and will be used for program evaluation purposes only.
We request that this survey be completed by the graduates immediate supervisor.
BACKGROUND INFORMATION:
Name of Graduate:
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Circle the rating
that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know
about a particular area, please circle N/A.
5=Strongly Agree 4 =Generally Agree 3 =Neutral (acceptable) 2 =Generally Disagree 1 =Strongly Disagree N/A =Not Applicable
Comments:
18
INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Circle the rating
that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know
about a particular area, please circle N/A.
5=Strongly Agree 4 =Generally Agree 3 =Neutral (acceptable) 2 =Generally Disagree 1 =Strongly Disagree N/A =Not Applicable
Comments:
Comments:
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IV. OVERALL RATING:
Please rate and comment on the OVERALL quality of this programs graduate.
Comments:
What qualities or skills (if any) did you expect of the graduate upon employment that he/she did not possess?
Please provide comments and suggestions that would help this program to better prepare future graduates.
If given the opportunity, would you hire another graduate from this program? YES NO
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GRADUATE & EMPLOYER FEEDBACK MATRIX
(TO BE COMPLETED FOLLOWING EACH GRADUATING CLASS)
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"SAMPLE" GRADUATE & EMPLOYER FEEDBACK MATRIX
(TO BE COMPLETED FOLLOWING EACH GRADUATING CLASS)
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