LPN Educational Needs Assessment

This survey is to be completed by Licensed Practical nurses only. If you are an RN, please exit and select the appropriate survey.

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1. How many years have you been in practice?

How many years have you been in practice?

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2. Please indicate your age.

Please indicate your age.

3. Please indicate the area that best describes your place of employment:

Please indicate the area that best describes your place of employment: Hospital

Ambulatory care center

Long-term care facility

Self-employed

Rehabilitation center

Physician's office or clinic

Other (please specify)

4. What is your level of interest in a program which would allow you to earn a higher degree>

What is your level of interest in a program which would allow you to earn a higher degree> Very interested

Somewhat interested

Not interested

5. If you are interested in such a program, what is your preferred method of teaching/course delivery?

If you are interested in such a program, what is your preferred method of teaching/course delivery? Traditional classroom lecture

Compressed video from remote sites (Live, interactive audio/video classes transmitted from a remote site to a central reception location)

Web-based online courses (Non-clinical courses offered entirely via the Internet)

6. If such a program is offered via compressed video or traditional classroom methods, how far will you be willing to travel to participate in these courses?

If such a program is offered via compressed video or traditional classroom methods, how far will you be willing to travel to participate in these courses? 20-40 miles once or twice weekly

40-60 miles twice weekly

More than 60 miles once or twice weekly

If I have to travel, I cannot enter the program

7. For a web-based online program, the following are required:
-PC which is capable of running Windows XP OR Mac 32 bit 10.2 or 10.3
-Software: MS Office and Internet Explorer
-Internet access: DSL or Cable modem connection with Internet service provider (no dial-up)

Please choose the one that best describes your access for a web-based online program:

For a web-based online program, the following are required: -PC which is capable of running Windows XP OR Mac 32 bit 10.2 or 10.3 -Software: MS Office and Internet Explorer -Internet access: DSL or Cable modem connection with Internet service provider (no dial-up) Please choose the one that best describes your access for a web-based online program: I have the necessary computer requirements

I will be able to acquire the necessary computer requirements

I do not have one or more of the necessary requirements, and will be unable to acquire it.

8. Would the availability of financial assistance affect your decision to enter and complete the program?

Would the availability of financial assistance affect your decision to enter and complete the program? Yes

No

9. If enrolled, would you attend on a full-time or part-time basis?

If enrolled, would you attend on a full-time or part-time basis? Full-time

Part-time

10. When do you anticipate enrolling?

When do you anticipate enrolling? Within 1 year

Within 2 years

Within 3 years

Within 4 years

Within 5 years

Uncertain

11. What type of program would you most likely enroll in?

What type of program would you most likely enroll in? Associate Degree RN

Bachelor of Science in Nursing

12. I would like information about program offerings. My email address is:

I would like information about program offerings. My email address is:

13. My physical address is:

My physical address is: Name:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:

Thank you for your participation!

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