Exit this survey Cultural Survey Question Title * 1. Please indicate the following areas that you would like additional information or education to improve your professional practice based on interest or changing demographics in your community. (check all that apply) African American American Indian/Alaska Natives Amish Asian American Bariatric Developmental Disabilities Eastern Europeans Geriatrics Health Disparities Health Literacy Jehovah's Witnesses Latinos/Hispanic Native Hawaiian/Other Pacific Islanders Lesbian, Gay, Bisexual, Transgender Mental Health Sub-Saharan Africans Other (please specify) Question Title * 2. What is your current healthcare profession? RN Pharmacist Social Work Chaplain Interpreter OT/PT Phlebotomist RT RD MD Nursing Assistant LPN Student Other (please specify) Question Title * 3. How many years have you been in current role? < 2years 2-4 years 5-10 years 10-15 years 16-20 years > 20 years Question Title * 4. How many years have you been in healthcare? < 2years 2-4 years 5-10 years 10-15 years 16-20 years > 20 years Question Title * 5. What is your age group? <20 years 20-29 years 30-39 years 40-49 years 50-59 years 60+ years Question Title * 6. What is your current practice setting? Clinic Home Health Community Hospice Hospital LTACH Nursing Home Surgical Services (OR/PACU/FDS) School Corrections Other (please specify) Question Title * 7. Have you attended a course focused on cultural congruence (competence) in the past 12 months? Yes No Question Title * 8. How confident do you feel in your knowledge base when it comes to providing culturally congruent care for diverse populations? Very confident, I know everything I need to know Confident Somewhat confident Not confident Question Title * 9. Do you believe that biases and limitations exist in healthcare? Yes No Question Title * 10. Do you believe that you have biases and limitations? Yes No Question Title * 11. Do you believe that health care disparities exist? Yes No Question Title * 12. How confident do you feel when interviewing clients of different cultural backgrounds to learn about their values and beliefs? Very confident, I know everything I need to know Confident Somewhat confident Not confident Question Title * 13. How knowledgeable do you feel about ways cultural factors may influence the care you provide when thinking about clients of different cultural backgrounds? Very confident, I know everything I need to know Confident Somewhat confident Not confident Question Title * 14. Would you attend educational/informational sessions to promote culturally congruent care in the state of Wisconsin? Yes No Question Title * 15. Please answer the following in regards to distance education, or modes other than in-person programs. I have participated I would participate Journal Club Journal Club I have participated Journal Club I would participate Powerpoint slides Powerpoint slides I have participated Powerpoint slides I would participate Case studies Case studies I have participated Case studies I would participate Videos Videos I have participated Videos I would participate Computer based training Computer based training I have participated Computer based training I would participate Question Title * 16. What region of the state of Wisconsin best represents your practice area?There is a map showing the regions at http://www.travelwisconsin.com/maps_guides.aspx if that could be shown as a reference picture. Northwest Northeast Central Southwest South central Southeast East central Question Title * 17. Anything additional you would want us to know topic suggestions for education: Question Title * 18. How would you best describe yourself? (check all that apply) Black/African American Asian American Indian/Alaska Native Latino/Hispanic White Sub-Saharan African Native Hawaiian/Other Pacific Islander Other (please specify) Done