This is some instructions about how to use this for research purposes. Privacy statement. This may end up being quite long. We will see how much is required here. 
Who are you?

Question Title

* 1. Who are you?

What activities help improve your practice?

Question Title

* 2. What activities help improve your practice?

  Makes things worse Does not help Improves my practice Is valuable to my practice Is essential to my practice N/A
Continuing Medical Education
Committee Work
Quality Improvement work
Research
Filling out a survey
What activities are you involved in?

Question Title

* 3. What activities are you involved in?

How much time have you spent on the following activities in a typical week (in the last year)?

Question Title

* 4. How much time have you spent on the following activities in a typical week (in the last year)?

  No time Less than an hour 1 - 5 hours More than 5 hours
Research
Teaching
Quality Improvement
CME
Clinical Time
How interested are you in the following activities?

Question Title

* 5. How interested are you in the following activities?

  Not interested at all Somewhat interested Very interested
Committee Work
Research
Quality Improvement
Local Research
What are the obstacles to doing research?

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* 6. What are the obstacles to doing research?

How does research affect your patients?

Question Title

* 7. How does research affect your patients?

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