'The Threads Among Us' - Workshop Evaluation
Thank you for participating in 'The Threads Among Us' workshop! Please take 10 minutes to give us your feedback. Your answers will be anonymous, and we greatly value your time and input!
1.
How did you participate in "The Threads Among Us" workshop?
Real time, in a group, face-to-face
Real time, online/streaming
Asynchronous, individually, online/streaming
Other (please specify)
2.
What is your gender?
Female
Male
Other
I wish not to specify
3.
What is your racial or ethnic identity? (Select all that apply.)
African American / Black
American Indian / Alaska Native
Asian / Asian American
Hispanic/Latino
Native Hawaiian / Pacific Islander
White
Other (please specify)
4.
What is your job title and level of experience? (Choose one from drop-down menu.)
Nurse
Nurse Practitioner
Physician Assistant
Medical Student - 1st Year
Medical Student - 2nd Year
Medical Student - 3rd Year
Medical Student - 4th Year
Resident - 1st Year
Resident - 2nd Year
Resident - 3rd Year
Resident - 4th Year
Resident - 5th Year
Resident - >5th Year
Fellow -1st Year
Fellow - 2nd Year
Fellow - 3rd Year
Fellow - >3rd Year
Attending Physician
(1-5 years)
Attending Physician
(6-10 years)
Attending Physician
(11-15 years)
Attending Physician
(>15 years)
Administrator/Administrative Staff
Other (please specify)
5.
How often do you observe incivility IN YOUR OWN department/section/unit/specialty?
Less than once per month
Several times per month
Weekly
Daily
6.
How often do YOU cause or contribute to incivility in your
workplace?
Less than once per month
Several times per month but less than weekly
Weekly
Daily
7.
How often do you experience incivility directed TOWARD YOU in your workplace?
Less than once per month
Several times per month but less than weekly
Weekly
Daily
8.
How often do you experience incivility in OTHER departments/sections/units/specialties?
Less than once per month
Several times per month but less than weekly
Weekly
Daily
9.
Does your department/section/unit have well-defined policies or procedures for addressing incivility in the workplace?
Yes, well-defined
Yes, but not well-defined
Yes, but poorly-defined
No, no policy
10.
BEFORE the workshop, how comfortable were you addressing workplace incivility?
Very comfortable
Comfortable
Uncomfortable
Very uncomfortable
11.
Now, AFTER the workshop, how comfortable will you be addressing workplace incivility in the future?
Very comfortable
Comfortable
Uncomfortable
Very uncomfortable
12.
How well did the video present common scenarios of incivility between health care providers?
Very well
Well
Poorly
Very poorly
13.
In general,
Activity 1 (Social Contagion)
was:
Excellent
Good
Fair
Not worth the time
14.
In general,
Activity 2 (Video Debrief)
was:
Excellent
Good
Fair
Not worth the time
15.
In general,
Activity 3 (The Ladder of Inference)
was:
Excellent
Good
Fair
Not worth the time
16.
In general,
Activity 4 (Letter of Gratitude)
was:
Excellent
Good
Fair
Not worth the time
17.
When were you MOST engaged in the workshop? What made it so?
18.
When were you LEAST engaged in the workshop? What made it so?
19.
What has been MOST valuable to you from the workshop in terms of your professional development?
20.
What has been LEAST valuable to you from the workshop, in terms of your professional development? How would you change it?
21.
Would you recommend the video to others?
Yes
No
22.
Would you recommend the workshop to others?
Yes
No
23.
Do you have any other feedback?
Thank you for completing this evaluation of 'The Threads Among Us' workshop. Be sure to click [DONE] or your answers will not be submitted.