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* 1. In 2023, how often did you attend CISM Team meetings?

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* 2. If you attended CISM Team meetings in 2023 did your team practice peer support skills regularly?

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* 3. Please describe any barriers that prevented you from attending CISM Team meetings in 2023:

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* 4. In 2023, how often did you and/or your CISM Team present the Pre-Incident Education slides to your department?

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* 5. Please describe any barriers that prevented you and/or your CISM Team from facilitating Pre-Incident Education in 2023:

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* 6. In 2023, how many informal peer support interactions did you engage in? (i.e., check-ins, peer support conversations, handing out brochures, etc.)

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* 7. In 2023, how often did you provide individual (one-on-one) crisis intervention (SAFER-R)?

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* 8. In 2023, how often did you refer a person you were supporting to the next-level-of-care, such as to a mental health professional?

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* 9. In 2023, how often did you use the CCDR model for Suicide Response, facilitate a suicide intervention or support a person experiencing suicide ideation?

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* 10. In 2023, if you provided peer support, did you use assessment strategies and the 5T's formula to develop a Strategic Plan?

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* 11. If you provide peer support in 2023, did you consult with any of the following anytime before, during or after the activation?

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* 12. How would you rate the responsiveness of the consultation you sought?

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* 13. How would you rate the effectiveness of that consultation?

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* 14. In 2023, how often did you facilitate a Rest, Information and Transition Services (RITS)?

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* 15. In 2023, how often did you facilitate a Crisis Management Briefing (CMB)?

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* 16. In 2023, how often did you facilitate a Defusing?

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* 17. In 2023, how often did you facilitate a Critical Incident Stress Debriefing (CISD)?

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* 18. If you facilitated a CISD in 2023, was a CISM-trained mental health professional present?

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* 19. How would you rate the outcome of your support in 2023 on average?

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* 20. In 2023, were you activated to provide peer support through the ACIPN IamResponding app?

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* 21. If activated through the ACIPN IamResponding app, how did you find the initial process?

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* 22. How familiar are you with the ACIPN IamResponding activation algorithm?

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* 23. In 2023, did you attend ACIPN's synchronous (online) CISM refresher training?

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* 24. Did the synchronous refresher training meet your expectations?

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* 25. How effective was the synchronous refresher training you attended?

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* 26. How would you rate your confidence in providing effective peer support BEFORE attending synchronous refresher training? (Please skip if you did not attend synchronous refreshers).

0 (Not at All Confident) 50 (Somewhat Confident) 100 (Extremely Confident)
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i We adjusted the number you entered based on the slider’s scale.

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* 27. How would you rate your confidence in providing effective peer support AFTER attending synchronous refresher training? (Please skip if you did not attend synchronous refreshers).

0 (Not at All Confident) 50 (Somewhat Confident) 100 (Extremely Confident)
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i We adjusted the number you entered based on the slider’s scale.

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* 28. Did the synchronous refresher schedule adequately accommodate your availability?

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* 29. What aspect of the synchronous refresher sessions do you find most beneficial for you as a peer?

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* 30. Please share any comments you think could improve the synchronous refresher training experience.

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* 31. In 2023, did you attend in-person CISM refresher training through ACIPN?

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* 32. Did the in-person refresher training meet your expectations?

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* 33. How effective was the in-person refresher session you attended?

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* 34. How would you rate your confidence in providing effective peer support BEFORE attending in-person refresher training? (Please skip this question if you did not attend).

0 (Not at All Confident) 50 (Somewhat Confident) 100 (Extremely Confident)
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 35. How would you rate your confidence in providing effective peer support AFTER attending in-person refresher training? (Please skip this question if you did not attend).

0 (Not at All Confident) 50 (Somewhat Confident) 100 (Extremely Confident)
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 36. How would you rate your current confidence in providing effective peer support?

0 (Not at All Confident) 50 (Somewhat Confident) 100 (Extremely Confident)
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i We adjusted the number you entered based on the slider’s scale.

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* 37. How would you rate your current level of preparedness to provide peer support?

0 (Not at All Prepared) 50 (Somewhat Prepared) 100 (Extremely Prepared)
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i We adjusted the number you entered based on the slider’s scale.

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* 38. Can you access all the materials you need to provide effective peer support?

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* 39. If you couldn't attend CISM refresher training through ACIPN in 2023, please list the main barriers to your attendance. If you did attend refresher training, please list any barriers that interfere with your attendance.

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* 40. Do you have a coping plan to manage potential residual effects associated with being a supporter, such as secondary traumatic stress, cumulative stress and compassion fatigue?

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* 41. Do you know what your own supports are and how to access them?

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* 42. How much do you agree with the statement, "CISM Training and becoming a peer has increased my own resilience."

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* 43. Are there any barriers you can identify in yourself or your organization to providing effective peer support:

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* 44. How much does your leadership support your integrated CISM Team?

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* 45. Have you updated your ACIPN and IamResponding Profiles in the last 3 months?

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* 46. Please complete the information below

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