MDI November 2016 Accra, Ghana Overall Evaluation

Dear Participant,
We are kindly requesting your time to complete this short evaluation form to provide feedback on your experiences during the one-week MDI Program. Your honest input will help us make the course more effective for future participants.
Thank you in advance for your time and feedback.

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* 1. Your Name and Title

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* 2. Your Organization

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* 3. Please select the type of organization you work with:

Hospital/clinical care

Faith-based NGO

NGO

Government

Training institution (e.g., university)

Other (please specify)

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* 4. Please rate the following program elements:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Program content/topics covered	Program content/topics covered 1 [Lowest]	Program content/topics covered 2	Program content/topics covered 3	Program content/topics covered 4	Program content/topics covered 5	Program content/topics covered 6	Program content/topics covered 7 [Highest]
Faculty/Speakers	Faculty/Speakers 1 [Lowest]	Faculty/Speakers 2	Faculty/Speakers 3	Faculty/Speakers 4	Faculty/Speakers 5	Faculty/Speakers 6	Faculty/Speakers 7 [Highest]
CHIP process	CHIP process 1 [Lowest]	CHIP process 2	CHIP process 3	CHIP process 4	CHIP process 5	CHIP process 6	CHIP process 7 [Highest]
Networking	Networking 1 [Lowest]	Networking 2	Networking 3	Networking 4	Networking 5	Networking 6	Networking 7 [Highest]
Degree to which MDI raised your understanding of management and leadership	Degree to which MDI raised your understanding of management and leadership 1 [Lowest]	Degree to which MDI raised your understanding of management and leadership 2	Degree to which MDI raised your understanding of management and leadership 3	Degree to which MDI raised your understanding of management and leadership 4	Degree to which MDI raised your understanding of management and leadership 5	Degree to which MDI raised your understanding of management and leadership 6	Degree to which MDI raised your understanding of management and leadership 7 [Highest]
Degree to which MDI will influence the way you manage and lead	Degree to which MDI will influence the way you manage and lead 1 [Lowest]	Degree to which MDI will influence the way you manage and lead 2	Degree to which MDI will influence the way you manage and lead 3	Degree to which MDI will influence the way you manage and lead 4	Degree to which MDI will influence the way you manage and lead 5	Degree to which MDI will influence the way you manage and lead 6	Degree to which MDI will influence the way you manage and lead 7 [Highest]

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* 5. Please rate the usefulness of course materials:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Materials provided in advance	Materials provided in advance 1 [Lowest]	Materials provided in advance 2	Materials provided in advance 3	Materials provided in advance 4	Materials provided in advance 5	Materials provided in advance 6	Materials provided in advance 7 [Highest]
Materials provided on-site	Materials provided on-site 1 [Lowest]	Materials provided on-site 2	Materials provided on-site 3	Materials provided on-site 4	Materials provided on-site 5	Materials provided on-site 6	Materials provided on-site 7 [Highest]
CHIP workbook	CHIP workbook 1 [Lowest]	CHIP workbook 2	CHIP workbook 3	CHIP workbook 4	CHIP workbook 5	CHIP workbook 6	CHIP workbook 7 [Highest]

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* 6. Please rate the effectiveness of the Learning Group process:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Allows sufficient time to do required CHIP work	Allows sufficient time to do required CHIP work 1 [Lowest]	Allows sufficient time to do required CHIP work 2	Allows sufficient time to do required CHIP work 3	Allows sufficient time to do required CHIP work 4	Allows sufficient time to do required CHIP work 5	Allows sufficient time to do required CHIP work 6	Allows sufficient time to do required CHIP work 7 [Highest]
Helps me apply course concepts to my organization and my work	Helps me apply course concepts to my organization and my work 1 [Lowest]	Helps me apply course concepts to my organization and my work 2	Helps me apply course concepts to my organization and my work 3	Helps me apply course concepts to my organization and my work 4	Helps me apply course concepts to my organization and my work 5	Helps me apply course concepts to my organization and my work 6	Helps me apply course concepts to my organization and my work 7 [Highest]
CHIP process	CHIP process 1 [Lowest]	CHIP process 2	CHIP process 3	CHIP process 4	CHIP process 5	CHIP process 6	CHIP process 7 [Highest]
Supports peer networking	Supports peer networking 1 [Lowest]	Supports peer networking 2	Supports peer networking 3	Supports peer networking 4	Supports peer networking 5	Supports peer networking 6	Supports peer networking 7 [Highest]
Overall effectiveness of the Learning Group	Overall effectiveness of the Learning Group 1 [Lowest]	Overall effectiveness of the Learning Group 2	Overall effectiveness of the Learning Group 3	Overall effectiveness of the Learning Group 4	Overall effectiveness of the Learning Group 5	Overall effectiveness of the Learning Group 6	Overall effectiveness of the Learning Group 7 [Highest]

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* 7. Please rate the effectiveness of your Teaching Associate:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Understands the theory and framework behind the CHIP	Understands the theory and framework behind the CHIP 1 [Lowest]	Understands the theory and framework behind the CHIP 2	Understands the theory and framework behind the CHIP 3	Understands the theory and framework behind the CHIP 4	Understands the theory and framework behind the CHIP 5	Understands the theory and framework behind the CHIP 6	Understands the theory and framework behind the CHIP 7 [Highest]
Provides constructive and helpful feedback on my CHIP	Provides constructive and helpful feedback on my CHIP 1 [Lowest]	Provides constructive and helpful feedback on my CHIP 2	Provides constructive and helpful feedback on my CHIP 3	Provides constructive and helpful feedback on my CHIP 4	Provides constructive and helpful feedback on my CHIP 5	Provides constructive and helpful feedback on my CHIP 6	Provides constructive and helpful feedback on my CHIP 7 [Highest]
Involves participants in discussions (one-on-one or as a group) about the CHIP	Involves participants in discussions (one-on-one or as a group) about the CHIP 1 [Lowest]	Involves participants in discussions (one-on-one or as a group) about the CHIP 2	Involves participants in discussions (one-on-one or as a group) about the CHIP 3	Involves participants in discussions (one-on-one or as a group) about the CHIP 4	Involves participants in discussions (one-on-one or as a group) about the CHIP 5	Involves participants in discussions (one-on-one or as a group) about the CHIP 6	Involves participants in discussions (one-on-one or as a group) about the CHIP 7 [Highest]
Maintains an environment conducive to learning and working	Maintains an environment conducive to learning and working 1 [Lowest]	Maintains an environment conducive to learning and working 2	Maintains an environment conducive to learning and working 3	Maintains an environment conducive to learning and working 4	Maintains an environment conducive to learning and working 5	Maintains an environment conducive to learning and working 6	Maintains an environment conducive to learning and working 7 [Highest]
Overall effectiveness of my TA in leading the Learning Group	Overall effectiveness of my TA in leading the Learning Group 1 [Lowest]	Overall effectiveness of my TA in leading the Learning Group 2	Overall effectiveness of my TA in leading the Learning Group 3	Overall effectiveness of my TA in leading the Learning Group 4	Overall effectiveness of my TA in leading the Learning Group 5	Overall effectiveness of my TA in leading the Learning Group 6	Overall effectiveness of my TA in leading the Learning Group 7 [Highest]

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* 8. Name of your TA

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* 9. Please rate the quality of the facilities:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Location	Location 1 [Lowest]	Location 2	Location 3	Location 4	Location 5	Location 6	Location 7 [Highest]
Comfort of meeting rooms	Comfort of meeting rooms 1 [Lowest]	Comfort of meeting rooms 2	Comfort of meeting rooms 3	Comfort of meeting rooms 4	Comfort of meeting rooms 5	Comfort of meeting rooms 6	Comfort of meeting rooms 7 [Highest]
Food	Food 1 [Lowest]	Food 2	Food 3	Food 4	Food 5	Food 6	Food 7 [Highest]
Comfort of sleeping rooms	Comfort of sleeping rooms 1 [Lowest]	Comfort of sleeping rooms 2	Comfort of sleeping rooms 3	Comfort of sleeping rooms 4	Comfort of sleeping rooms 5	Comfort of sleeping rooms 6	Comfort of sleeping rooms 7 [Highest]
Administrative support	Administrative support 1 [Lowest]	Administrative support 2	Administrative support 3	Administrative support 4	Administrative support 5	Administrative support 6	Administrative support 7 [Highest]

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* 10. Please rate the quality of the admissions process:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Application information requested	Application information requested 1 [Lowest]	Application information requested 2	Application information requested 3	Application information requested 4	Application information requested 5	Application information requested 6	Application information requested 7 [Highest]
Submission process	Submission process 1 [Lowest]	Submission process 2	Submission process 3	Submission process 4	Submission process 5	Submission process 6	Submission process 7 [Highest]
Communication	Communication 1 [Lowest]	Communication 2	Communication 3	Communication 4	Communication 5	Communication 6	Communication 7 [Highest]
Timing of notification	Timing of notification 1 [Lowest]	Timing of notification 2	Timing of notification 3	Timing of notification 4	Timing of notification 5	Timing of notification 6	Timing of notification 7 [Highest]

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* 11. What is your preferred timing of notification of program acceptance?

2 weeks

4 weeks

6 weeks

8 weeks

Other (please specify)

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* 12. Please rate your overall experience:

	1 [Lowest]	2	3	4	5	6	7 [Highest]
Satisfaction with your overall experience in the program	Satisfaction with your overall experience in the program 1 [Lowest]	Satisfaction with your overall experience in the program 2	Satisfaction with your overall experience in the program 3	Satisfaction with your overall experience in the program 4	Satisfaction with your overall experience in the program 5	Satisfaction with your overall experience in the program 6	Satisfaction with your overall experience in the program 7 [Highest]
Likelihood to recommend the program to other leaders in the healthcare community.	Likelihood to recommend the program to other leaders in the healthcare community. 1 [Lowest]	Likelihood to recommend the program to other leaders in the healthcare community. 2	Likelihood to recommend the program to other leaders in the healthcare community. 3	Likelihood to recommend the program to other leaders in the healthcare community. 4	Likelihood to recommend the program to other leaders in the healthcare community. 5	Likelihood to recommend the program to other leaders in the healthcare community. 6	Likelihood to recommend the program to other leaders in the healthcare community. 7 [Highest]

MDI November 2016 Accra, Ghana Overall Evaluation

Question Title

* 1. Your Name and Title

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* 2. Your Organization

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* 3. Please select the type of organization you work with:

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* 4. Please rate the following program elements:

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* 5. Please rate the usefulness of course materials:

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* 6. Please rate the effectiveness of the Learning Group process:

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* 7. Please rate the effectiveness of your Teaching Associate:

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* 8. Name of your TA

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* 9. Please rate the quality of the facilities:

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* 10. Please rate the quality of the admissions process:

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* 11. What is your preferred timing of notification of program acceptance?

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* 12. Please rate your overall experience:

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* 13. What was the most valuable/important aspect of the program to you?

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* 14. What would you recommend we do differently in the future?

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* 15. Are there any additional comments or suggestions you would like to share?