H-NIP TOT Training Post Assessment Survey

	Not at all confident*	A little confident	Somewhat confident	Confident	Very confident
Have mastered Module 1 Screening & Diagnosis?	Have mastered Module 1 Screening & Diagnosis? Not at all confident*	Have mastered Module 1 Screening & Diagnosis? A little confident	Have mastered Module 1 Screening & Diagnosis? Somewhat confident	Have mastered Module 1 Screening & Diagnosis? Confident	Have mastered Module 1 Screening & Diagnosis? Very confident
Have mastered Module 2 Basic HIV Primary Care?	Have mastered Module 2 Basic HIV Primary Care? Not at all confident*	Have mastered Module 2 Basic HIV Primary Care? A little confident	Have mastered Module 2 Basic HIV Primary Care? Somewhat confident	Have mastered Module 2 Basic HIV Primary Care? Confident	Have mastered Module 2 Basic HIV Primary Care? Very confident
Have mastered Module 3 Antiretroviral Therapy?	Have mastered Module 3 Antiretroviral Therapy? Not at all confident*	Have mastered Module 3 Antiretroviral Therapy? A little confident	Have mastered Module 3 Antiretroviral Therapy? Somewhat confident	Have mastered Module 3 Antiretroviral Therapy? Confident	Have mastered Module 3 Antiretroviral Therapy? Very confident
Have mastered Module 4 Co-Occurring Conditions?	Have mastered Module 4 Co-Occurring Conditions? Not at all confident*	Have mastered Module 4 Co-Occurring Conditions? A little confident	Have mastered Module 4 Co-Occurring Conditions? Somewhat confident	Have mastered Module 4 Co-Occurring Conditions? Confident	Have mastered Module 4 Co-Occurring Conditions? Very confident
Have mastered Module 5 Prevention of HIV?	Have mastered Module 5 Prevention of HIV? Not at all confident*	Have mastered Module 5 Prevention of HIV? A little confident	Have mastered Module 5 Prevention of HIV? Somewhat confident	Have mastered Module 5 Prevention of HIV? Confident	Have mastered Module 5 Prevention of HIV? Very confident
Have mastered Module 6 Key Populations?	Have mastered Module 6 Key Populations? Not at all confident*	Have mastered Module 6 Key Populations? A little confident	Have mastered Module 6 Key Populations? Somewhat confident	Have mastered Module 6 Key Populations? Confident	Have mastered Module 6 Key Populations? Very confident
Can provide support to your faculty peers on Module 1 Screening & Diagnosis?	Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Not at all confident*	Can provide support to your faculty peers on Module 1 Screening & Diagnosis? A little confident	Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Somewhat confident	Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Confident	Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Very confident
Can provide support to your faculty peers on Module 2 Basic HIV Primary Care?	Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Not at all confident*	Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? A little confident	Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Somewhat confident	Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Confident	Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Very confident
Can provide support to your faculty peers on Module 3 Antiretroviral Therapy?	Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Not at all confident*	Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? A little confident	Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Somewhat confident	Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Confident	Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Very confident
Can provide support to your faculty peers on Module 4 Co-Occurring Conditions?	Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Not at all confident*	Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? A little confident	Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Somewhat confident	Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Confident	Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Very confident
Can provide support to your faculty peers on Module 5 Prevention of HIV?	Can provide support to your faculty peers on Module 5 Prevention of HIV? Not at all confident*	Can provide support to your faculty peers on Module 5 Prevention of HIV? A little confident	Can provide support to your faculty peers on Module 5 Prevention of HIV? Somewhat confident	Can provide support to your faculty peers on Module 5 Prevention of HIV? Confident	Can provide support to your faculty peers on Module 5 Prevention of HIV? Very confident
Can provide support to your faculty peers on Module 6 Key Populations?	Can provide support to your faculty peers on Module 6 Key Populations? Not at all confident*	Can provide support to your faculty peers on Module 6 Key Populations? A little confident	Can provide support to your faculty peers on Module 6 Key Populations? Somewhat confident	Can provide support to your faculty peers on Module 6 Key Populations? Confident	Can provide support to your faculty peers on Module 6 Key Populations? Very confident

Not at all confident*

A little confident

Somewhat confident

Confident

Very confident

Have mastered Module 1 Screening & Diagnosis?

Have mastered Module 1 Screening & Diagnosis? Not at all confident*

Have mastered Module 1 Screening & Diagnosis? A little confident

Have mastered Module 1 Screening & Diagnosis? Somewhat confident

Have mastered Module 1 Screening & Diagnosis? Confident

Have mastered Module 1 Screening & Diagnosis? Very confident

Have mastered Module 2 Basic HIV Primary Care?

Have mastered Module 2 Basic HIV Primary Care? Not at all confident*

Have mastered Module 2 Basic HIV Primary Care? A little confident

Have mastered Module 2 Basic HIV Primary Care? Somewhat confident

Have mastered Module 2 Basic HIV Primary Care? Confident

Have mastered Module 2 Basic HIV Primary Care? Very confident

Have mastered Module 3 Antiretroviral Therapy?

Have mastered Module 3 Antiretroviral Therapy? Not at all confident*

Have mastered Module 3 Antiretroviral Therapy? A little confident

Have mastered Module 3 Antiretroviral Therapy? Somewhat confident

Have mastered Module 3 Antiretroviral Therapy? Confident

Have mastered Module 3 Antiretroviral Therapy? Very confident

Have mastered Module 4 Co-Occurring Conditions?

Have mastered Module 4 Co-Occurring Conditions? Not at all confident*

Have mastered Module 4 Co-Occurring Conditions? A little confident

Have mastered Module 4 Co-Occurring Conditions? Somewhat confident

Have mastered Module 4 Co-Occurring Conditions? Confident

Have mastered Module 4 Co-Occurring Conditions? Very confident

Have mastered Module 5 Prevention of HIV?

Have mastered Module 5 Prevention of HIV? Not at all confident*

Have mastered Module 5 Prevention of HIV? A little confident

Have mastered Module 5 Prevention of HIV? Somewhat confident

Have mastered Module 5 Prevention of HIV? Confident

Have mastered Module 5 Prevention of HIV? Very confident

Have mastered Module 6 Key Populations?

Have mastered Module 6 Key Populations? Not at all confident*

Have mastered Module 6 Key Populations? A little confident

Have mastered Module 6 Key Populations? Somewhat confident

Have mastered Module 6 Key Populations? Confident

Have mastered Module 6 Key Populations? Very confident

Can provide support to your faculty peers on Module 1 Screening & Diagnosis?

Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Not at all confident*

Can provide support to your faculty peers on Module 1 Screening & Diagnosis? A little confident

Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Somewhat confident

Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Confident

Can provide support to your faculty peers on Module 1 Screening & Diagnosis? Very confident

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care?

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Not at all confident*

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? A little confident

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Somewhat confident

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Confident

Can provide support to your faculty peers on Module 2 Basic HIV Primary Care? Very confident

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy?

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Not at all confident*

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? A little confident

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Somewhat confident

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Confident

Can provide support to your faculty peers on Module 3 Antiretroviral Therapy? Very confident

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions?

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Not at all confident*

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? A little confident

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Somewhat confident

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Confident

Can provide support to your faculty peers on Module 4 Co-Occurring Conditions? Very confident

Can provide support to your faculty peers on Module 5 Prevention of HIV?

Can provide support to your faculty peers on Module 5 Prevention of HIV? Not at all confident*

Can provide support to your faculty peers on Module 5 Prevention of HIV? A little confident

Can provide support to your faculty peers on Module 5 Prevention of HIV? Somewhat confident

Can provide support to your faculty peers on Module 5 Prevention of HIV? Confident

Can provide support to your faculty peers on Module 5 Prevention of HIV? Very confident

Can provide support to your faculty peers on Module 6 Key Populations?

Can provide support to your faculty peers on Module 6 Key Populations? Not at all confident*

Can provide support to your faculty peers on Module 6 Key Populations? A little confident

Can provide support to your faculty peers on Module 6 Key Populations? Somewhat confident

Can provide support to your faculty peers on Module 6 Key Populations? Confident

Can provide support to your faculty peers on Module 6 Key Populations? Very confident

	Very Unsatisfactory	Unsatisfactory	Neutral	Satisfactory	Very Satisfactory
Module 1 Screening and Diagnosis?	Module 1 Screening and Diagnosis? Very Unsatisfactory	Module 1 Screening and Diagnosis? Unsatisfactory	Module 1 Screening and Diagnosis? Neutral	Module 1 Screening and Diagnosis? Satisfactory	Module 1 Screening and Diagnosis? Very Satisfactory
Module 2 Basic HIV Primary Care?	Module 2 Basic HIV Primary Care? Very Unsatisfactory	Module 2 Basic HIV Primary Care? Unsatisfactory	Module 2 Basic HIV Primary Care? Neutral	Module 2 Basic HIV Primary Care? Satisfactory	Module 2 Basic HIV Primary Care? Very Satisfactory
Module 3 Antiretroviral Therapy?	Module 3 Antiretroviral Therapy? Very Unsatisfactory	Module 3 Antiretroviral Therapy? Unsatisfactory	Module 3 Antiretroviral Therapy? Neutral	Module 3 Antiretroviral Therapy? Satisfactory	Module 3 Antiretroviral Therapy? Very Satisfactory
Module 4 Co-Occurring Conditions?	Module 4 Co-Occurring Conditions? Very Unsatisfactory	Module 4 Co-Occurring Conditions? Unsatisfactory	Module 4 Co-Occurring Conditions? Neutral	Module 4 Co-Occurring Conditions? Satisfactory	Module 4 Co-Occurring Conditions? Very Satisfactory
Module 5 Prevention of HIV?	Module 5 Prevention of HIV? Very Unsatisfactory	Module 5 Prevention of HIV? Unsatisfactory	Module 5 Prevention of HIV? Neutral	Module 5 Prevention of HIV? Satisfactory	Module 5 Prevention of HIV? Very Satisfactory
Module 6 Key Populations?	Module 6 Key Populations? Very Unsatisfactory	Module 6 Key Populations? Unsatisfactory	Module 6 Key Populations? Neutral	Module 6 Key Populations? Satisfactory	Module 6 Key Populations? Very Satisfactory

Very Unsatisfactory

Unsatisfactory

Neutral

Satisfactory

Very Satisfactory

Module 1 Screening and Diagnosis?

Module 1 Screening and Diagnosis? Very Unsatisfactory

Module 1 Screening and Diagnosis? Unsatisfactory

Module 1 Screening and Diagnosis? Neutral

Module 1 Screening and Diagnosis? Satisfactory

Module 1 Screening and Diagnosis? Very Satisfactory

Module 2 Basic HIV Primary Care?

Module 2 Basic HIV Primary Care? Very Unsatisfactory

Module 2 Basic HIV Primary Care? Unsatisfactory

Module 2 Basic HIV Primary Care? Neutral

Module 2 Basic HIV Primary Care? Satisfactory

Module 2 Basic HIV Primary Care? Very Satisfactory

Module 3 Antiretroviral Therapy?

Module 3 Antiretroviral Therapy? Very Unsatisfactory

Module 3 Antiretroviral Therapy? Unsatisfactory

Module 3 Antiretroviral Therapy? Neutral

Module 3 Antiretroviral Therapy? Satisfactory

Module 3 Antiretroviral Therapy? Very Satisfactory

Module 4 Co-Occurring Conditions?

Module 4 Co-Occurring Conditions? Very Unsatisfactory

Module 4 Co-Occurring Conditions? Unsatisfactory

Module 4 Co-Occurring Conditions? Neutral

Module 4 Co-Occurring Conditions? Satisfactory

Module 4 Co-Occurring Conditions? Very Satisfactory

Module 5 Prevention of HIV?

Module 5 Prevention of HIV? Very Unsatisfactory

Module 5 Prevention of HIV? Unsatisfactory

Module 5 Prevention of HIV? Neutral

Module 5 Prevention of HIV? Satisfactory

Module 5 Prevention of HIV? Very Satisfactory

Module 6 Key Populations?

Module 6 Key Populations? Very Unsatisfactory

Module 6 Key Populations? Unsatisfactory

Module 6 Key Populations? Neutral

Module 6 Key Populations? Satisfactory

Module 6 Key Populations? Very Satisfactory

Question Title

* 3. Please check one response on each row. If you checked “not at all confident”, “a little confident”, “very unsatisfactory” or “unsatisfactory” on any row please explain the reasons why at the bottom of the page. Your feedback will be used to improve future rounds of the TOT program.

H-NIP TOT Training Post Assessment

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* 1. How confident are you that you:

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* 2. How would you rate the assistance you received from the Faculty Expert on:

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* 4. Your Name and Institution: