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FACILITATOR SELF EVALUATION
1.
Facilitator Name:
2.
Co-Facilitator Name:
3.
Date Training Completed:
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
4.
Province Training was Held:
BC
AB
SK
MB
ON
QC
LAB
5.
Treatment Centre/First Nation/Organization Trained:
6.
What modules did you facilitate:
Module 1 - About Suicide
Module 2 - Myths & Facts
Module 3 - Decreasing Stigma
Module 4 - Colonization
Module 5 - Reducing Risk Factors for Suicide
Module 6 - Warning Signs for Suicide
Module 7 - Media Guidelines
Module 8 - Engagement
Module 9 - When and Why Youth Seek Help
Module 10 - Protective Factors
Module 11 - Getting Help for Someone
Module 12 - Self Care
7.
Have you learned anything new about yourself since presenting this last time?
8.
Were you able to address all the questions you received during the dialogue?
Yes
No
9.
If not, what will you do differently next time to be able to answer similar questions?
10.
How confident did you feel in your understanding of the material presented? (on a scale of 1-5 with 1 low and 5 high)
Not confident at all
Somewhat confident
Confident
Very confident
Extremely confident
Not confident at all
Somewhat confident
Confident
Very confident
Extremely confident
11.
Approximately how much time did you spend preparing to Facilitate?
0-60 minutes
1 - 4 hours
4 - 8 hours
1-2 days
3-4 days
5+ days
12.
Did you:
Check video links before starting?
Read/review your facilitator notes?
Have ice breakers ready in case they were needed during the training?
13.
Did you develop any new activities?
Yes
No
14.
If yes, please describe the activity?
15.
If yes, where did you insert the activity into the training?
16.
Did you have to assist participants in using the QR survey code:
Yes
No
17.
Were any manual evaluations completed?
Yes
No
18.
If yes, how many?
19.
Did you enter them into survey monkey?
Yes
No
20.
If no, why? or who did?
21.
Did you provide certificates to those who completed the course?
Yes
No
22.
If no, why? Who did?
23.
Did you feel you met the objectives in teaching the modules?
Yes
No
24.
What could you have done better?
25.
What did you enjoy the most about facilitating the Life is Sacred program?
26.
What is your confidence level in presenting the training this time? (on a scale of 1-5 with 1 low and 5 high)
Not confident at all
Somewhat confident
Confident
Very confident
Extremely confident
Not confident at all
Somewhat confident
Confident
Very confident
Extremely confident
27.
Please list the names of participants who received Certificates (for database/statistical purposes)