Faculty Development Videos Feedback Form

Thank you for watching a faculty development video brought to you by the Weitzman Institute (WI) and Community Health Center, Inc. (CHC).

Please complete this quick survey to tell us how we did and provide suggestions for future videos.

Please be sure to respond to the questions in reference to the video that you watched!

Question Title

* 1. Name:

Question Title

* 2. I have been a faculty member for Weitzman Institute and/or CHC for:

Less than 1 year

1-3 years

4-6 years

7-9 years

10+years

Question Title

* 3. To what degree do you agree with the following statements?

	Strongly Agree	Agree	Disagree	Strongly Disagree
I learned something new by watching this video.	I learned something new by watching this video. Strongly Agree	I learned something new by watching this video. Agree	I learned something new by watching this video. Disagree	I learned something new by watching this video. Strongly Disagree
I plan on using best practices shared in this video.	I plan on using best practices shared in this video. Strongly Agree	I plan on using best practices shared in this video. Agree	I plan on using best practices shared in this video. Disagree	I plan on using best practices shared in this video. Strongly Disagree
I feel more confident in my work as a faculty member because of this training video.	I feel more confident in my work as a faculty member because of this training video. Strongly Agree	I feel more confident in my work as a faculty member because of this training video. Agree	I feel more confident in my work as a faculty member because of this training video. Disagree	I feel more confident in my work as a faculty member because of this training video. Strongly Disagree
I would like to watch additional training videos produced by WI Education.	I would like to watch additional training videos produced by WI Education. Strongly Agree	I would like to watch additional training videos produced by WI Education. Agree	I would like to watch additional training videos produced by WI Education. Disagree	I would like to watch additional training videos produced by WI Education. Strongly Disagree

Faculty Development Videos Feedback Form

Question Title

* 1. Name:

Question Title

* 2. I have been a faculty member for Weitzman Institute and/or CHC for:

Question Title

* 3. To what degree do you agree with the following statements?

Question Title

* 4. Please include ideas for topics for training videos you would like to have offered.

Question Title

* 5. Please use this space to provide additional comments about the training video that you watched.