Form Q Survey

OMB #: 0925-0542

Expiration Date: 4-30-08

The FORM Q

Brain Power!

The NIDA Junior Scientists Program

Online Survey for Teachers

1. Including this year, how long have you been teaching? (Please circle one response for each item.)

Number of years	0-5 years	6-11 years	12-17 years	18-23 years	24 years or more
a. Teaching	1	2	3	4	5
b. Teaching current grade.	1	2	3	4	5
c. Teaching at this school.	1	2	3	4	5

2. In what grades did you use the Brain Power! curriculum?

K-1 2-3 4-5 6-9

3. Are you:

Male? 1

Female? 2

4. What is your age? (Please circle one.)

Less than 25 1

25-35 2

36-45 3

46-55 4

56-65 5

65 or older 6

5. What is your current level of education? (Please circle one.)

Bachelor’s degree 1

Bachelor’s degree plus additional graduate course credit(s) 2

Master’s degree 3

Master’s degree plus additional graduate course credit(s) 4

Professional degree 5

6. How would you describe your knowledge in each of the following topics prior to and after teaching the Brain Power! curricula? (Please circle one response for each item in Column I to describe your knowledge prior to teaching the curriculum and one response for each item in Column II to describe your knowledge after teaching the curriculum.)

Topic	Column I. Knowledge prior to teaching					Column II. Knowledge after teaching
	Modest or very little amount	Fair or moderate amount	Signifi- cant or sizable amount			Modest or very little amount	Fair or moderate amount	Signifi- cant or sizable amount
a. Names of major regions of the brain	1	2	3			1	2	3
b. Specific responsibilities of each brain region	1	2	3			1	2	3
c. The parts of a neuron and their individual functions	1	2	3			1	2	3
d. The process of neurotransmission	1	2	3			1	2	3
e. The role of neurotransmitters	1	2	3			1	2	3
f. The effect of drugs on neurotransmitters	1	2	3			1	2	3
g. The effects of marijuana on the brain	1	2	3			1	2	3
h. The effects of cocaine, caffeine, and other stimulants on brain chemistry	1	2	3			1	2	3
i. The effects of nicotine on the body	1	2	3			1	2	3
j. The effect of nicotine on neurotransmission	1	2	3			1	2	3
k. The effect of aspirin, acetaminophen, fluoride, immunizations, and antibiotics on the body	1	2	3			1	2	3
l. The process of scientific inquiry	1	2	3			1	2	3
m. Health recommendations for children (diet, exercise, sleep)	1	2	3			1	2	3
n. Long-term effects of alcoholism	1	2	3			1	2	3
o. Characteristics of addiction	1	2	3			1	2	3

7. How would you rate the following aspects of the Brain Power! curriculum content overall? (Please circle one on each line.)

Curriculum content	Excellent	Good	Fair	Poor	Unaccep-table
a. Relevance to your students	1	2	3	4	5
b. Ability to maintain student interest	1	2	3	4	5
c. Appropriateness for designated grade level	1	2	3	4	5
d. Ability to challenge students	1	2	3	4	5

8. To what extent do you agree or disagree with the following statements about the Brain Power! materials? Mark NA if did not use the materials or have no opinion. (Please circle one on each line.)

Statement	Strongly agree	Agree	Disagree	Strongly disagree	NA
a. The curricular materials were easy to use in general	1	2	3	4	5
b. Any material that was new to me was explained with enough detail and context to be understood clearly	1	2	3	4	5
c. The directions for teachers were easy to understand and follow	1	2	3	4	5
d. The background information supplied was sufficient for teaching purposes	1	2	3	4	5
e. The student materials required (but not included with the curriculum package) were easily available in my school	1	2	3	4	5
f. The steps recommended in the teacher’s guide for Preparation were vague and/or unclear.	1	2	3	4	5
g. The Discussion Questions were helpful in developing and extending student understanding	1	2	3	4	5
h. The trading cards were inviting and fun for students, while reinforcing key concepts	1	2	3	4	5
i. Extension activities made appropriate and relevant links to other subject areas	1	2	3	4	5
j. Assessment questions provided useful checks for student understanding	1	2	3	4	5
k. Resources for Teachers and Resources for Students were valuable extended learning opportunities	1	2	3	4	5
l. Student handouts required little or no revision before student use	1	2	3	4	5

9. Besides the main activity, which of the following components of the Brain Power! curriculum did you use? Which ones did you use most often? (Please circle one response for each item in Column I. If you circle “Yes” in Column I, please also answer “Yes” or “No” in Column II.)

	Column I.		Column II.
	Have used		Use most often
	Yes	No	Yes	No
a. Discussion questions	1	2	1	2
b. Extension ideas	1	2	1	2
c. Assessment suggestions	1	2	1	2
d. Resources for teachers	1	2	1	2
e. Resources for students	1	2	1	2
f. Video or CD segments	1	2	1	2
g. Trading cards	1	2	1	2

10. Which of the following do you consider strengths of the Brain Power! curriculum? (Please circle one on each line.)

Yes No

a. Ready-to-use lesson modules 1 2

b. Engaging hands-on activities 1 2

c. The user-friendly ancillary materials (trading cards, posters, student handouts) 1 2

d. The entertaining and instructive student video 1 2

e. The positive reinforcement for students (i.e., award certificates, verbal praise in the video, written praise on student handouts) 1 2

f. Realistic timeframes in which to complete lessons 1 2

g. Potential to teach students valuable and perhaps life-saving information 1 2

h. Relevance to student experiences 1 2

i. Alignment to current state/district/national standards 1 2

j. Other (specify) 1 2

11. In which of the following ways could the Brain Power! curriculum use improvement? (Please circle one on each line.)

Yes No

a. Time estimations to complete each module 1 2

b. Selection of hands-on activities 1 2

c. Selection of materials for use in experiments or tasks 1 2

d. Selection of content 1 2

e. Links to web-based resources or other technology applications 1 2

f. Links to other subject areas 1 2

g. Assessment suggestions and/or assessment instruments 1 2

h. CD/Video quality 1 2

i. Parental materials 1 2

j. Teacher’s guide organization/usability 1 2

k. Student handout usability 1 2

l. Trading card usability 1 2

m. Other (specify) 1 2

12. If there were any parental communication, what were the terms? (Please circle all that apply.)

Yes

a. Questions about the content of the materials 1

b. Concerns about the appropriateness of materials 1

c. Questions or concerns about how to make best use of the suggestions in the parent newsletter or how to get involved with the material at home 1

d. Questions regarding specific websites listed in the parent newsletter 1

e. Concerns that children may be considering drug use 1

f. Questions about how to talk to child about drugs 1

g. Other (specify)………………………………………………………………… 1

h. None…………………………………………………………………………… 1

13. Which of the following statements best describes your overall experience using the Brain Power! curriculum? (Circle only one.)

I enjoyed teaching the curriculum and found it useful for my students 1

I enjoyed teaching the curriculum and found it useful for my students, but feel
the program needs a few minor adjustments 2

I think the curriculum has merit, but needs substantial revision in terms of
student engagement and student learning 3

I think the curriculum has merit, but needs substantial revision in terms of
appropriateness of content 4

Other (please specify) 5

THANK YOU!

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