0990-0372_Attachment A_Survey of Community College Faculty_063011

Form Approved

OMB No. 0990-

Exp. Date XX/XX/20XX

Attachment A

Faculty Survey and Supporting Materials

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990- . The time required to complete this information collection is estimated to average (0 hours)(10 minutes) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

Survey of Community College Faculty Affiliated with the Workforce Program

Name of Community College Consortium________________________[Pre-fill info if possible]

Name of Community College__________________________________[Pre-fill info if possible]

Question Number	Questions	Response Options
1.	Are you currently a…?	Part-time instructor Full-time instructor
2.	Which of the following best describes your experience teaching courses to college-level or professional students prior to teaching as part of the Workforce program:	This is my first teaching experience. I have taught for less than 2 years. I have taught for 2-5 years. I have taught for more than 5 years.
3.	How many years, if any, have you worked in the following fields (NOT including teaching in these fields): Health IT Health (but not IT-related) IT (but not health-related)	FOR EACH: Never Less than 2 years 2-5 years More than 5 years
4.	Please list the name(s) of the course(s) you have taught or are currently teaching as part of this program.	OPEN-ENDED
5.	In what format(s) were the courses you taught? (Please select all that apply.)	[PRE-POPULATE WITH COURSES LISTED IN Q4 AND GIVE THE FOLLOWING OPTIONS FOR EACH] In-person Webinar Self-paced online course Video conference Online discussion boards Other (specify probe)
6.	During your time teaching at [PRE-POPULATE WITH SCHOOL NAME], which version of the materials developed by the Curriculum Development Centers have you used? (Please select all that apply.)	First version Second version (available May 2011)
7.	[ONLY ASK IF MORE THAN ONE ITERATION WAS SELECTED IN Q6] To what extent do you agree that the Curriculum Development Centers have improved the course materials over time?	Strongly Agree Somewhat Agree Neither Agree Nor Disagree Somewhat Disagree Strongly Disagree
8.	Please indicate if you used the curriculum materials developed by the Curriculum Development Centers for any of the following components. If you used materials for more than one component. (Please select all that apply.)	Check box of the 20 components, plus the following two additional options: “Did not use any of the Curriculum Development Center materials” “Do not know the names of the components I used” [IF SELECTED “did not use” THEN SKIP TO Q13.]
9.	To what extent did you modify the Curriculum Development Center materials that you used in your teaching for your own courses?	Used without modification Modified minimally Modified moderately Modified extensively Modified almost completely
10.	Overall, how would you describe the usefulness of the materials developed by the Curriculum Development Centers?	Extremely useful Somewhat useful Not very useful Not at all useful
11.	Please rate the degree to which you think the students were satisfied with the materials developed by the Curriculum Development Centers.	Extremely satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Extremely dissatisfied Not able to say
12.	Thinking about the ways in which the Curriculum Development Centers could improve these materials, what specific comments/suggestions do you have?	Open-ended
13.	Did you ask for any assistance or support from the National Training and Dissemination Center (OHSU)?	No, I did not seek any support. Yes, I asked for support, but did not receive any. Yes, I asked for and received a response from the National Training and Dissemination Center. [IF REPLY 1 OR 2, SKIP TO Q15].
14.	Overall, how would you describe the usefulness of the assistance or support you received from the National Training and Dissemination Center (OHSU)?	Poor Fair Average Good Excellent
15.	Overall, how would you describe the usefulness of the assistance or support you received from the project director and other administrators to help you successfully teach your courses?	Poor Fair Average Good Excellent
16.	In your opinion, in general, to what extent were your students adequately prepared for the courses you taught in terms of their prior background?	Extremely well-prepared Somewhat prepared Somewhat unprepared Very unprepared

5