Form Approved
OMB No. 0990-
Exp. Date XX/XX/20XX
Attachment 2
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
Faculty Email Invitation
[DATE]
Dear [INSTRUCTOR’S NAME],
In an effort to gain knowledge about the Health Information Technology (IT) Workforce program being implemented at [INSERT CC NAME] and other community colleges across the United States, we are asking you to participate in the Health IT Workforce Program Evaluation. This study is being conducted by the National Opinion Research Center (NORC) at the University of Chicago on behalf of the Office of the National Coordinator for Health Information Technology (ONC) at the U.S. Department of Health and Human Services.
We have asked you and other instructors affiliated with the community colleges participating in the Workforce Program to complete a web-based survey regarding the program and courses you have taught. The purpose for this survey is to gather information that will help to evaluate the effectiveness of the academic program in preparing a well-trained workforce in the Health IT industry. Your responses will help ONC refine the curriculum materials and implementation for a more effective and robust program and to improve the academic and career opportunities available in the future for individuals who enroll in Health IT programs.
We would greatly appreciate your contribution to this important study by completing a 20 minute questionnaire online.
Accessing the Survey
To access the Health IT Workforce Program Evaluation survey, please go to the following URL address:
[INSERT WEB SURVEY LINK]
Because this format is secure and confidential, you’ll need to use a unique Personal Identification Number (PIN) and Password to access the survey after you have gone to the URL address. Your unique PIN and Password are as follows.
PIN: [WEBPIN] Password: [WEBPWD]
Should you need to stop the survey at any time while taking it, you may suspend and re-access the survey to finish it at a later time.
Confidentiality
Please keep in mind that NORC maintains strict confidentiality standards. Your responses will be reported in summary form only and will be safeguarded in accordance with the Privacy Act of 1974. Your individual data will not be shared with your school. Please also keep in mind:
Your participation in this survey is voluntary.
This online survey is housed on a secure and protected web server.
Background Information
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 created the Workforce Program to support the development of Health IT education programs for the purpose of facilitating the creation of a robust workforce dedicated to the rapid and widespread adoption and use of health information technology. Additional information on Health IT Workforce and other HITECH programs may be found here: http://healthit.hhs.gov.
NORC at the University of Chicago has a long history of conducting high-quality social science research to inform public policy and promote the public interest.
Contact Us
If you have any questions regarding the survey, please e-mail us at [EMAIL ADDR] or call our toll-free number at [STUDY TOLL FREE]. If you have questions about your rights as a study participant, you may call the NORC IRB Administrator, toll free, at 866-309-0542.
Again, thank you for your time and we look forward to further contact with you.
Sincerely,
Kristina Lowell, Ph.D.
Project Director
NORC at the University of Chicago
Faculty Email Invitation – Follow-up
[DATE]
Dear [INSTRUCTOR’S NAME],
Hopefully you have received our previous email inviting you to participate in an online survey for instructors who teach courses for the Health IT academic programs at community colleges across the nation. We would greatly appreciate your participation in this very important study and would like you to hear from you soon.
In an effort to gain knowledge about the Health Information Technology (IT) Workforce program being implemented at [INSERT CC NAME] and other community colleges across the United States, we are asking you to participate in the Health IT Workforce Program Evaluation. This study is being conducted by the National Opinion Research Center (NORC) at the University of Chicago on behalf of the Office of the National Coordinator for Health Information Technology (ONC) at the U.S. Department of Health and Human Services.
We have asked you and other instructors affiliated with the community colleges participating in the Workforce Program to complete a web-based survey regarding the program and courses you have taught. The purpose for this survey is to gather information that will help to evaluate the effectiveness of the academic program in preparing a well-trained workforce in the Health IT industry. Your responses will help ONC refine the curriculum materials and implementation for a more effective and robust program and to improve the academic and career opportunities available in the future for individuals who enroll in Health IT programs.
We would greatly appreciate your contribution to this important study by completing a 20 minute questionnaire online.
Accessing the Survey
To access the Health IT Workforce Program Evaluation survey, please go to the following URL address:
[INSERT WEB SURVEY LINK]
Because this format is secure and confidential, you’ll need to use a unique Personal Identification Number (PIN) and Password to access the survey after you have gone to the URL address. Your unique PIN and Password are as follows.
PIN: [WEBPIN] Password: [WEBPWD]
Should you need to stop the survey at any time while taking it, you may suspend and re-access the survey to finish it at a later time.
Confidentiality
Please keep in mind that NORC maintains strict confidentiality standards. Your responses will be reported in summary form only and will be safeguarded in accordance with the Privacy Act of 1974. Your individual data will not be shared with your school. Please also keep in mind:
Your participation in this survey is voluntary.
This online survey is housed on a secure and protected web server.
Background Information
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 created the Workforce Program to support the development of Health IT education programs for the purpose of facilitating the creation of a robust workforce dedicated to the rapid and widespread adoption and use of health information technology. Additional information on Health IT Workforce and other HITECH programs may be found here: http://healthit.hhs.gov.
NORC at the University of Chicago has a long history of conducting high-quality social science research to inform public policy and promote the public interest.
Contact Us
If you have any questions regarding the survey, please e-mail us at [EMAIL ADDR] or call our toll-free number at [STUDY TOLL FREE]. If you have questions about your rights as a study participant, you may call the NORC IRB Administrator, toll free, at 866-309-0542.
Again, thank you for your time and we look forward to further contact with you.
Sincerely,
Kristina Lowell, Ph.D.
Project Director
NORC at the University of Chicago
Faculty Web-Survey Consent Form
Login Page:
The National Opinion Research Center (NORC) at the University of Chicago is conducting an important study on behalf of the Office of the National Coordinator for Health Information Technology (ONC) on their Health Information Technology for Economic and Clinical Health (HITECH) Workforce program. The primary purpose of this study is to evaluate the effects of the program on preparing a well-trained Health IT workforce.
You should have received a personal identification number (PIN) and a password by mail or e-mail that will help you gain access to this survey. Please enter them in the fields below, and then click the "Continue" button.
IMPORTANT: Your password is CASE SENSITIVE and will not let you login without proper UPPER and LOWER CASE for the LETTERS in password.
Thank you for taking the time to complete the survey.
Please enter your PIN: Please enter your Password:
If you have any issues accessing the survey, please contact the study at [INSERT STUDY TOLL FREE NUMBER] or send an e-mail to [INSERT STUDY EMAIL ADDRESS].
Consent Page:
Under contract with ONC within the U.S. Department of Health and Human Services (HHS), NORC seeks to obtain information from instructors who taught courses in the Health Information Technology workforce program concerning their experiences with the program. You are being asked to participate in this important study, the Health IT Workforce Program Evaluation.
The information collected in the questionnaire is solicited under the authority of the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) and your data is protected under the Privacy Act of 1974 as amended. NORC and ONC are required to treat all information you provide as confidential. The information you provide will be used only for the purpose of analyzing data and preparing scientific reports and articles. Any information publicly released (such as statistical summaries) will be in a form that does not personally identify you. Your individual information will not be shared with your school.
Your participation will be used to identify areas for possible improvement to the Health IT academic programs and help ONC to evaluate the effectiveness of the academic program in preparing a well-trained workforce in Health IT. Your response is voluntary and failure to provide some or all of the requested information will not in any way adversely affect you. You may skip questions you do not feel comfortable answering or end the survey at any time. Actual time to complete the questionnaire may vary depending on your circumstances. On the average, it will take approximately 20 minutes.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current valid OMB Control Number. The OMB Control Number is xxxx-xxxx for this study and approval expires on xx/xx/xxxx.
If you have any questions or comments regarding this study, you may refer to the Frequently Asked Questions at [INSERT LINK TO FAQs]. If you have further questions, please contact the study at [INSERT STUDY TOLL FREE NUMBER] or send an e-mail to [INSERT STUDY EMAIL ADDRESS].
Again, thank you for your time and effort in completing this very important study on the Health Information Technology Workforce Program.
{Please Click the “CONSENT” button to launch the survey.}
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…?
|
|
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: |
1. This is my first teaching experience. 2. I have taught for less than 2 years. 3. I have taught for 2-5 years. 4. I have taught for more than 5 years. |
3. |
How many years, if any, have you worked in the following fields:
|
FOR EACH:
|
4. |
Please list the name/s of the course/s you taught. |
OPEN-ENDED |
5. |
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 WITH ADDITIONAL OPTIONS FOR “DID NOT USE ANY OF THE CURRICULUM DEVELOPMENT CENTER MATERIALS” OR “DO NOT KNOW THE NAME OF THE COMPONENT.” IF SELECT “DID NOT USE,” THEN SKIP TO QUESTION 11. |
6. |
[THIS QUESTION WILL BE ASKED FOR EACH COMPONENT SELECTED IN Q. 5] Thinking about the course materials developed by the Curriculum Development Centers for this component, approximately what percentage of your course was based directly on these materials? |
|
7. |
[THIS QUESTION WILL BE ASKED FOR EACH COMPONENT SELECTED IN Q. 5] Based on the course materials that you did use, please describe the degree to which you modified the materials. |
1. Used without modification 2. Modified minimally 3. Modified moderately 4. Modified extensively 5. Modified almost completely |
8. |
Overall, how would you describe the usefulness of the materials developed by the Curriculum Development Centers? |
1. Extremely useful 2. Somewhat useful 3. Not very useful 4. Not at all useful |
9. |
Please rate the degree to which you think the students were satisfied with the materials developed by the Curriculum Development Centers. |
1.Extremely satisfied 2. Somewhat satisfied 3. Neither satisfied nor dissatisfied 4. Somewhat dissatisfied 5. Extremely dissatisfied 6. Not able to say |
10. |
Thinking about the ways in which the Curriculum Development Centers could improve these materials, what specific comments/suggestions do you have? |
Open-ended |
11. |
Have you asked for any assistance or support from the Curriculum Development Centers? |
1. No, I did not seek any support. 2. Yes, I asked for support, but did not receive any. 3. Yes, I asked for and received a response from the Curriculum Development Centers.
IF REPLY 1 OR 2, SKIP TO 13. |
12. |
Overall, how would you describe the usefulness of the assistance or support you received from the Curriculum Development Centers? |
1. Poor 2. Fair 3. Average 4. Good 5. Excellent |
13. |
Did you ask for any assistance or support from the National Training and Dissemination Center (OHSU)? |
1. No, I did not seek any support. 2. Yes, I asked for support, but did not receive any. 3. Yes, I asked for and received a response from the National Training and Dissemination Center.
IF REPLY 1 OR 2, SKIP TO 15. |
14. |
Overall, how would you describe the usefulness of the assistance or support you received from the National Training and Dissemination Center (OHSU)? |
1. Poor 2. Fair 3. Average 4. Good 5. Excellent |
15. |
In your opinion, in general, to what extent were your students adequately prepared for the courses you taught in terms of their prior background? |
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| File Type | application/msword |
| File Title | Form Approved |
| Author | DHHS |
| Last Modified By | DHHS |
| File Modified | 2010-11-18 |
| File Created | 2010-11-18 |