Form Attachment A3.4 Attachment A3.4 Screenshots for Customer Satisfaction On-line Host Surve

CUSTOMER SATISFACTION SURVEY FOR HOST INSTITUTIONS
OMB# EXP. DATE:
Public reporting burden for this collection of information is estimated to average 15 minutes, including the time for reviewing
instructions, searching existing data sources, gather and maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any
other aspect of this collection of information to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda,
MD 20892-7974, ATTN: PRA (0925-0534). Do not return the completed form to this address.
If you have comments or concerns regarding the status of your individual submission of this survey, please email
NIH-EIA-institutions-survey@mail.nih.gov
Introduction
Thank you for accessing the customer satisfaction survey for host institutions that have applied to the Early Independence
Award Program (EIA) as announced in RFA-RM-11-007 (http://grants.nih.gov/grants/guide/rfa-files/RFA-RM-11-007.html). The
purpose of this survey is to gather opinions about the EIA program. This is an opportunity for your institution to share
experiences and provide feedback. The information collected may be used to make adjustments to the EIA program in
subsequent announcements.
You have been identified as the single point-of-contact for this survey. We would like to ask you to coordinate the completion of
the survey by your institution. Some of the survey questions may require you to seek information from other offices within your
institution involved in the recruitment and selection of the EIA junior scientist(s).
The survey should take approximately 15 minutes to complete. There are no right or wrong answers, and you may skip any
questions that you do not wish to address. You can stop at any point and continue at another time.
The website for the survey will be open from [INSERT START DATE] to [INSERT START DATE] (11:59 pm Eastern
Daylight Time).
Privacy and Participation
Your participation is voluntary and non-participation will have no impact on you or your institution. Your responses will be kept
private. If you choose to participate, your privacy will be protected to the extent permitted by law, and will not be disclosed to
anyone but the researchers conducting this study, except as otherwise required by law. You will not be identified by name and
information from the study will only be reported in the aggregate. Your responses will be combined with those of other
respondents in the final report. Responses will be used solely for the purpose of program improvement. Any identifiers (e.g.,
names, institutions, e-mail addresses, etc.) will be removed when responses are compiled. No proprietary, classified,
confidential, or sensitive information should be included in your responses.
Agree to Participate
Press "START SURVEY" if you agree to participate. Your participation is greatly appreciated.

Start Survey

CUSTOMER SATISFACTION SURVEY FOR HOST INSTITUTIONS
OMB# EXP. DATE:
Please note that you can stop at any time and return to complete the survey at a later day. The submission deadline is (insert
date) (11:59pm EST).
For purposes of this survey, the term "candidate" refers to the exceptional junior scientist that applies as the principal
investigator with a host institution.
Section I. Recruitment and selection of candidates
1. How did your institution learn about the Early Independence Award (EIA) program? Please check all that apply.
The NIH website (webpage, e-newsletter posting, blog, etc.)
An NIH-sponsored listserv email or notice
NIH news release
Posted announcement in the NIH Nexus
Your institution's listserv email or notice
A notice from a professional society
Other (please specify):
2. How did your institution recruit potential candidates within and/or outside the institution?

3. What was the total number of candidates your institution had?

4. How many internal candidates (i.e., within the institution) sought to receive support for the EIA program at your
institution?

5. How many external candidates (i.e., outside the institution) applied at your institution to receive support for the EIA
program?

6. What were your institution's selection criteria (e.g., publication records, active pending support, high-risk and
innovative research, collaborative approach, scientific area, institution priorities, references, awards and honors,
leadership, etc.)?

7. What was the process by which your institution selected candidate(s)? Please select only one opton.
My institution had a formal process (e.g., written procedures for reviewing and selecting candidates)
Please describe the review/approval process, including the materials requested from candidates:

My institution had an informal process (e.g., no written procedures for reviewing and selecting candidates)
Please explain:

8. Is your institution considering changes to the recruitment and selection process in the future?
Yes
Please list the changes being considered:

No
9. What challenges do you anticipate the position/appointment created by the EIA program may pose for your
institution?

10. What plans does your institution have for your candidate(s) if they do not receive an NIH Award (e.g., provide
institutional funds as an independent fellow; connect with a mentor for a traditional post-doc, enroll in clinical
fellowship, etc.)?

Section II. NIH EIA Grant Application
11. What challenges did your institution encounter in preparing the content of the NIH grant application to comply
with the RFA instructions for the EIA program?

Section III. Suggestions
12. Would your institution be willing to support more than two Early Independent PIs if allowed?

13. What are alternative methods for matching host institutions and candidates that might be more effective than the
current method? Examples may include, awarding grants to institutions which then find suitable candidates, or
allowing NIH to match host institutions and candidates

14. How could NIH improve the EIA program (e.g., eligibility requirements, RFA instructions, letters of
recommendations, review criteria, length of time, size and number of awards, etc.) to make it more attractive to your
institution?

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For technical support, please contact NIH-EIA-institutions-survey@mail.nih.gov