Form 5 Attachment E: Secondary Trainee One-time 12-month Survey

Survey #5: One-Time Survey of Secondary Trainees

(Web-Based Survey: Administered to Secondary Trainees at 12 months after completing the training)

Demographic Questions

1. What type of health care practitioner best describes you?

 Administrator/Clinical manager

 Care manager/Case manager

 Clinical nurse specialist

 Clinical psychologist

 Clinical social worker

 Dentist

 Diabetes educator/Diabetes management nurse

 Health care navigator/Patient navigator

 Medical assistant

 Certified nurse midwife

 Nurse

 Nurse practitioner

 Occupational therapist

 Patient health educator/Certified health education specialist (CHES)

 Pharmacist

 Physician assistant

 Physician

 Psychiatrist

 Quality improvement manager

 Registered dietitian

 Respiratory therapist

 Other _____________ (please specify)

2. In what kind of setting do you practice most of the time?

 Academic institution

 Ambulatory/office-based care setting

 Behavioral health care setting

 Community health care setting

 Correctional facility

 Emergency department

 Federally qualified health center or other public health center

 Home care

 Hospice and/or palliative care setting

 Hospital based setting

 Long-term care facility

 Migrant worker health center

 Pharmacy setting

 Rehabilitation center

Public reporting burden for this collection of information is estimated to average 10 minutes per response, the estimated time required to complete the survey. 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, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

 Specialty clinic

 Substance use/abuse treatment center

 University health care/hospital setting

 Urgent care setting

 Veteran or military health care center/hospital

 Other _______________ (please specify)

3. Which of the following best describes where your practice setting is located?

 Rural area

 Small or commuter town

 Suburban area

 Urban area

4. How many years have you been working in your current occupation?

 2 years or less

 3-9 years

 10-19 years

 20-25 years

 26+ years

5. To what extent do you work as part of an interdisciplinary patient care team?

 To a great extent

 Somewhat

 Not at all

6. Is the organization you work for recognized as a patient-centered medical home or patient-centered specialty practice (PCMH/PCSP)?

 Yes

 No, but in the process of becoming recognized as one

 No

 I don’t know

7. Is the organization you work for an accredited Accountable Care Organization (ACO)?

 Yes

 No, but in the process of becoming an accredited ACO

 No

 I don’t know

8. Please briefly describe any other accreditation, certifications, distinctions, or recognitions that your organization maintains.

Use of Training in Practice - General Questions

Implementation Questions

9. Compared to before you completed the AHRQ Patient-Centered Outcomes Research in Shared Decisionmaking (PCOR in SDM) training:

	To a great extent	Somewhat	Not at all
Has your use of AHRQ’s PCOR tools and resources in practice increased?
Has your implementation of SDM processes in practice with patients increased?
Has your use of PCOR resources in SDM with patients increased?

10. How often have you used the following AHRQ Effective Health Care (EHC) Program tools/resources since you participated in the training?

	Daily or almost daily	At least once a week	Two to three times a month	About once a month	A couple of times in the past 6 months	Never
AHRQ EHC Program Web site
Patient/consumer summaries – shared with patient and/or family members
Patient decision aids – shared with patient and/or family members
Spanish-language consumer summaries – shared with patient and/or family members
Mobile access to the AHRQ EHC Web site
Clinician summaries (for my own ongoing learning)
PCOR Continuing education modules (CME/CE/CEU)
Faculty slide decks
Research reviews or syntheses
An EHC Web conference
Webcasts

11. How often have you used the following AHRQ SDM Toolbox tools/resources in the past 6 months?

	Daily or almost daily	At least once a week	Two to three times a month	About once a month	A couple of times in the past 6 months	Never
SDM toolbox Web page on the AHRQ Web site
SDM quick reference guide
Sample dialogue guide/Talking points
Cultural awareness checklist
Health literacy strategies summary
Implementation brief for interdisciplinary teams
Administrator brief about the benefits of implementing PCOR in SDM between providers and patients

12. How useful do you find the following AHRQ SDM Toolbox tools/resources?

	Very useful	Somewhat useful	Not very useful	Not at all useful	I did not use this tool/resource
SDM toolbox Web page on the AHRQ Web site
SDM quick reference guide
Sample dialogue guide/Talking points
Cultural awareness checklist
Health literacy strategies summary
Implementation brief for interdisciplinary teams
Administrator brief about the benefits of implementing PCOR in SDM between providers and patients

13. Please describe any new tools that would be helpful to you in sharing AHRQ PCOR resources with your patients in SDM. ________________________

14. Please indicate how useful each of the following components of the AHRQ PCOR in SDM training have been to your personal practice?

	Very useful	Somewhat useful	Not very useful	Not at all useful	Not applicable
Locating trusted CER/PCOR resources.
Using CER/PCOR to facilitate health care decisionmaking.
Sharing CER/PCOR decision aids with patients.
Discussing risks and benefits about health care options with patients
Engaging patients to learn their preferences and values for their health care options
Including patients in decisionmaking if they want to be involved.

15. In your opinion, have there been any changes in the following areas regarding your patient population?

	Increased greatly	Increased slightly	No change	Decreased slightly	Decreased greatly	Don’t know/ Unsure
Patients’ active involvement in decisionmaking
Patient satisfaction
Patient compliance with health decisions/treatments
Patient outcomes
Patient requests for interventions/treatments with limited/equivocal evidence of effectiveness
Financial costs to patients (i.e., their out-of-pocket expenses)

16. Please describe any other perceived patient benefits or impacts you have observed after applying what you learned during the PCOR in SDM training in your practice?

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

17. Which of the following have been the biggest obstacles to implementing and applying PCOR in SDM concepts in your own patient practice? (check all that apply)

• Accessing PCOR tools and resources

• Not having enough time with my patients

• My patients aren’t interested

• Obtaining resources for distribution to my patients

• Obtaining support from my organization

• Obtaining resources to implement change

• None of the above

Other (please specify)

Wrap Up

18. Please briefly describe how you have used what you learned during the PCOR in SDM training in your practice? _____________________________________________________________________________

_____________________________________________________________________________

19. Are there any additional comments you would like to share with us? _____________________________________________________________________________

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ATTACHMENT E: AHRQ EtE -- Survey 5 – Annually-Administered Survey of Secondary Trainees 10