Attachment C8 – Mine Rescue participants: Post-Simulation Questionnaire
Form
Approved OMB
No. 0920-0975 Exp.
Date xx/xx/20xx
First, on the top row, circle your role during today’s simulation. For each item below, rate (from 1 to 5) how well you and each member of your team did during the simulation you just completed.
CIRCLE ONE: |
Mine Rescue Captain |
Map Man |
Gas Man |
Stretcher Man |
Tail Captain |
Briefing Officer |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 = Poor |
|
|
|
|
|
|
2 = Below Average |
|
|
|
|
|
|
3 = Average |
|
|
|
|
|
|
4 = Above Average |
|
|
|
|
|
|
5 = Excellent |
|
|
|
|
|
|
|
|
|
|
2. Think about the simulation you just completed and place an “X” in the appropriate box.
a) The mental demands were: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
b) The physical demands of the exercise were: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
c) The level of stress I experienced was: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
|
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
e) The level of frustration I experienced was: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
f) The amount of effort needed to complete the task was: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
g) The level of eye strain I experienced was: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
h) The level of strain I experienced from standing during the simulation was: |
|||||||||||
Very Low |
|
|
|
|
|
|
|
|
|
|
Very High |
Public reporting burden of
this collection of information is estimated to average 3 minutes per
response, including the time for reviewing instructions, searching
existing data sources, gathering 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, including suggestions for reducing this burden, to CDC,
Project Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA,
30333, ATTN: PRA (0920-0975).
3. Answer the following questions about the simulation by placing an “X” in the appropriate box.
a) How natural did moving through the virtual mine seem? |
||||||||
Not Natural |
|
|
|
|
|
|
|
Very Natural |
b) How much did your experience in the virtual simulation seem consistent with your real-world experiences in an actual mine? |
||||||||
Not Consistent |
|
|
|
|
|
|
|
Very Consistent |
c) How natural were your interactions with the environment (e.g., opening doors, taking gas readings)? |
||||||||
Not Natural |
|
|
|
|
|
|
|
Very Natural |
d) Were you involved in the exercise to the extent that you lost track of time? |
||||||||
No – I did not lose track of time at all |
|
|
|
|
|
|
|
Yes – I completely lost track of time |
e) How responsive was the simulation to actions that you performed with the air mouse? |
||||||||
Not at all responsive |
|
|
|
|
|
|
|
Very responsive |
f) How engaged were you in the virtual reality experience? |
||||||||
Not at all engaged |
|
|
|
|
|
|
|
Very engaged |
g) How immersed did you feel in the virtual environment? |
||||||||
Not at all immersed |
|
|
|
|
|
|
|
Very immersed |
4. On a scale from 1 to 10, rate how difficult or easy it was for you, by the end of the simulation, to do the following.
Place an “X” in the appropriate box. |
Very Difficult |
|
|
|
|
|
|
Very Easy |
||
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
5. Rate how much you agree or disagree that the words and phrases below describe the simulation you just completed.
|
Strongly Disagree |
Disagree |
Neither |
Agree |
Strongly Agree |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
6. Are you able to see stereoscopic 3D images? Yes No
7. Rate how much, if at all, you experienced the symptoms below as a result of the VR simulation.
|
None |
Slight |
Moderate |
Severe |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
8. How often do you get motion sickness in the following situations?
|
Never |
Once in a while |
Sometimes |
Frequently |
Always |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
9. How much, if any, motion sickness did you experience during the following events in the VR simulation?
|
None |
Slight |
Moderate |
Severe |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
10. Did you enjoy participating in this VR simulation? Yes No
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | CDC User |
File Modified | 0000-00-00 |
File Created | 2021-01-27 |