HRSA NURSE Corps Satisfaction Questionnaire
Health Resources and Services Administration
Bureau of Health Workforce
Survey to be administered via the Web. Instructions and headings in BOLD and question numbers will not be seen by the respondents. Respondent will see either NURSE Corps Scholarship Program or Loan Repayment Program information throughout, based on sample identification.
The NURSE Corps is committed to continuous performance improvement. As part of this commitment, we are requesting feedback on your experiences with the NURSE Corps.
This survey is hosted on a secure server and your responses will remain anonymous. This survey is authorized by Office of Management and Budget Control No. 1090-0007, which expires May 31, 2018.
This survey will take approximately 15 minutes to complete. Thank you in advance for your participation.
Please click on the “Next” button below to begin.
TYPE OF SERVICE (IDENTIFIED IN SAMPLE):
NURSE Corps Loan Repayment Program
NURSE Corps Scholarship Program
NURSE Corps Loan Repayment Program – Nurse Faculty
Through which program did you most recently join the NURSE Corps?
Scholarship Program
Loan Repayment Program
Loan Repayment Program – Nurse Faculty
None of the above [TERMINATE SURVEY]
[IF INTRO1=1] Are you currently in nursing school?
Yes [DEFINE as GROUP 3 – Scholars in School]
No
[IF INTRO 2a = 2] Are you currently in residency?
Yes [DEFINE as GROUP 3 – Scholars in School]
No
[IF INTRO2a=1] When do you expect to graduate?
[NOTE: Drop down box for month and year selection]
[IF INTRO2a=1] Do you plan to complete a residency?
Yes
No
I don’t know
Please select your current professional health discipline.
Nurse Practitioner
Registered Nurse
Advanced Practice Registered Nurse
Nurse Faculty
Please select your highest nursing degree or certification attained from the list below.
Nursing Diploma
Associate’s
Bachelor’s
Bachelor’s Accelerated
Graduate Master’s
Post Master’s Certificate
Doctor of Nursing Practice
PhD
[IF INTRO3b=1,2,3,4,5,6,] Are you currently pursuing a higher nursing degree or certification?
Yes
No
[If INTRO3c=2] Do you plan to pursue a higher nursing degree or certification?
Yes
No
[IF INTRO3c=1 or INTRO3d=1] What degree or certification are you currently or planning to pursue? [CAPTURE RESPONSE]
What is your specialty?
None – I don’t have a specialty
Adult
Family Practice
Pediatrics
Psychiatry
Women’s Health
Other, please specify [CAPTURE RESPONSE]
Which one of the following best describes your current service status?
Graduated, but not yet serving [DEFINE as GROUP 3 – Scholars in School] [Skip to Q19]
Currently serving [DEFINE as GROUP 1 – In Service]
Completed service obligation [DEFINE as GROUP 2 – Alumni]
[ONLY Group 2 (Alumni)] On what date did you complete your service obligation with the NURSE Corps? [NOTE: Drop down box for month and year selection]
[ONLY Group 1 (In Service)] Do you plan to remain at your current site after you have fulfilled your NURSE Corps service obligation?
Yes
No
Don’t know (SKIP TO Q16)
[If Q3=YES] How long do you plan to remain at your current site?
Less than 1 year
1 year to less than 2 years
2 to 5 years
More than 5 years
Don’t know
[If Q3=YES] What will most influence your decision to remain at your current site after your service obligation is complete? [Rank up to 5 responses, with 1 being the most influential]
Overall experience with the NURSE Corps
Commitment to underserved communities
Salary and benefits
Opportunities for advancement
Ability to provide full scope of services
Tenured track (INTRO 1=3 ONLY)
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of training opportunities
Availability of resources to do my job well
Peer relationships
Community support
Close to extended family/parents and siblings
Spouse employment opportunities
School district
Difficulty finding another job
Length of commute
Other, please specify [CAPTURE RESPONSE]
[ONLY IF Q3=NO] What could your site do to encourage you to remain at your current site? (Rank up to 3 with 1 being the most influential.)
There’s nothing my site could do to change my decision to leave. (EXCLUSIVE)
Schedule flexibility
Salary increase
Improved benefits
Change in site leadership
Opportunities for advancement/leadership
Additional training opportunities
Hire additional support staff
Provide additional resources to do my job well
Mentoring support
Ability to provide input on site policies
Offer telehealth
Other (Capture response)
[ONLY IF Q3=NO] Are any of these external factors contributing to your decision to leave after you have fulfilled your NURSE Corps service obligation? [Rank up to 3, with 1 being the most influential]
Patient population
Didn’t like the community and/or lifestyle
Distance from extended family/parents/siblings
Spouse employment opportunities
School district
Length of commute
Retirement
Change of career
No external factors are contributing to my decision to leave. (EXCLUSIVE)
Other, please specify [CAPTURE RESPONSE]
[If Group 2 (Alumni)] Are you still employed at the critical shortage facility or teaching at the academic institution where you fulfilled your NURSE Corps service obligation?
Yes
No
[If Q8=YES] How long do you plan to remain at this site?
Less than 1 year
1 year to less than 2 years
2 to 5 years
More than 5 years
I don’t know
[ONLY IF Q8=YES] What influenced your decision to remain at your current site? [Rank up to 5, with 1 being the most influential]
Commitment to underserved communities
Salary
Opportunities for advancement
Ability to provide full scope of services
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Availability of training opportunities
Availability of resources to do my job well
Mentoring support
Peer relationships
Community support
Close to extended family/parents and siblings
Spouse employment opportunities
School district
Other, please specify [CAPTURE RESPONSE]
[ONLY IF Q8=NO] What could your site have done to encourage you to remain at your current site? (Rank up to 3 with 1 being the most influential.)
There’s nothing my site could do to change my decision to leave.
Schedule flexibility
Salary increase
Improved benefits
Change in site leadership
Opportunities for advancement/leadership
Additional training opportunities
Hire additional support staff
Provide additional resources to do my job well
Mentoring support
Ability to provide input on site policies
Offer telehealth
Other (Capture response)
[ONLY IF Q8=NO] Did any of these external factors contribute to your decision to leave your site? [Rank up to 3, with 1 being the most influential]
Patient population
Didn’t like the community and/or lifestyle
Distance from extended family/parents/siblings
Spouse employment opportunities
School district
Length of commute
Change of career
No external factors are contributing to my decision to leave. (EXCLUSIVE)
Other, please specify [CAPTURE RESPONSE]
[If Q8=NO] Have you chosen to continue at a different critical shortage facility or academic institution since fulfilling your service obligation with the NURSE Corps Program?
Yes
No
Did you relocate to perform your service obligation?
1. Yes
2. No
Why did you relocate to perform your service obligation?
1. No eligible facilities nearby
2. Local eligible facilities were not hiring
3. I wanted to relocate
4. Other [CAPTURE RESPONSE]
[ONLY for GROUP 1 and GROUP 2] How long after completing your degree did it take for you to find employment?
1-6 months
7-12 months
More than 1 year
[Group 1- In Service Clinicians] Please consider your previous training, including any post graduate training. Using a 10-point scale on which 1 means Very poorly prepared and 10 means Very well prepared, how prepared were you to practice at your site?
Evidence based care
Patient-centered care
Team-based integrated care
Practice management and administration
Social determinants of health
Working in underserved community
Caring for medically complex/special needs patients
Population-based health
Quality improvement
Value based care
[Group 1- In Service Clinicians] What additional training opportunities would have better prepared you to work in this environment? (Please rank up to 5, with 1 being the most important.)
Evidence based care
Patient-centered care
Team-based integrated care
Practice management and administration
Social determinants of health
Working in underserved community
Caring for medically complex/special needs patients
Population-based health
Quality improvement
Value based care
How
did you learn about the NURSE Corps Program? (Select all that apply)
[Allow
for
multiple responses]
Site administrator or site staff
Faculty at school/training programs
Colleague
Family member or friend
Current NURSE Corps member
NURSE Corps alumnus
NURSE Corps Web page
NURSE Corps Staff (Regional Office/Headquarters)
NURSE Corps Literature/Materials
Online research
Professional Association
Primary Care Office (PCO)
Primary Care Association (PCA)
Social Media (such as Facebook)
Exhibit at a professional meeting
Advertisements (print, newsletters, etc.)
Career Counselor
Other (please specify) [CAPTURE RESPONSE]
[INTRO1=2] Did you know about the NURSE Corps Loan Repayment Program before you began working at a critical shortage facility?
Yes
No
[If Q20=1] Did you seek employment at this site because of the NURSE Corps Loan Repayment Program?
Yes
No
[INTRO1=3] Did you know about the NURSE Corps Loan Repayment Program - Faculty before you began working at an academic institution?
Yes
No
[Only Groups 1 & 2] How did you become aware of the job where you completed (or are planning to complete) your NURSE Corps service requirement?
Health Workforce Connector (formerly NHSC Jobs Center)
I was already employed at the site
Direct recruitment by a site recruiter
Online job search site
Social media
Word of mouth
Referral from a friend or colleague
NURSE Corps staff
NURSE Corps site representative
Other (Please Specify)
[IF previous question = 4] Please specify which online job search site you used.
Monster
GlassDoor
CareerBuilder
Indeed
SimplyHired
Craigslist
usajobs.gov
ihs.gov
Other (Please specify)
Would you be interested in serving as a Clinical Instructor/preceptor in exchange for loan repayment?
1. Yes
2. No
3. Don’t know
[If the answer is “Health Workforce Connector (formerly NHSC Jobs Center)” from Q23] How did you hear about the Health Workforce Connector (formerly NHSC Jobs Center)?
Received an email from NHSC
Word of mouth
School representative
NURSE Corps website
Social media
Other website (Please specify)
Other (Please specify)
[Groups 1, 2, 3] Which of the following features would be most helpful in assisting with your online job search?
Ability to "favorite" sites and receive notifications/alerts when a site posts new jobs
Ability to upload resume and directly apply to open positions on the Health Workforce Connector (formerly NHSC Jobs Center)
Ability to search for, connect, and network with other nurses or health care professionals
Other (Please Specify)
Have you used the online Customer Service Portal in the last 12 months? The Customer Service Portal is a secured online account where NURSE Corps members can conduct transactions, upload required documents, ask questions, and perform other online activities.
Yes
No [Skip to NEXT SECTION – Customer Service]
Don’t know [Skip to NEXT SECTION – Customer Service]
How have you used the online Customer Service Portal in the last 12 months?
Please choose up to 5 of your most common uses, and provide a ranking based on how frequently you used the Customer Service Portal for this purpose. Of the 5 selections you make, please use 1 for your most common use and a 5 for your least common use. [Note - limit options based on respondent group]
Enrollment verification [Group 3]
Post graduate training verification/request [Group 3]
Ask a question [all]
Update my personal information [all]
Look at my service obligation end date [all]
Access my continuation application information [Group 1]
Request a transfer to a new site [Group 1]
Maternity/Paternity/Adoption leave request [Group 1 & 3]
Medical or non-medical suspension [Group 1 & 3]
Request a conversion from full-time to half-time service [Group 1
Report unemployment [Group 1]
Request a default/waiver [Group 1]
Request assistance to find an eligible site/critical shortage facility [Group 3]
Complete in-service verification [Group 1]
View payment history [all]
Leave of absence request (personal/family/medical reasons) [Group 3]
Update contact information [all]
Update banking information [Group 1 and Group 3]
Tax Information [all]
Request a debt estimate [Group 1 and Group 3]
Other, please specify [all] [CAPTURE RESPONSE]
What additional feature, if any, would you like to see added to the online Customer Service Portal? [CAPTURE RESPONSE]
Please think about your overall experience using the online Customer Service Portal in the last 12 months. Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:
The ease of navigation
Ability to find the information needed
Your ease of understanding the information communicated
The organization of the information provided
The usefulness of completing service requests through the online Customer Service Portal
The timeliness of NURSE Corps responses
Have you contacted the NURSE Corps during the past 12 months?
Yes
No [Skip to NEXT SECTION – Information/Communication]
Through what means have you contacted the NURSE Corps in the past 12 months? (Select all that apply) [Allow for multiple responses]
Telephone (Customer Care Center)
E-mail (Direct Analyst Assistance)
Fax
Customer Service Portal
Other, please specify [CAPTURE RESPONSE]
For what reasons did you contact the NURSE Corps in the past 12 months. [Rank up to 5 responses, with 1 bring the most common]; Note -limit options based on respondent group
General information [Groups 1 and 3]
Program requirements [Groups 1 and 3]
New application question [Groups 1 and 3]
Unemployment assistance [Group 1]
Continuation application question [Group 1]
Site search [Group 3]
Site transfer [Group 1]
Maternity/paternity/adoption leave [Group 1 & 3]
Medical or non-medical suspension [Group 1 & 3]
Conversion to half-time service [Group1]
Six-month service verification [Group 1]
Deferment [Group 3]
Scholarship award (tuition, fees and stipend) [Group 3]
View payment history [all]
Leave of absence request (personal/family/medical reasons) [Group 3]
Update contact information [Groups 1 and 3]
Update banking information [Groups 1 and 3]
Request tax information [all]
Default questions [all]
Request a debt estimate [Group 1 & 3]
Other (please specify) [all] [CAPTURE RESPONSE]
Of all the reasons you selected for contacting the NURSE Corps in the past 12 months, what was the reason of your most recent contact? [Only show selections made in Q38]
General information
Program requirements
New application question
Unemployment assistance
Continuation application question
Site search
Site transfer
Maternity/paternity/adoption leave
Medical or non-medical suspension
Conversion to half-time service
Six-month service verification
Deferment
Scholarship award (tuition, fees and stipend)
View payment history
Leave of absence request (personal/family/medical reasons)
Update contact information
Update banking information
Request tax information
Default questions
Request a debt estimate
[CAPTURED RESPONSE]
For your most recent contact, approximately how long did it take for the NURSE Corps to first respond to, or acknowledge, your initial contact?
Within 24 hours
Between 24 and 48 hours
Between 2 and 4 days
More than 4 days but less than 1 week
More than 1 week but less than 1 month
More than 1 month
They have never responded to my initial contact
For your most recent contact, ideally, how long should the NURSE Corps have taken to first respond to, or acknowledge, your initial contact?
No more than 24 hours
No more than 48 hours
No more than 2-4 days
No more than 1 week
No more than 1 month
Was the NURSE Corps representative able to resolve your issue?
Yes
No
[If Q42=1] How long did it take the NURSE Corps to resolve your issue/situation?
Within 24 hours
Between 24 and 48 hours
Between 2 and 4 days
More than 4 days but less than 1 week
More than 1 week but less than 1 month
More than 1 month
[If Q42=1] Ideally, what is your expectation for how long it should have taken the NURSE Corps to resolve your issue/situation?
No more than 24 hours
No more than 48 hours
No more than 2-4 days
No more than 1 week
No more than 1 month
[If Q42=2] You indicated that the NURSE Corps representative was not able to resolve your issue. Did the representative refer you elsewhere for further assistance?
Yes
No
[If Q45=1] To where did the NURSE Corps representative refer you?
Customer Service Portal
NURSE Corps Web page
Another NURSE Corps representative
Customer Care Center
Other (please specify) [CAPTURE RESPONSE]
Thinking about your most recent contact with the NURSE Corps, and using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate:
Ease of reaching a NURSE Corps representative
Courteousness of the NURSE Corps representative
Knowledge of the NURSE Corps representative
Timeliness of the representative’s response to your inquiry or concern
Relevance of the information provided by the NURSE Corps representative
Level of service provided by the NURSE Corps representative
Please use this space for any additional information you would like to provide the NURSE Corps regarding ways we can improve the program [CAPTURE RESPONSE]
[ONLY Group 3] Is there any other information that the NURSE Corps should consider providing to help you with your transition from training to service? [CAPTURE RESPONSE]
[ONLY Group 1 AND INTRO1=1] Was there any other information that the NURSE Corps could have provided to improve your transition from training to service? [CAPTURE RESPONSE]
Mentoring
MENTOR1 (GROUP 3 – IN SCHOOL) Why would you participate in a mentoring program? (Select all that apply)
Insights on NURSE Corps service experience
Candid feedback/advice on course selection and clinical rotations
Resume/curriculum vitae (CV) feedback
Guidance on finding a potential service site
Impartial or independent guidance
Understanding complexities of practicing in a Health Professional Shortage Area (HPSA)
Networking opportunities with other current NURSE Corps participants
Networking opportunities with past NURSE Corps participants
Other (Capture Response)
MENTOR2 (GROUP 1 & 2 – IN SERVICE & ALUMNI) Why would you serve as a mentor to NURSE Corps participants still in school? (Select all that apply)
Helps
prepare the next generation of clinicians
Give back to the NURSE Corps program
Leadership development
Networking opportunities
Potential recruitment opportunities for your organization
Opportunity to reflect on your current practice
Other (Capture Response)
MENTOR 3 (GROUP 1 IN – SERVICE)_Would you also be interested in having a mentor?
Yes
No
MENTOR4 (IF MENTOR 3 = YES) Why would you request to have a mentor? (Select all that apply)
Insights on NURSE Corps service experience
Career guidance
Impartial or independent guidance
Understanding complexities of practicing in a Health Professional Shortage Area (HPSA)
Networking opportunities with other current NURSE Corps participants
Networking opportunities with past NURSE Corps participants
Other (Capture Response)
MENTOR5 (IF MENTOR 3 = NO) Why would you choose not to participate in a mentor program?
Already have a mentor or mentee
Scheduling conflicts/limited availability
Do not see value in participation
Other (Open Ended)
MENTOR 6 (GROUP 3 – IN SCHOOL) Is there any other mentoring assistance that NURSE Corps can provide to improve your transition from training to service? (Open Ended - Capture Response)
MENTOR 7 (GROUP 1 – IN SERVICE) Is there any other mentoring assistance that NHSC/NURSE Corps can provide during your service commitment? (Open Ended - Capture Response)
CFI: We added the “b” questions to capture responses from nurse faculty
IF INTRO1=1 or 2
Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate your overall experience at the site where you have fulfilled/are fulfilling your service obligation with the NURSE Corps. [CAPTURE RESPONSE]
Please explain the reason for the rating you provided of your overall experience at the site where you have fulfilled/are fulfilling your service obligation with the NURSE Corps. [CAPTURE RESPONSE]
Using a scale from 1 to 10, where 1 means Not at all Prepared and 10 means Very Prepared, please rate how prepared you felt for dealing with the patient population at your site at the start of your NURSE Corps service obligation. [CAPTURE RESPONSE]
[IF Q58 = 1-4] What additional training or information would you have liked to receive? [Capture Response]
[If Q58= 7-10] What information did you receive that helped prepare you and from whom? [Capture Response]
What type of support did your site provide that was useful? (Select all that apply) [Allow for multiple responses]
Peer-to-peer communication
Conferences
Network opportunities
Mentoring
Continuing education
Other, please specify [CAPTURE RESPONSE]
Does
your organization have a need for NURSE Corps participants to split
their time across
multiple sites within the same network?
Yes
No
Unsure
[Ask 60B-63B IF INTRO1=3]
Using a scale from 1 to 10, where 1 means Poor and 10 means Excellent, please rate your overall experience at the academic institution where you have fulfilled/are fulfilling your service obligation with the NURSE Corps. [CAPTURE RESPONSE]
Please explain the reason for the rating you provided of your overall experience at the academic institution where you have fulfilled/are fulfilling your service obligation with the NURSE Corps. [CAPTURE RESPONSE]
Using a scale from 1 to 10, where 1 means Not at all Prepared and 10 means Very Prepared, please rate how prepared you felt for dealing with the students at your academic institution while you fulfilled/are fulfilling your service obligation with the NURSE Corps. [CAPTURE RESPONSE]
What type of support did your academic institution provide that was useful? (Select all that apply) [Allow for multiple responses]
Peer-to-peer communication
Conferences
Network opportunities
Mentoring
Continuing education
Cultural competency
Other, please specify [CAPTURE RESPONSE]
Please consider all of the experiences you have had with the NURSE Corps program. Using a 10-point scale on which 1 means Very Dissatisfied and 10 means Very Satisfied, how satisfied are you with the NURSE Corps? [CAPTURE RESPONSE]
Using a 10-point scale on which 1 means Falls Short of Your Expectations and 10 means Exceeds Your Expectations, to what extent has the NURSE Corps fallen short of or exceeded your expectations? [CAPTURE RESPONSE]
Imagine an ideal scholarship and loan repayment program. How well do you think the NURSE Corps compares with that ideal program? Please use a 10-point scale on which 1 means Not Very Close to Ideal, and 10 means Very Close to Ideal. [CAPTURE RESPONSE]
On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to continue to provide health services in a critical shortage facility after your service obligation is completed? [CAPTURE RESPONSE]
(If Q67>=7) What has contributed to the likelihood that you will continue to serve in a
critical shortage facility after your service obligation is complete? (Rank up to 5, with 1
being the most influential)
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of training opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Length of commute
Commitment to underserved communities
Other, please specify [CAPTURE RESPONSE]
Q69 (If Q67<7) What would increase your likelihood to continue to serve in a critical shortage
facility after your service obligation is complete? (Rank up to 5, with 1 being the most
influential)
Salary
Opportunities for advancement
Cost of living
Experience at site
Site operation/direction closely aligned with my personal goals
Balanced schedule/hours
Use of electronic health record system
Use of telemedicine
Availability of distance learning opportunities
Availability of resources to do my job well
Community support
Close to extended family/parents and siblings
Family wanted to stay in community
Spouse employment opportunities
School district
Length of commute
Better prepared to work with patient population
Other, please specify [CAPTURE RESPONSE]
Q70 On a scale from 1 to 10 where 1 means Completely Disagree and 10 means Completely Agree, to what extent do you agree that the NURSE Corps is delivering a meaningful experience to its members? [CAPTURE RESPONSE]
Q71 On a scale from 1 to 10 where 1 means Not at All Likely and 10 means Very Likely, how likely are you to recommend the NURSE Corps to someone else? [CAPTURE RESPONSE]
What is your gender?
Male
Female
Prefer not to say
What is your age?
18-24
25-34
35-44
45-54
55-64
65 and over
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
Prefer not to say
What is your race? (Select all that apply) [Allow for multiple responses]
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other, please specify [CAPTURE RESPONSE]
Prefer not to say
Do you speak a language other than English?
Yes
No
[If DEM5=1] What language(s), other than English, do you speak? (Select all that apply) [Allow for multiple responses]
Spanish
French
German
Chinese (Mandarin or Cantonese)
Hindi
Other, please specify [CAPTURE RESPONSE]
[IF DEM5=1] Are you able to use this other language at your job?
Yes
No
[ONLY Groups 1 and 2] Are you currently practicing, or have you practiced, in an underserved area that is within 100 miles of where you grew up/where you consider home?
Yes
No
[ONLY Groups 1 and 2] Are you currently practicing, or have you practiced, in an underserved area that is within 100 miles of where you completed your clinical training?
Yes
No
[ONLY Group 3] Are you currently attending a nursing school within 100 miles of where you grew up/where you consider home?
Yes
No
[ONLY Group 3] Do you plan to practice within 100 miles of where you completed your clinical training?
Yes
No
Don’t know
[IF DEM10=2] Do you plan to practice within 100 miles of where you grew up/where you consider home?
Yes
No
Don’t know
Ask DEM 13-DEM 19 of [Group 1 AND INTRO1=1 or 2] only
Does the site where you are currently working use any form of telehealth?
Yes
No [SKIP to DEM19]
What type?
Behavioral
Oral
ICU
I don’t know
Other [CAPTURE RESPONSE]
Is your clinic
the originating site (where the patient is located)
the distant site (where the clinician is located)
both the originating site and distant site
Do you personally use some form of telehealth in your clinical practice?
Yes
No
[If DEM16=YES AND DEM15=BOTH] Are you…
the clinician at the distant site providing the care
the clinician at the originating site assisting with the care
other [CAPTURE RESPONSE]
[If DEM16=NO] Why don’t you use telehealth in your clinical practice? [CAPTURE RESPONSE]
[If DEM13=NO] Why doesn’t your site use some form of telehealth? (Select all that apply)
Costs too high
Lack technical knowledge
Resistance among staff
Licensing barriers
Connectivity/bandwidth
I don’t know
Other [CAPTURE RESPONSE]
[ONLY Group 1] From the list below, please select the option that best describes where you currently work.
Hospital – Critical Access Hospital
Hospital – Disproportionate Share Hospital
Hospital – Public Hospital
Hospital – Private Hospital
Ambulatory Care – Ambulatory Surgical Center
Ambulatory Care – Federally Qualified Health Center (FQHC) or Look-Alike
Ambulatory Care – American Indian Health Facility
Ambulatory Care – Native Hawaiian Health Center
Ambulatory Care – Nurse Managed Health Clinic/Center
Ambulatory Care – Rural Health Clinic
Ambulatory Care – Urgent Care Center
Public Health (State or Local Public Health or Human Service Department)
Long Term Care – End Stage Renal Disease Dialysis Centers
Long Term Care – Home Health Agency
Long Term Care – Hospice Program
Long Term Care – Residential Nursing Home
Long Term Care – Skilled Nursing Facility
Mental Health – Certified Community Behavioral Health Clinic (CCBHC)
Public Academic Institution/Nursing School
Private Academic Institution/Nursing School
No Longer Providing Direct Patient Care
Private Practice/Solo Group
[ONLY Group 2] From the list below, please select the site that best describes where you were working when you finished your service obligation.
Hospital – Critical Access Hospital
Hospital – Disproportionate Share Hospital
Hospital – Public Hospital
Hospital – Private Hospital
Ambulatory Care – Ambulatory Surgical Center
Ambulatory Care – Federally Qualified Health Center (FQHC) or Look-Alike
Ambulatory Care – Indian Health Service Health Center
Ambulatory Care – Native Hawaiian Health Center
Ambulatory Care – Nurse Managed Health Clinic/Center
Ambulatory Care – Rural Health Clinic
Ambulatory Care – Urgent Care Center
Public Health (State or Local Public Health or Human Service Department)
Long Term Care – End Stage Renal Disease Dialysis Centers
Long Term Care – Home Health Agency
Long Term Care – Hospice Program
Long Term Care – Residential Nursing Home
Long Term Care – Skilled Nursing Facility
Mental Health – Certified Community Behavioral Health Clinic (CCBHC)
Public Academic Institution/Nursing School
Private Academic Institution/Nursing School
No Longer Providing Direct Patient Care
Private Practice/Solo Group
Other, Please Specify (capture response)
[ONLY Group 2] From the list below, please select the site that best describes where you are working now.
Hospital – Critical Access Hospital
Hospital – Disproportionate Share Hospital
Hospital – Public Hospital
Hospital – Private Hospital
Ambulatory Care – Ambulatory Surgical Center
Ambulatory Care – Federally Qualified Health Center (FQHC) or Look-Alike
Ambulatory Care – American Indian Health Facility
Ambulatory Care – Native Hawaiian Health Center
Ambulatory Care – Nurse Managed Health Clinic/Center
Ambulatory Care – Rural Health Clinic
Ambulatory Care – Urgent Care Center
Public Health (State or Local Public Health or Human Service Department)
Long Term Care – End Stage Renal Disease Dialysis Centers
Long Term Care – Home Health Agency
Long Term Care – Hospice Program
Long Term Care – Residential Nursing Home
Long Term Care – Skilled Nursing Facility
Mental Health – Certified Community Behavioral Health Clinic (CCBHC)
Public Academic Institution/Nursing School
Private Academic Institution/Nursing School
No Longer Providing Direct Patient Care
Private Practice/Solo Group
[ONLY Groups 1 and 2 AND INTRO1=1 OR 2] How many patients does your site see per year?
1-2,500 patients
2,501-5,000 patients
5,001-7,500 patients
7,501-10,000 patients
10,001-15,000 patients
15,001-20,000 patients
Over 20,000 patients
[Groups 1 & 2] On average, how many patients do you see per day?
[WHOLE NUMBER VALUE]
[ONLY THOSE THAT SELECTED MENTAL AND BEHAVIORAL HEALTH DISCIPLINE] Does your site provide mental and behavioral health services?
Yes
No
[ONLY Groups 1 and 2] From the drop-down box below, please select the state where you are currently employed. [CAPTURE RESPONSE]
[ONLY Groups 1 and 2] Please list the ZIP code of the site where you are currently employed. [CAPTURE RESPONSE]
[ONLY Group 3] From the drop-down box below, please select the state where you are currently attending health professions school. [CAPTURE RESPONSE]
Thank you for your time. The Health Resources and Services Administration’s NURSE Corps Program appreciates your input!
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GROUP 1 – In Service; GROUP 2 – Alumni; GROUP 3 – Scholars in School/Residency
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | HRSA OPR |
Author | Heather Reed/Sheri Teodoru |
File Modified | 0000-00-00 |
File Created | 2021-01-22 |