NASA Office of Education Undergraduate Internship Impact Surveys - Retrospective and Traditional Development Surveys

#3b Development Outcome Retrospective Internship Scale 
Privacy Notice: This is an official NASA application hosted on Surveymonkey.com. This is not
a government application, the application is controlled and operated by a third party. NASA’s
Web Privacy Policy does not apply to this application. NASA will not maintain, use, or share
Personally Identifiable Information (PII) that becomes available through the use of this third
party application unless expressly stated and consent is obtained from the user. For additional
information on NASA’s Third-Party Privacy Notice please go to
http://www.nasa.gov/about/highlights/HP_Privacy.html.
Confidentiality Statement: In accordance with the Privacy Act of 1974, as amended (5 U.S.C.
552a), you are hereby notified that this study is sponsored by the National Aeronautics and
Space Administration (NASA) Office of Education (Education), under authority of the
Government Performance and Results Modernization Act (GPRMA) of 2010 that requires
quarterly performance assessment of Government programs for purposes of assessing agency
performance and improvement. NASA Education may use the information provided for statistical
purposes related to data collection instrument development and will hold the information in
confidence to the full extent permitted by law. Although efforts will be taken to ensure
confidentiality, there remains a remote risk of personal data becoming identifiable. A nonidentifying code number will be assigned to participants’ data records, which will be stored in
accordance with federal regulatory procedures and accessible only to the investigator. While
qualitative data is usually analyzed in aggregate, any use of individual data to illustrate specific
assessment results will be labeled in a manner to preserve the participants’ anonymity.
Information will be secured and removed from this server and location upon guidelines set out
by the NASA Records Retention Schedule 1392, 1 68D. For additional information, please go to
http://nodis3.gsfc.nasa.gIov/npg_img/N_PR_1441_001E_/NRRS_1441_0001.doc.
Introduction: This research seeks to support the mission of the NASA Office of Education by
asking you to take part in pre-internship surveys pertaining to our interest in the ways in which
NASA project activities impact outcomes for participants. The information we collect will help us
to improve the nature of the project activity and the accuracy with which NASA Education can
report to its community about the project activities it offers.
Purpose of the Study: Determine the degree to which instruments accurately capture the ways
participant outcomes are measured by data collection instruments.
Description of Study Procedures: You are asked to complete a short collection of related
surveys accessed by separate Surveymonkey links presented to you in the introductory email
from the NIFS Director or your NASA internship point of contact.
Study Consent: There are no foreseeable risks to participants electing to participate in this
study. Your participation is completely voluntary. In no way does refusing participation in preinternship survey development preclude you from eligibility for NASA education project activities
now or in the future. If you agree to participate, please answer the following questions to the
best of your ability.
Estimation of Time Required: To be determined through the testing procedure. Please note
your start time at the beginning of each survey. At the end of each, you will be asked to
approximate the time it to you to complete that particular survey.
Contact Person: If you have any additional questions concerning the research, this passive
consent, or confidentiality of responses, please contact Dr. Lisa E. Wills, Senior Research
Associate, at lisa.e.wills@nasa.gov or call (202)258-6021.

Wills 

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#3b Development Outcome Retrospective Internship Scale 

I. About you
Please note your start time. At the end of this survey, you will be asked to approximate
the time required to complete this survey.
For the questions below, please indicate your state of being before and after your
participation in the internship. At the end of this survey there is a place for you to add
any additional comments relating to your experiences.
Drop down menu options are as follows:
Not at all
A little
Moderately
Very
confident confident
confident
confident

Highly
confident

Ability to complete my
current degree
Before the internship:
After the internship:
Potential for growing into
b.
a more well-rounded
person
Before the internship:
After the internship:
My
critical
thinking skills
c.
Before the internship:
After the internship:
Preparation for the
d.
career I want
Before the internship:
After the internship:
Ability to manage a
e.
project
Before the internship:
After the internship:
Ability to teach myself
f.
new things
Before the internship:
After the internship:
Ability to do this kind of
g.
work as a career
Before the internship:
After the internship:
Adapted from: Crede, E., & Borrego, M. (2013). From ethnography to items: A mixed methods approach 
to developing a survey to examine graduate engineering student retention. Journal of Mixed Methods 
Research, 7(1), 62‐80. 

a.

Wills 

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#3b Development Outcome Retrospective Internship Scale 

2. Please use this space to provide any additional feedback about your
internship experience you’d like to share with us (500 characters with
spaces):_________________________________________________________
________________________________________________________________
________________________________________________________________
3. Please provide a current email address and your NASA UUPIC number so
that we are able to connect your Pre-experience and Post-experience
surveys with your profile information in NASA’s database.
Email address: ______________________
UUPIC number: _____________________
I do not have a NASA UUPIC number:____
II. Feedback on the overall survey experience:
Please provide the following feedback on your experience completing this survey:
4. How many minutes did you take to complete this survey? (whole number
only)___
Please indicate the level to which you agree or disagree with each statement, using the
drop down menu:
5. The survey instructions were clear. (Drop down menu options are as follows):

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#3b Development Outcome Retrospective Internship Scale 

6. The questions were easy to understand. (Drop down menu options are as
follows):

7. Do you have any additional comments or feedback on the instructions,
questions, or survey navigation? (500 characters with spaces):_____________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Thank you for participating!

Paperwork Reduction Act Statement: This information collection meets the requirements of
44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do
not need to answer these questions unless we display a valid Office of Management and
Budget (OMB) control number. The OMB control number for this collection is 2700-0159 and
expires 04/30/2018. We estimate that it will take 5 minutes to read the instructions and answer
the questions. Send only comments relating to this time estimate to: lisa.e.wills@nasa.gov

Wills 

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