Pre-interview Questionnaire

Clinical Laboratory Interview Feedback on DLS Professional Development Service Offerings: Questionnaire

1. Form Approved

2. OMB Control No. 0920-0974

3. Exp. Date: 10/31/2019

Project Title: Clinical Laboratory Interview Feedback on CDC Division of Laboratory Systems Professional Development Service Offerings

Pre-Interview Questionnaire

CDC estimates the average public reporting burden for this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0974).

Dear Colleague:

Thank you for volunteering to participate in an interview regarding CDC’s laboratory training and professional development offerings. By sharing your thoughts and experiences, you will help us improve CDC’s portfolio of laboratory training and other professional development resources.

We are conducting individual interviews via telephone (or in-person if that is more convenient for the participant) between May – June 2019. The interview will be recorded with your permission to verify the accuracy of our project team’s notes. Once the notes are deemed accurate, the audio recording will be destroyed. The notes will be de-identified as an additional confidentiality measure. Your name and other identifying information will not be linked to your responses.

Please complete the attached pre-interview questionnaire and email your responses by [MONTH, DAY] to Amy Hoying at AHoying@cdc.gov. Once we receive your responses, we will let you know whether you have been selected to participate in an interview and we will reach out to you for scheduling. Please feel free to contact Amy with any questions you may have about the interview or the questionnaire.

Thank you,

Renee Ned-Sykes, MMSc, PhD

Team Lead, Training and Workforce Development Branch

Division of Laboratory Systems (DLS)

Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)

Centers for Disease Control and Prevention (CDC)

Please fill out the questions below to the best of your ability and return the completed questionnaire to Amy Hoying at AHoying@cdc.gov. Thank you for your participation.

1. What best describes your current place of employment?

___ State Public Health Laboratory

___ Local/City/US Territory Public Health Laboratory

___ Other Governmental Laboratory

___ Hospital/Clinic Laboratory

___ Physician Office Laboratory

___Independent Reference Laboratory

___ Other (please describe) ___________________

2. How many years have you been employed by one or more laboratories that fall into the categories above?

3. In which city and state (or territory) does your current laboratory reside?

4. What is the approximate number of laboratory personnel who work at your current laboratory?

5. Please indicate your highest level of education.

___ High school diploma/GED

___ Associate degree, including Medical Laboratory Technician (MLT) degree

___ Bachelor's degree (BS, BA, etc.)

___ Master’s degree (MS, MPH, MBA, MPA, MPP, etc.)

___ Doctoral degree (PhD, DrPH, DSc, ScD, MD, DVM, DDS, etc.)

6. Do you supervise personnel? (Yes or No)

7. Do you have direct responsibilities managing or leading critical support activities for the laboratory or subset of the laboratory? If yes, please specify your role below. If no, please select “Not applicable.”

___ Quality Assurance Officer/Manager

___ Training Coordinator
___ Safety Officer
___ Other (please describe) ___________________

___ Not applicable

8. Do you have a role in deciding how the knowledge, skills, and abilities of laboratory staff are assessed? (Yes or No)

9. To what extent do you consider yourself knowledgeable about the availability, accessibility, or use of trainings and professional development opportunities that your organization’s laboratory staff engage in (other than yourself)?

___ 1 Not Knowledgeable

___ 2 Somewhat Knowledgeable
___ 3 Knowledgeable
___ 4 Very Knowledgeable

10. What is the best number and email to contact you to set up an interview?

Phone: __________________ Email: ___________________

11. Can you recommend other colleagues who may be interested in speaking with us? If so, please provide their name(s) and as much contact information as possible.

Name: __________________ Phone: __________________

Email: ___________________