4 Trainee Survey

Attachment 5: RPHWTNP Trainee Survey
Question No.

Question

Skip Logic

Response Options

Required

Valid Response
Restriction

The following survey is designed to assess information on behalf of the Health Resources and Services Administration (HRSA) for the Rural Public Health
Workforce Training Network Program (RPHWTN) administered by the Federal Office of Rural Health Policy (FORHP). The purpose of this survey is to
understand the population who may benefit from rural health training programs and the training needs of the those enrolled in this program. Please note that
your individual responses within this survey are completely confidential and will never be shared with your employer, your training organization, or anyone
outside of the Health Resources and Services Administration.
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. The OMB control number for this information collection is 0915/0906-XXXX and it is valid until XX/XX/202X. This information collection is voluntary.
Public reporting burden for this collection of information is estimated to average 0.25 hours per response, including the time for reviewing instructions,
searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B,
Rockville, Maryland, 20857 or paperwork@hrsa.gov.
Today's Training
1
Have you participated in a training today?
No
*
Yes
2
Did you receive this survey link due to
Skip to Q3
No, I did not participate in a past
*
your participation in a past training?
training.
Skip to Q4
Yes, I did participate in a past training.
3
Please indicate how received this survey
Skip to end of Free-text
250 character limit
link.
survey.
4
We are only collecting data from
No, I am 18 years old, or older.
*
individuals 18 and over for this program.
Are you under the age of 18?
Skip to end of Yes, I am under the age of 18.
survey.
5

Please indicate your age.

18-19 years old
20-24 years old
25-39 years old
30-34 years old
35-39 years old
40-44 years old
45-49 years old

*

Dropdown

6

What training did you complete?

Skip to Q8

Skip to Q7
7

Please indicate what training you
completed.

50-54 years old
55-59 years old
60-64 years old
65-69 years old
70-74 years old
75-79 years old
80-84 years old
85+ years old
I prefer not to answer
behavioral health
care coordination
case management
community health workers
community paramedicine
COVID-related topics
cultural competence
cybersecurity
doula services
electronic health records (EHR)
emergency medical technician (EMT)
health IT
HIPAA compliance
insurance benefits counseling
medical assistant
medical billing and coding
nursing
peer recovery/ peer support
respiratory care
telehealth
None of the above.
Free-text

*

Attachment 5: RPHWTNP Trainee Survey

8

9

10

11

12

Demographics
13

Was the content of this training new to
you or was it information that you were
already familiar with? Please rank your
level of familiarity with the information
presented in this training. The content of
this training was…
Do you feel like you had access to all of
the necessary resources to help you
successfully complete this training?
What resources would you have needed
to help you be more successful in
completing this training?
Do you feel that this training expanded
your knowledge base and/or skill set?

How likely are you to use the
knowledge/skills gained from this training
in your current or future job?
Please check all the following that you
identify as:

14

Do you identify as Hispanic or
Latino/Latina/Latinx?

15

What is the primary language that you
speak at home?

Likert scale (Not familiar at all Extremely familiar)

*

Skip to Q10

No

*

Skip to Q11

Yes
Free-text

No
Yes
Unsure. Please explain [free-text]
Likert scale (Extremely unlikely Extremely likely)

250 character limit

*

*

White
*
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific
Islander
I prefer a different term [free-text]
I prefer not to answer
Yes
*
No
I prefer not to answer
English
*
Spanish
Not listed here - please indicate what
language you speak at home [freetext]
Attachment 5: RPHWTNP Trainee Survey

16

What language(s) do you speak at work?
(Select all that apply.)

Free-text

*

17

Where are you currently located? Please
indicate the state and country where you
currently live.

State [dropdown]

*

18
Background
19

County [dropdown]
Free-text, numeric

What is the ZIP code where you currently
live?
What is the highest level of education you
have completed?

5 digits

High school diploma/ GED
Associate's Degree
Bachelor's Degree
Postgraduate Degree - Master's Level.
Please specify what degree: [free-text]

*

Postgraduate Degree - PhD Level.
Please specify what degree: [free-text]
20

21

Have you completed any other trainings
or coursework, other than the training
indicated in question #6, in the past 5
years?
Which topics have you successfully
completed trainings on in the past 5
years? These can include professional
certifications, standalone trainings, etc.
Select all that apply.

Skip to Q22

Skip to Q23

None of the above.
No
Yes

*

behavioral health
care coordination
case management
community health workers
community paramedicine
COVID-related topics
cultural competence
cybersecurity
doula services
electronic health records (EHR)
emergency medical technician (EMT)
health IT
HIPAA compliance
insurance benefits counseling

*

Attachment 5: RPHWTNP Trainee Survey

Skip to Q22
22

23

24

25

Please indicate what other topics have
you completed trainings on in the past 5
years.
Are you currently employed?

250 character limit

No, I am not currently employed.
Yes, I am currently employed at 1 job.
Yes, I am currently employed at 2 or
more jobs.
Part-time (less than 35 hours/week)

Please select your current type of
employment:
(Select all that apply.)

I currently work in the following
industry/industries (select all that apply):

medical assistant
medical billing and coding
nursing
peer recovery/ peer support
respiratory care
telehealth
None of the above.
Free-text

Skip to 27

Skip to 26
Skip to 27

Full-time (35 hours or more/week)
Contract
Self-employed
architecture and engineering

*

*

*

arts and design
building and grounds cleaning
business and financial
community and social service
computer and information technology
construction and extraction
education, training, and library
entertainment and sports
farming, fishing, and forestry
food preparation and serving
healthcare and healthcare support
installation, maintenance, and repair
legal
Attachment 5: RPHWTNP Trainee Survey

26

27

You have indicated that you work in the
healthcare and healthcare support
industry. Please indicate which of the
following best categorizes your current
job:

Please indicate your current annual salary
range, including income for all jobs you
currently work.

life, physical, and social science
management
media and communication
military
office and administrative support
personal care and service
production
protective service
sales
transportation and material moving
community health support

*

health IT and/or telehealth technical
support
community paramedicine
case management
respiratory therapist
None of these options describe my
current job. My current job is: [freetext]
Less than $10,000

*

$10,000 - $19,999
$20,000 - $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 - $69,999
$70,000 - $79,999
$80,000 - $89,999
$90,000 - $99,999
More than $100,00
I prefer not to answer
Attachment 5: RPHWTNP Trainee Survey

28

Are you currently seeking new
employment opportunities?

No, I am not seeking new employment
opportunities.
Skip to Q29

29

What types of positions are you seeking
employment in? (Select all that apply.)

Yes, I am seeking new employment
opportunities.
administrative (i.e., receptionists,
secretaries, administrative assistants,
information clerk, general office
clerks, etc.)
community health support (i.e.,
community health workers, health
education specialists, interpreters,
translators, peer recovery specialists,
substance use counselors, mental
health counselors, etc.)
dental (i.e., dental assistants, dental
hygienists, etc.)
financial (i.e., medical billing and
coding, bill and account collectors,
bookkeeping, accounting, auditing,
financial clerks, etc.)
IT and computer specialty (i.e., health
information technologists, computer
support specialists, database
administrators, information security
analysts, cybersecurity specialists,
network specialists, etc.)
medical support (i.e., home health
aides, personal care aides, medical
assistants, etc.)
medical technician (i.e., pharmacy
technicians, radiologic technologists,
diagnostic medical sonographers, etc.)

*

*

nursing (i.e., registered nurses (RN),
licensed practical nurses (LPN), nurse
anesthetists, nurse midwives, nurse
practitioners, nursing assistants,
orderlies, etc.)
Attachment 5: RPHWTNP Trainee Survey

paramedics and/or emergency
medical technicians (EMT)

Accessibility

recordkeeping (i.e., medical records
specialists, scribes, medical
transcriptionists, etc.)
respiratory therapy
none of the above. Please specify
what types of positions you are
currently seeking employment in:
[free-text]
The Americans with Disabilities Act (ADA) defines a person with a disability as someone who: "has a physical or mental impairment that
substantially limits one or more major life activities, has a history or record of such an impairment (such as cancer that is in remission),
or is perceived by others as having such an impairment (such as a person who has scars from a severe burn)." There are several types of
disability including learning disabilities, intellectual disabilities, physical disabilities, mental/intellectual disabilities, etc. More information
on the ADA can be found at https://www.ada.gov/.
Reasonable accommodations are adjustments made that give people with disabilities an equal opportunity at achieving success.
Examples of reasonable accommodations can be found at https://www.dol.gov/agencies/odep/programareas/employers/accommodations. The following section will ask questions regarding your accessibility and accommodation needs.

30

Do you currently have, or did you have,
any accessibility and/or accommodation
needs for this training?

Skip to 32

No, I do not have any accessibility or
accommodation needs.

Skip to 31

Yes, I do have accessibility or
accommodation needs.
I prefer not to answer.
No, this training did not meet my
accessibility and/or accommodation
needs.
Yes, this training did meet my
accessibility and/or accommodation
needs.
I prefer not to answer.

Skip to 32
31

Cost
32

Did this training meet your accessibility
and/or accommodation needs?

Are you paying/ have you paid for this
training?

Skip to Q35

No, the training has been made
available to me free of cost.

*

*

*

Attachment 5: RPHWTNP Trainee Survey

33

Which of the following best describes the
source of this training cost assistance?
(Select all that apply.)

Skip to Q34

Yes, I am paying for the training
completely on my own.

Skip to Q33

Yes, but I am getting assistance with
the cost
My family members/ friends are
assisting me with the training cost.

*

The training program has subsidized
some of the training cost.
My employer is assisting with some of
the training cost.
My source of training cost assistance is
something else. Please specify:

34
Skills
35

How much are you paying/have you paid
for this training?

Slider

*

Please rank how strong you feel your skills
are in the following topics:
Technical Skills
Benefits counseling
Billing and coding
Case management
Contract management
CPR/AED
Crisis intervention
Math and science
Physical strength
Programming
Service coordination
Soft Skills
Analytical
Coordination
Critical thinking
Decision making
Listening

$0 - 3000

*
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Attachment 5: RPHWTNP Trainee Survey

Interpersonal
Problem-solving
Time management
Verbal communication
Written communication

Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)
Likert scale (Very weak - Very strong)

Attachment 5: RPHWTNP Trainee Survey