Draft_A.01.02_Survey_(PWS_Exhibit_B).docx
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- W81K04-16-R-0012
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Department of the Army Medical Command
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Draft PWS Exhibit B
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Exhibit B - Survey
End of Course Feedback/Evaluation
Organization: __________________________________________ Date: _______________ Facilitator(s): _________________________________________ Military □ Civilian □ Supervisor? Yes □ No □
Course ____________________________________________________________________________________________ Thank you for taking the time to attend this course.
To help us evaluate and improve the effectiveness of this course we would appreciate your feedback on the course content, materials and overall presentation of the course by completing the following survey.
1. Please rate each of the following statements: (please place an ”X” in the box)
| Strongly Disagree |
| Disagree |
| Neither Agree or Disagree |
| Agree |
| Strongly Agree |
| a. The content/material was relevant for me. |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
| b. The content/material was easy to understand. |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
| c. As a result of this experience, I am more aware of my potential impact on others. |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
| d. I believe there is an opportunity for me to apply the concepts I have learned in my current situation(s). |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
| e. I believe this course could have a positive impact on my organization. |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
| f. I would recommend this course to others. |
| □1 |
| □2 |
| □3 |
| □4 |
| □5 |
2. Based on your ratings above what additional feedback do you have?
3. Please share with us, any other comments you may have about how we can improve this course.
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