Form 4 survey

9

Attachment 4: Case Study Questionnaire for FIC Trainees

OMB #: 0925-xxxx

Expiration Date: xx/xxxx

Public reporting burden for this collection of information is estimated to average fifteen minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*). Do not return the completed form to this address.

1. Personal Information

Name
1.1 Age	□ 20-29 □ 30-39 □ 40-49 □ 50-59 □ 60 or older
1.2 Gender	□ Male □ Female
1.3 Current Employer
1.4 Current Position
1.5 Years at organization	□ 0 to 5 years □ 6 to 10 years □ Over 10 years
1.6 Please indicate what percentage of your time you spend within the following categories in a typical year:	Research ________________________________ (%) Teaching ________________________________ (%) Mentorship ______________________________ (%) Policy advice _____________________________ (%) Clinical practice ­___________________________ (%) Program management ______________________ (%) Administrative duties _______________________ (%)
Please indicate which teaching courses you currently contribute to.	Course 1:___________________________________ Course 2:___________________________________ Course 3:___________________________________ Course 4:___________________________________ Course 5:___________________________________
1.8 FIC Program in which you participated	AITRP ICOHRTA ETC ETC ETC
1.9 FIC Training Period	From : ______________(Month, Year) To : _____________(Month, Year)
1.10 Degree received upon completion of FIC training	□ Master’s degree (Specify field: ____________________) □ Ph. D. (Specify field: ____________________) □ Medical degree (e.g. MD) □ Dental degree (e.g. DDS) □ Other: Specify ____________________
1.11 Other advanced degrees	□ Master’s degree (Specify field: ____________________) □ Ph. D. (Specify field: ____________________) □ Medical degree (e.g. MD) □ Dental degree (e.g. DDS) □ Other: Specify ____________________
1.12 Please indicate source of support for other advanced degrees, NOT funded by FIC	Source: _____________________________________

2. Impact of FIC Training

Please indicate the degree to which you agree or disagree with the following statements. Please focus on the effects of the training that you received with FIC support	Strongly Agree	Agree	Neither agree nor disagree	Disagree	Strongly Disagree
Training effects
My training experience prepared me to conduct high quality research
My training experience prepared me to seek and manage research funding
My training experience developed my network of professional contacts
My training experience prepared me as a teacher in my field
My training experience prepared me to take on leadership roles within my organization
My training experience prepared me to be a good mentor for more junior researchers
My training experience prepared me to engage in dialogue with policy makers and programme managers

3. Satisfaction with organizational environment  

Please indicate the degree to which you agree or disagree with the following statements	Very Satisfied		Satisfied	Neither satisfied nor dissatisfied	Dis-satisfied	Very dissatisfied
3.1 Career Development Pathways/Professional Development
How secure things look for me in the future of this organization
My prospects for promotion
That my academic achievements will be duly rewarded in terms of promotion
		Strongly Agree	Agree	Neither agree nor disagree	Disagree	Strongly Disagree
3.2 Adequacy of remuneration
High achievement on the job is reflected in our pay
My job offers adequate pay compared with similar jobs
The income I receive is a fair reflection of my skills, knowledge and training
The income I receive more than covers my basic needs such as food, transport and accommodation
With this job I have no worries about how to support myself and my family
		Strongly Agree	Agree	Neither agree nor disagree	Disagree	Strongly Disagree
3.3 Availability of resources & Bureaucratic efficacy
This organization provides everything I need to do my job effectively
My work is rarely disrupted due to bureaucratic processes
There are adequate resources (office space, computer systems, libraries and reference resources) for me to work effectively
I am often prevented from getting my work done effectively and efficiently by bureaucracy
I receive sufficient assistance with grant management and administration

4. Research experience and satisfaction (Please complete ONLY if you currently spend most of your time in a university setting)

Research experience
4.1 Out of your whole career, how many years have you been in a position which involved conducting at least some research?	>10 years
	5-10 years
	2-5 years
	6 months – 2 years
	1-6 months
	No time in research
4.2 Research development and publication experience (Note: Research products refers to journal articles in the case of publications in peer-reviewed journals; in the case of non-peer reviewed venues, research products can include program reports, policy briefs, etc.)		Peer-reviewed journals	Non-peer reviewed journals, program reports, or online journals
	Written >20 research products
	Written 6-20 research products
	Written 1-5 research products
	Presented data at conferences
	Research products where you were first author (please include number)
4.3 Since completing your academic training how many research grants have you been the principal investigator on	None
	1-2
	2-5
	6-10
	>10

Please indicate the degree to which you agree or disagree with the following statements	Strongly Agree	Agree	Neither agree nor disagree	Disagree	Strongly Disagree
4.4 Research Satisfaction
I make a significant contribution to the University’s research portfolio
I make a significant contribution to my country’s availability and use of data for decision-making
I am satisfied with the time I have available to conduct research
I have autonomy to choose my research direction
My organization’s leadership helps protect my time to conduct research
My current research work is attractive compared to other available job opportunities
4.5 Overall satisfaction	Yes, definitely	Probably	Not sure	Probably not	No, definitely not
If you had to decide all over again, do you think you would choose a research career at this organization?
Would you recommend a research career at this organization to a colleague?
Do you think you will look for a job outside your organization in the next year?

5.   Professional Collaborations

 

5.1      Thinking back on the last 6 months, please list up to 10 individuals (within or outside of your University) with whom you collaborate on a day to day basis and the frequency of your contact with them, using the following guidelines

o       Very frequent contact (more than once per week)

o       Frequent contact (3-5 times per month)

o       Infrequent contact (more than once every 3 months)

 

Name of collaborator	Organization, position title	Very frequent	Frequent	Infrequent
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5.2    Thinking back on the last 6 months, please list up to 10 individuals (within our outside of your organization) that you reach out to as your mentors, or for career and/or technical guidance related to your work, using the following guidelines

o       Very frequent contact (more than once per week)

o       Frequent contact (3-5 times per month)

o       Infrequent contact (more than once every 3 months)

Name of collaborator	Organization, position title	Very frequent	Frequent	Infrequent
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5.3    Thinking back on the last 6 months, please list up to 10 policymakers, program managers, practitioners, or other research users with whom you have been in contact with and whether it was about generating research ideas or about dissemination of research findings

 

Name of policymaker, program manager, practitioner, or other research user	Organization, position title	Generating Ideas (Y/N)	Research Dissemi-nation (Y/N)
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5.4    Please list up to 5 professional associations or networks in which you currently are a member and please note those in which you play a leadership role

Professional association/Network	Leadership Role (Y/N)
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6. Please describe any particularly significant impacts that your research and/or programs have had in the last 5-10 years.