Form Approved
OMB No: 0920-0445
Expiration Date: xx/xx/xxxx
Physical
Education and Activity
Classroom Questionnaire
6 January 2011
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§
Public reporting burden for this collection of information is estimated to average 40 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: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445).
Physical Education and
Activity
Classroom Questionnaire
Questions
General Course Characteristics and Content 1–2
Physical Activities 3–13
Teaching and Evaluation Techniques 14–34
Students with Disabilities 35–37
Respondent Background 38–50
NOTE: THROUGHOUT THIS QUESTIONNAIRE, TEXT THAT APPEARS IN ALL CAPITAL LETTERS WILL NOT BE READ ALOUD TO RESPONDENTS.
THIS QUESTIONNAIRE WILL BE ADMINISTERED USING COMPUTER ASSISTED PERSONAL INTERVIEW TECHNOLOGY. THE INTERVIEWER WILL READ THE QUESTIONS ALOUD AND TYPE RESPONSES TO THE QUESTIONS INTO THE LAPTOP COMPUTER. THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE.
NOTE: PRIOR TO THE INTERVIEW, PHYSICAL EDUCATION COURSES, TEACHERS, AND SECTIONS WERE RANDOMLY SELECTED AT EACH SCHOOL. IN ELEMENTARY SCHOOLS, THE SCHOOL CONTACT PROVIDED A LIST OF ALL GRADES IN WHICH PHYSICAL EDUCATION IS REQUIRED. TWO GRADES WERE RANDOMLY SELECTED FROM THIS LIST (UNLESS THERE WERE ONLY TWO OR FEWER GRADES, IN WHICH CASE ALL WERE SELECTED). FOR EACH SELECTED GRADE, ONE TEACHER WAS RANDOMLY SELECTED TO BE INTERVIEWED. WHEN NECESSARY, A SECTION (E.G., MORNING KINDERGARTEN CLASS) WAS RANDOMLY SELECTED FOR THE TEACHER TO FOCUS ON THROUGHOUT THE INTERVIEW. IN MIDDLE SCHOOLS AND HIGH SCHOOLS, THE SCHOOL CONTACT PROVIDED A LIST OF ALL REQUIRED PHYSICAL EDUCATION COURSES FOR THE 2005–06 SCHOOL YEAR WITH A CORRESPONDING LIST OF TEACHERS FOR EACH COURSE. IF THE NUMBER OF REQUIRED PHYSICAL EDUCATION COURSES WAS EIGHT OR FEWER, ALL THE COURSES WERE SELECTED. IF THE NUMBER OF REQUIRED PHYSICAL EDUCATION COURSES EXCEEDED EIGHT, EIGHT COURSES WERE RANDOMLY SELECTED. FOR EACH SELECTED COURSE, ONE TEACHER WAS RANDOMLY SELECTED TO BE INTERVIEWED AND ONE SECTION OF THAT TEACHER’S COURSE (E.G., 2ND PERIOD PHYSICAL EDUCATION 101) WAS RANDOMLY SELECTED FOR HIM/HER TO FOCUS ON THROUGHOUT THE INTERVIEW.
The first questions I am going to ask you are about the general characteristics and content of a required physical education course or class that you teach. By “physical education,” I mean class time that is spent teaching a physical education curriculum. Please do not include instruction on physical activity topics that are part of health education or any other subject. Also, do not consider regularly scheduled recess. Throughout this interview, please think about what took place when you taught _____ section of this course.
ANSWER Q1 FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q2.
Was this class a combined health education and physical education course? By “health education,” I mean topics not directly related to physical activity, such as alcohol or other drug use prevention.
Yes 1
No 2
At the end of the class, how many students were enrolled in the class?
Students
In that class, did you teach…
Yes No
ANSWER A FOR ELEMENTARY SCHOOL ONLY. OTHERWISE, SKIP TO B.
Movement concepts and skills? 1 2
Individual or paired activities? 1 2
Group or team activities? 1 2
Aquatic activities? 1 2
Dance activities? 1 2
ANSWER Q4 IF MOVEMENT CONCEPTS AND SKILLS WERE TAUGHT IN THIS CLASS (Q3A IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q5.
SHOW CARD 1
How many contact hours did your students spend in this class on…
Number of Hours
Space awareness, such as space, directions, or levels? 0 1 2 3 4 5 6 7 8 9 10 11 12
Locomotor skills, such as walking, skipping, or hopping? 0 1 2 3 4 5 6 7 8 9 10 11 12
Manipulative skills, such as throwing, catching, kicking, or striking? 0 1 2 3 4 5 6 7 8 9 10 11 12
Non-locomotor skills, such as bending, twisting, or rocking? 0 1 2 3 4 5 6 7 8 9 10 11 12
Combination movement skills, such as combining traveling, balancing, and weight transfer? 0 1 2 3 4 5 6 7 8 9 10 11 12
ANSWER Q5 IF INDIVIDUAL OR PAIRED ACTIVITIES WERE TAUGHT IN THIS CLASS (Q3B IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q6.
SHOW CARD 2
The next questions are about the amount of time spent on individual or paired activities. Please include any time you might spend on lead-up skills, skills specific to the activity, or modified versions of the activity.
How many contact hours did your students spend in this class on…
Number of Hours
Aerobics, such as step or low impact? 0 1 2 3 4 5 6 7 8 9 10 11 12
Archery? 0 1 2 3 4 5 6 7 8 9 10 11 12
Badminton? 0 1 2 3 4 5 6 7 8 9 10 11 12
Bowling? 0 1 2 3 4 5 6 7 8 9 10 11 12
Canoeing or kayaking? 0 1 2 3 4 5 6 7 8 9 10 11 12
Cardiovascular exercise machines, such as rowers, ski machines, stair climbers, stationary bikes, or treadmills? 0 1 2 3 4 5 6 7 8 9 10 11 12
Climbing ropes or wall ladders? 0 1 2 3 4 5 6 7 8 9 10 11 12
Climbing walls? 0 1 2 3 4 5 6 7 8 9 10 11 12
Physical activity or fitness stations? 0 1 2 3 4 5 6 7 8 9 10 11 12
Frisbee or frisbee golf? 0 1 2 3 4 5 6 7 8 9 10 11 12
Golf? 0 1 2 3 4 5 6 7 8 9 10 11 12
Gymnastics? 0 1 2 3 4 5 6 7 8 9 10 11 12
Hiking, backpacking, or orienteering? 0 1 2 3 4 5 6 7 8 9 10 11 12
Jumping rope? 0 1 2 3 4 5 6 7 8 9 10 11 12
Martial arts? 0 1 2 3 4 5 6 7 8 9 10 11 12
Non-stationary bicycling? 0 1 2 3 4 5 6 7 8 9 10 11 12
Pilates? 0 1 2 3 4 5 6 7 8 9 10 11 12
(Q5 continued)
Number of Hours
Racquet sports, other than tennis, such as racquetball, handball, squash, or paddleball? 0 1 2 3 4 5 6 7 8 9 10 11 12
Rock climbing? 0 1 2 3 4 5 6 7 8 9 10 11 12
Running or jogging? 0 1 2 3 4 5 6 7 8 9 10 11 12
Skating, such as roller, in-line, or ice skating? 0 1 2 3 4 5 6 7 8 9 10 11 12
Skiing, such as cross country, downhill, or water skiing? 0 1 2 3 4 5 6 7 8 9 10 11 12
Student-designed games? 0 1 2 3 4 5 6 7 8 9 10 11 12
Table tennis or ping pong? 0 1 2 3 4 5 6 7 8 9 10 11 12
Tennis? 0 1 2 3 4 5 6 7 8 9 10 11 12
Track and field? 0 1 2 3 4 5 6 7 8 9 10 11 12
Walking? 0 1 2 3 4 5 6 7 8 9 10 11 12
Weight training? 0 1 2 3 4 5 6 7 8 9 10 11 12
Wrestling? 0 1 2 3 4 5 6 7 8 9 10 11 12
Yoga? 0 1 2 3 4 5 6 7 8 9 10 11 12
ANSWER Q6 IF GROUP OR TEAM ACTIVITIES WERE TAUGHT IN THIS CLASS (Q3C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q8.
SHOW CARD 3
The next questions are about the amount of time spent on group or team activities. Please include any time you might spend on lead-up skills, skills specific to the activity, or modified versions of the activity.
How many contact hours did your students spend in this class on…
Number of Hours
	Baseball, softball,
or
	whiffleball?	0	1	2	3	4	5	6	7	8	9	10	11	12
Basketball? 0 1 2 3 4 5 6 7 8 9 10 11 12
Dodgeball or bombardment? 0 1 2 3 4 5 6 7 8 9 10 11 12
Touch or flag football? 0 1 2 3 4 5 6 7 8 9 10 11 12
Hockey, such as field, floor, roller, or ice hockey? 0 1 2 3 4 5 6 7 8 9 10 11 12
Kickball? 0 1 2 3 4 5 6 7 8 9 10 11 12
Lacrosse? 0 1 2 3 4 5 6 7 8 9 10 11 12
Soccer? 0 1 2 3 4 5 6 7 8 9 10 11 12
Student-designed games? 0 1 2 3 4 5 6 7 8 9 10 11 12
Ultimate frisbee? 0 1 2 3 4 5 6 7 8 9 10 11 12
Volleyball? 0 1 2 3 4 5 6 7 8 9 10 11 12
ANSWER Q7 IF THIS SCHOOL IS AN ELEMENTARY SCHOOL AND GROUP OR TEAM ACTIVITIES WERE TAUGHT IN THIS CLASS (Q3C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q8.
SHOW CARD 4
How many contact hours did your students spend in this class playing…
Number of Hours
Duck-duck-goose? 0 1 2 3 4 5 6 7 8 9 10 11 12
Elimination tag? 0 1 2 3 4 5 6 7 8 9 10 11 12
King of the hill or capture the flag? 0 1 2 3 4 5 6 7 8 9 10 11 12
Red rover? 0 1 2 3 4 5 6 7 8 9 10 11 12
Relay races? 0 1 2 3 4 5 6 7 8 9 10 11 12
ANSWER Q8 IF DANCE ACTIVITIES WERE TAUGHT IN THIS CLASS (Q3E IS “YES”). OTHERWISE, SKIP TO Q9.
SHOW CARD 6
The next questions are about the amount of time spent on dance activities. Please include any time you might spend on lead-up skills, skills specific to the activity, or modified versions of the activity.
How many contact hours did your students spend in this class on…
Number of Hours
Ballroom dances? 0 1 2 3 4 5 6 7 8 9 10 11 12
Folk or multicultural dances? 0 1 2 3 4 5 6 7 8 9 10 11 12
Performing art dances, such as ballet, jazz, tap, or modern dances? 0 1 2 3 4 5 6 7 8 9 10 11 12
Social dances, such as ballroom dances, line dances, hip hop, or party dances? 0 1 2 3 4 5 6 7 8 9 10 11 12
Square dances? 0 1 2 3 4 5 6 7 8 9 10 11 12
During a typical class period, how many minutes did you provide for students to…
Minutes
Change clothes before class? _____
Have roll taken, listen to
	announcements,
and participate in other administrative
	tasks
while not being physically active?	 _____
Do warm-up activities? _____
Receive instruction through lecture or demonstration? _____
Do skills drills? _____
Participate in games, sports, or dance? _____
Do cool-down activities? _____
Shower or change clothes after activities? _____
SHOW CARD 7
This card lists topics that are taught in physical education. As I read the list of topics on the card, please tell me if you taught about each one in the class. By “teach”, some advanced planning on your part was involved; the subject was not just brought up in class.
Did you teach about…
Yes No
The difference between physical
	activity, exercise,
and fitness?	1	2
The difference between moderate and
	vigorous
physical activity?	1	2
The physical, psychological, or social
	benefits
of physical activity?	1	2
The role of physical activity in reducing
	risk for chronic
diseases, such as diabetes, heart disease or
	osteoporosis?	1	2
Health-related fitness, that is,
	cardiovascular endurance,
muscular endurance, muscular
	strength, flexibility,
and body composition?	1	2
Skill-related fitness, that is, agility,
	power, balance, speed,
and coordination?	1	2
(Q10 continued)
Yes No
Phases of an exercise session, that is
	warm-up, workout,
and cool down?	1	2
How much physical activity is enough, that
	is, determining
frequency, intensity, duration, and type of
	physical activity?	1	2
Mechanics of movement, such as the role of
	muscles
in movement, force absorption, or throwing
	mechanisms?	1	2
Setting personal goals for physical activity participation? 1 2
ANSWER K AND L FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO M.
Developing an individualized physical activity plan? 1 2
Monitoring progress toward reaching goals
	in
an individualized physical activity plan?	1	2
Identifying and overcoming barriers to physical activity? 1 2
Opportunities for physical activity in the community? 1 2
How to find valid information, services, or
	products
related to physical activity and fitness?	1	2
Balancing food intake and physical activity? 1 2
The importance of healthy eating? 1 2
Preventing injury during physical activity? 1 2
Weather-related safety, for example avoiding
	heat stroke,
hypothermia, and sunburn while physically
	active?	1	2
Dangers of using performance-enhancing
	drugs
and supplements, such as steroids?	1	2
When planning to teach or teaching the class, did you use…
Yes No
Any state-developed curricula
	or standards
	
for physical education?	1	2
Any district-developed curricula
	or standards
	
for physical education?	1	2
Any school-developed curricula or
	standards
for
	physical education?	1	2
Internet resources, such as PE Central or
	NASPE’s
Teacher’s
	Toolbox?	1	2
Any commercially-developed curricula? 1 2
A commercially-developed student textbook? 1 2
A commercially-developed teacher's guide? 1 2
Physical Education performance assessment materials 1 2
Any materials from health organizations,
	such as
the American Heart Association or the American
Cancer
	Society?	1	2
Any materials from the President’s
	Council on Fitness,
Sports and Nutrition?	1	2
When preparing lessons for a physical education class, what percent of time do you typically allocate for students to be physically active?
0% to 24% 1
25% to 49% 2
50% to 74% 3
75% to 100% 4
How influential are the following factors in determining which activities are taught in your physical education class?
Not at all A little A lot
Whether the activity is…
Identified within the written curriculum? 1 2 3
Designed to ensure students are active? 1 2 3
Designed to
	teach students a specific
sport skill?	1	2	3
Designed to improve student competence? 1 2 3
Able to
	maximize students’ opportunity
to practice?	1	2	3
Part of a
	developmentally appropriate
sequence?	1	2	3
Appropriate for the facilities available? 1 2 3
Now, I would like to ask a few more general questions about the class. Please remember to answer these questions about this class only.
IF ONLINE COURSE, SKIP TO THE INSTRUCTIONS BEFORE Q16
SHOW CARD 8
When teaching the class, how often did you…
				Almost
			Some-	Always
or
	Never	Rarely	times	Always	N/A
Practice
	active supervision, that is,
observing, listening to
	students,
anticipating and effectively responding
to
	unsafe situations, and discouraging
pushing and
	bullying?	1	2	3	4
Select team captains? 1 2 3 4
Have team
	captains choose
team members?	1	2	3	4
Encourage
	prosocial behaviors, that is,
cooperation, conflict
	resolution,
and helping others?	1	2	3	4
Organize
	games that
eliminated students?	1	2	3	4
Use
	protective clothing and safety gear
that is appropriate to
	child’s size and
in good shape?	1	2	3	4	5
Have many
	students stand in line or
on the sidelines watching others
	and
waiting for a turn?	1	2	3	4
Use safe, age-appropriate equipment? 1 2 3 4
Organize
	activities in which fewer
than half of the students
	were
physically active?	1	2	3	4
Minimize
	exposure to sun, smog, and
extreme temperatures?	1	2	3	4
(Q14 continued)
				Almost
			Some-	Always
or
	Never	Rarely	times	Always	N/A
Allow
	highly skilled students to dominate
activities and
	games?	1	2	3	4
Offer
	activities that take into account
gender and cultural
	differences
in students’ interests?	1	2	3	4
Provide
	students with options for
performing physical activities at
	varying
skill levels?	1	2	3	4
Use
	infection control practices for
handling blood and other bodily
	fluids?	1	2	3	4	5
When teaching the class, how often did you…
				Almost
			Some-	Always or
	Never	Rarely	times	Always
Use
	alternative or modified rules for
traditional games to keep
	students active
(e.g., have all students run bases
in
	softball)?	1	2	3	4
Use smaller
	numbers of students per
team and more teams for
	traditional
sports games?	1	2	3	4
Ensure all
	students have a piece of
manipulative, physical activity,
or
	fitness equipment?	1	2	3	4
Keep students active during roll call? 1 2 3 4
SHOW CARD 9
The next questions ask about the use of various teaching methods.
How often did you use…
				Almost
			Some-	Always or
	Never	Rarely	times	Always
Competitive group activities? 1 2 3 4
Cooperative group activities? 1 2 3 4
Skills drills? 1 2 3 4
Physical activity or fitness stations? 1 2 3 4
Pledges or
	contracts
for behavior change?	1	2	3	4
Guest speakers? 1 2 3 4
Peer teaching? 1 2 3 4
Heart rate monitors? 1 2 3 4
Physical
	activity monitors,
such as pedometers?	1	2	3	4
The Internet? 1 2 3 4
Student
	physical activity logs
or journals?	1	2	3	4
Field trips as a method of instruction? 1 2 3 4
Did you ask students to…
Yes No
Perform volunteer work with a
	local physical activity
program or event, for example Little
	League or a fun run?	1	2
Participate in or attend a community health fair? 1 2
Gather information about physical activity
	programs
that are available in the community, for example
	activities
at clubs or parks?	1	2
Did you…
Yes No
Provide families of all students
	in the class with
information on the class?	1	2
Give students homework or projects that
	involve
family members?	1	2
Invite families of all students in the class
	to attend
the class?	1	2
Provide strategies to help students promote
	physical
activity among family members?	1	2
Collect suggestions from students about the class? 1 2
Collect suggestions from students’
	families
about the class?	1	2
Did you invite your principal or other school administrators to observe the class?
Yes 1
No 2
In this class, did you give…
Yes No
Written tests of students’
	knowledge related
to physical education?	1	2
Skill performance tests related to physical education? 1 2
Fitness tests? 1 2
ANSWER Q21–Q26 IF YOU GAVE FITNESS TESTS IN THIS CLASS (Q20C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q27.
How many times did you give fitness tests in this class?
Once 1
Twice 2
Three or more times 3
SHOW CARD 10
What fitness tests did you use in
	this class?
MARK ALL THAT APPLY
Fitnessgram 1
The Physical Fitness Test,
from the President’s
Challenge	2
Other (Specify) 3
Did you schedule time during class periods for the students in this class to practice for the fitness tests?
Yes 1
No 2
Did you compare these students’ fitness test scores with…
Yes No
National, state, or local
	criterion referenced standards?
By this I mean students’
	fitness test scores that are
considered to be consistent with
	good health for their
age and gender?	1	2
National, state, or local normative
	standards?
By this I mean fitness test scores of students
	relative to the
performance of children in a reference group;
	the reference
group may be one from national, state, or local
	samples,
including those of other students in the class?	1	2
The student’s prior fitness test scores? 1 2
The student’s fitness goals? 1 2
Did you provide students with an explanation of what their fitness test scores meant?
Yes 1
No 2
Did you share the students’ fitness test scores with…
Yes No
Students’ parents or guardians? 1 2
The principal or other school administrators? 1 2
ANSWER Q27 FOR MIDDLE AND HIGH SCHOOL ONLY. OTHERWISE, SKIP TO Q32.
Were students required to develop individualized physical activity plans?
Yes 1
No 2 SKIP TO Q32
ANSWER Q28 IF YOU GAVE FITNESS TESTS IN THIS CLASS (Q20C IS “YES”). OTHERWISE, SKIP TO Q29.
Did students use their fitness test scores to help develop individualized physical activity plans?
Yes 1
No 2
Did you provide students with individual feedback on their physical activity plans?
Yes 1
No 2
Did you provide students with instruction on how to monitor adherence to their physical activity plans?
Yes 1
No 2
Did you require that their plans include...
Yes No
Physical activity goals? 1 2
Fitness goals? 1 2
Specific rewards for meeting goals? 1 2
Scheduled times for engaging in physical activity? 1 2
A process for assessing progress toward
	goals,
such as self-monitoring or self-management?	1	2
Identification of barriers to physical activity? 1 2
Did you require that students keep a log of the physical activities they engaged in outside of the class?
Yes 1
No 2
SHOW CARD 11
As I read the list of assessment criteria on this card, please tell me if you used them to assess your students in physical education.
Did you assess students based on…
Yes No
Their attendance? 1 2
Wearing appropriate clothing for physical activity? 1 2
Their level of participation? 1 2
Their attitude? 1 2
Their performance on knowledge tests? 1 2
Their final scores on movement skills performance tests? 1 2
Their improvement in movement skills
	performance
test scores?	1	2
Their level of physical activity outside of
	physical education
class, as measured by physical activity
	logs, pedometers,
or other measures?	1	2
Their demonstration of self-management
	skills,
such as goal setting or self assessment?	1	2
ANSWER J IF YOU GAVE FITNESS TESTS IN THIS CLASS (Q20C IS “YES”). OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q34.
Physical fitness test scores? 1 2
ANSWER Q34 IF YOU REQUIRED STUDENTS TO DEVELOP INDIVIDUALIZED PHYSICAL ACTIVITY PLANS IN THIS CLASS (Q27 IS “YES”). OTHERWISE, SKIP TO THE INTRODUCTION TO Q35.
Did you assess students based on the quality of their individualized physical activity plans?
Yes 1
No 2
My next questions ask about teaching students with long-term physical, medical, or cognitive disabilities, such as Down syndrome or conditions that require permanent use of a wheelchair.
Were there any students with long-term physical, medical, or cognitive disabilities in the class?
Yes 1
No 2 SKIP TO THE INTRODUCTION TO Q38
Was there…
Yes No
An adapted physical education
	teacher or specialist
who taught students with
	disabilities?	1	2
A special education teacher with whom you
	coordinated
activities for students with disabilities?	1	2
A physical or occupational therapist who
	came in to assist
students with disabilities?	1	2
A teacher or aide who came in to assist
	students
with disabilities?	1	2
In teaching these students, did you use…
Yes No
Simplified instructional content
	or variations in the amount
or difficulty of material
	taught?	1	2
More skill modeling, practice, or repetition? 1 2
Modified equipment or facilities? 1 2
Modified assessment? 1 2
Peer teaching or coaching? 1 2
My last set of questions asks about your teaching experience and educational background.
Counting this year as a full year and including years spent teaching physical education at any other schools, how many years of experience do you have teaching physical education?
Years
IF THIS IS AN ONLINE PHYSICAL EDUCATION CLASS, SKIP TO Q40.
Have
	you ever taught an online or distance physical education class for
	any of
grades K–12?
Yes 1
No 2
Do you coach an interscholastic sport?
Yes 1
No 2
Do you have an undergraduate degree?
Yes 1
No 2 SKIP TO Q47
What did you major in?
MARK
	ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science	4
Other (Specify) 5
Did you have an undergraduate minor?
Yes 1
No 2 SKIP TO Q45
What
	did you minor in?
MARK ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science	4
Other (Specify) 5
Do you have a graduate degree?
Yes 1
No 2 SKIP TO Q47
In what area or areas?
MARK
	ALL THAT APPLY
Physical education 1
Health education 2
Other education 3
Kinesiology, exercise physiology,
or exercise science	4
Other (Specify) 5
Currently, are you certified, endorsed, or licensed by the state to teach physical education in…
			State does not
			offer
certification,
			licensure, or 
			endorsement
			to
teach physical
			education
	Yes	No	at this level
Elementary school? 1 2 3
Middle school? 1 2 3
High school? 1 2 3
My next questions are about professional development, which might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service.
SHOW CARD 12
As I read the list of topics on this card, please tell me if you received any professional development on each one during the past two years.
During the past two years, did you receive any professional development on...
Yes No
Methods to increase the amount of
	class time students
are engaged in moderate to vigorous
	physical activity?	1	2
Methods to promote gender equity in physical
	education
and sports?	1	2
Using technology such as computers or video
	cameras
for physical education?	1	2
Using physical activity monitoring devices,
	such as
pedometers or heart rate monitors for physical
	education?	1	2
Encouraging family involvement in physical activity? 1 2
Administering or using fitness tests? 1 2
Helping students develop individualized
	physical
activity plans?	1	2
Injury prevention and first aid? 1 2
How to prevent, recognize, and respond to
	concussions
among students?	1	2
Teaching physical education to students with
	long-term
physical,
	medical, or cognitive disabilities?	1	2
Teaching individual or paired activities or sports? 1 2
Teaching team or group activities or sports? 1 2
Teaching movement skills and concepts? 1 2
Assessing or evaluating student performance
	in
physical education?	1	2
Developing and using student portfolios
	for
physical education?	1	2
(Q48 continued)
Yes No
Teaching methods to promote inclusion and
	active
participation of overweight children during
physical
	education?	1	2
Chronic health conditions, for example
	asthma or diabetes,
including recognizing and responding to
	severe symptoms
or reducing triggers?	1	2
Methods for developing, implementing, and
	evaluating
intramural or physical activity clubs?	1	2
Developing, implementing, and evaluating
	comprehensive
school physical activity programs?	1	2
Establishing walking or biking to school programs? 1 2
Assessing student weight status using body
	mass index,
skinfolds, or bioelectric impedance?	1	2
Physical education standards? 1 2
Teaching online or distance education courses? 1 2
Transforming traditional face-to-face
	courses into
an online format?	1	2
SHOW CARD 13
Which of these topics would you
	like to receive further professional development on?
MARK ALL
	THAT APPLY
Methods to increase the amount of class time
students are
engaged in moderate to vigorous
physical activity	1
Methods to promote gender equity in physical
education and
sports	2
Using technology such as computers or video
cameras for physical
education	3
Using physical activity monitoring devices,
such as pedometers
or heart rate monitors
for physical education	4
Encouraging family involvement
in physical activity	5
(Q49 continued)
Administering or using fitness tests 6
Helping students develop individualized
physical activity
plans	7
Injury prevention and first aid 8
How to prevent, recognize, and respond
to concussions among
students	9
Teaching physical education to students
with long-term physical,
medical,
or cognitive disabilities	10
Teaching individual or paired activities
or sports	11
Teaching team or group activities or sports 12
Teaching movement skills and concepts 13
Assessing or evaluating student performance
in physical
education	14
Developing and using student portfolios
for physical
education	15
Teaching methods to promote inclusion
and active participation
of overweight
children during physical education	16
Chronic health conditions, for example asthma
or diabetes,
including recognizing and
responding to severe symptoms
or
reducing triggers	17
Methods for developing, implementing,
and evaluating intramural
or physical
activity clubs	18
Developing, implementing, and evaluating
comprehensive school
physical
activity programs	19
Establishing walking or biking
to school programs	20
Assessing student weight status using
body mass index,
skinfolds,
or bioelectric impedance	21
(Q49 continued)
Physical education standards 22
Teaching online or distance education courses 23
Transforming traditional face-to-face courses
into an online
format	24
None of these 25
My supervisor may wish to call you to ask about how I conducted this interview. Would you please tell me a telephone number where we might reach you starting with the area code?
( ) -
1) Daytime or
2) Evening/Weekend
Thank you very much for taking the time to complete this interview.
Physical Education Classroom Questionnaire—Public Use Version
| File Type | application/msword | 
| File Title | Form Approved | 
| Author | dallen | 
| Last Modified By | arp5 | 
| File Modified | 2011-03-09 | 
| File Created | 2011-03-03 |