Form 0917-0036 Computer Based Training (CBT)Post Class Survey

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: IHS Customer Service Satisfaction and Similar Surveys

Computer Based Training Post Class Survey 2015

Computer Based Post Class Survey

OMB: 0917-0036

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4. Computer Based Training Post Class SurveyREQUIRED OMB INFORMATION: 
Form Approved 
OMB Form No. 0917­0036 
Expiration Date: 
OIT values your input on the course you have just completed. Thank you for taking five minutes to complete this end of 
course survey. 

*1. What is your Area affiliation?
j Aberdeen
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n

 

 

j Alaska
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j Albuquerque
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j Bemidji
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j Billings
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j California
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j Headquarters
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j Nashville
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j Navajo
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j Oklahoma
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j Phoenix
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j Portland
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j Tucson
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Other (please specify) 

*2. What is your first name?
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*3. What is your last name?
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Comments included on this end of course survey are used to improve the effectiveness of OIT's training program. 

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4. Computer Based Training Post Class Survey-

*4. How did you hear about this computer based training session?
c OIT Training Web Site
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e
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g

 

 

c CAC
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c ISSO
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e
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c Distribution email
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c Other (please specify)
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g

 
 

*5. Please rate the technical components below.
Disagree

Somewhat Agree

Agree

N/A

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The OIT Training Web Site clearly identified available 
computer based training sessions.
The topic modules available on each application were 
easy to navigate.
The computer based training session opened quickly on 
my computer.
I did not encounter technical difficulties with the visual 
portion of the computer based training.
I did not encounter technical difficulties with the audio 
portion of the computer based training.

*6. Is there anything that would improve the accessibility of this session?
j No
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n

 
 

j Yes
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If yes, please note how accessibility may be improved: 

*7. Please rate the presentation methods.
Strongly 
Disagree

Disagree

Somewhat Agree

Agree

Strongly Agree

The presentation was clear and easy to follow.

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I am now able to accomplish the course objectives.

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The computer based training is a good reference tool.

j
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I would recommend this session to new users.

j
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I would recommend this session to users as a refresher 

j
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course.

*8. What part of the training did you find most useful?
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4. Computer Based Training Post Class Survey-

*9. What part of this training did you find least useful?
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10. Please make additional comments here.
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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information 
unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0917­0036­
28. 
The time required to complete this information collection is estimated to average five minutes per response, including 
the time to review instructions, search existing data resources, gather the data needed, and complete and review the 
information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for 
improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence 
Ave., S.W., Suite 336E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer. 

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