Form 1 Resilience Training Program feedback form

RESILIENCE TRAINING PROGRAM: BECOMING A RESILIENT SCIENTIST FEEDBACK FALL 2021
OMB Number: 0925-0648
Expiration Date: 30 June 2024
Burden Time: 10 minutes

GENERAL INFORMATION
What is your a!liation?:*

What is your educational status?:*

How did you participate in this event?:*

SATISFACTION WITH WEBINAR
Overall, how would you rate this webinar?
excellent

very good

good

fair

poor

How likely are you to recommend this webinar to a friend or a colleague?:
very likely
unlikely

somewhat likely

neither likely or unlikely

somewhat unlikely

I can use the information I learned in the webinar.:
strongly agree

agree

neutral

disagree

strongly disagree

The tools from the webinar were practical and easy to apply.:
strongly agree

agree

neutral

disagree

strongly disagree

I intend to share information learnend in this webinnar with a colleague or a friend.:
strongly agree

agree

neutral

disagree

strongly disagree

I am motivated to apply what I learned in the webinar.:
strongly agree

agree

neutral

disagree

strongly disagree

After the webinar, I am trying to implement the tools/changes I learned.:

very

strongly agree

agree

neutral

disagree

strongly disagree

How can we make the webinar better?:

What was your single biggest takeaway from the webinar?:

FEEDBACK ON SMALL DISCUSSION GROUPS
Overall, how would you rate the small group session?:
excellent

very good

good

fair

poor

How helpful was the small group session?:
extremely helpful

very helpful

moderately helpful

slightly helpful

not at all helpful

The small group session helped solidify what I learned in the webinar.:
strongly agree

agree

neutral

disagree

strongly disagree

The small group session motivated me to implement what I learned in the webinar.:
strongly agree

agree

neutral

disagree

strongly disagree

I felt comfortable discussing various issues in the small group session.:
strongly agree

agree

neutral

disagree

strongly disagree

The number of participants in the small group session was:
too large

a bit large

just right

a bit small

too small

If you have specific feedback about small group discussions, please let us know.:

SESSION I - INTRODUCTION TO RESILIENCE AND WELLNESS
How well did you understand Introduction to Resilience and Wellness BEFORE participating in the
webinar?:

extremely well

very well

moderately well

slightly well

not well at all

How well did you understand Introduction to Resilience and Wellness AFTER participating in the
webinar?:
extremely well

very well

moderately well

slightly well

not well at all

How helpful was the workbook?:
extremely helpful

very helpful

moderately helpful

slightly helpful

not helpful at all

SESSION II - EXPLORING OUR SELF-TALK: COGNITIVE DISTORTIONS AND IMPOSTER FEARS
How well did you understand Cognitive Distortions and Imposter Fears BEFORE participating in
the webinar?:
extremely well

very well

moderately well

slightly well

not well at all

How well did you understand Cognitive Distortions and Imposter Fears AFTER participating in the
webinar?:
extremely well

very well

moderately well

slightly well

not well at all

SESSION III - SELF-ADVOCACY AND ASSERTIVENESS
How well did you understand Self-Advocacy and Assertiveness BEFORE participating in the
webinar?:
extremely well

very well

moderately well

slightly well

not well at all

How well did you understand Self-Advocacy and Assertiveness AFTER participating in the
webinar?:
extremely well

very well

moderately well

slightly well

not well at all

SESSION IV - DEVELOPING FEEDBACK RESILIENCE
How well did you understand Feedback Resilience BEFORE participating in the webinar?:
extremely well

very well

moderately well

slightly well

not well at all

How well did you understand Feedback Resilience AFTER participating in the webinar?:
extremely well

very well

moderately well

slightly well

not well at all

SESSION V - MANAGING UP TO MAXIMIZE MENTORING RELATIONSHIPS
How well did you understand Managing Up to Maximize Mentoring Relationships BEFORE
participating in the webinar?:
extremely well

very well

moderately well

slightly well

not well at all

How well did you understand Managing Up to Maximize Mentoring Relationships AFTER
participating in the webinar?:
extremely well

very well

moderately well

slightly well

not well at all

Public reporting burden for this collection of information is estimated to average 10-minutes per
submission. 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 0925-0648. Do not return the completed form to this
address.
Collection of this information is authorized by The Public Health Service Act, Section 410 (42 USC 285).
Rights of participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are
no penalties for not participating or withdrawing from the study at any time. The information collected
in this study will be kept private to the extent provided by law. Names and other identifiers will not
appear in any report of the study. Information provided will be combined for all participants and
reported as summaries.

Submit Survey

Cancel