Feedback Survey

• Who are you?

  I am a…(required)

  Select an option Student Advisor / Teacher Administrator / Other

• What is your school and city or district?

  School Name(required)
  City or District(required)

• How was your experience?

  Overall, how would you rate our session?

  Overall Rating(required)

  Select an option Excellent Very Good Good Fair Poor

• What did you enjoy most?

  Tell us what stood out to you or what you found most valuable.

  What I Enjoyed Most

• What could we do better?

  Any suggestions help us make every session better.

  Suggestions for Improvement

• What is your biggest challenge right now?

  Question 6, for students

  Students: please answer this question. Advisors may skip to Question 7.

  Biggest Student Challenge

  Select an option Choosing a specific healthcare career path Study methods and academic stress Finding professional mentors/internships Staying motivated for the long journey ahead

• How can MartijaIHPE best support your program?

  Question 7, for advisors and teachers

  Advisors/Teachers: please answer this question. Students may skip ahead.

  Program Support Needed

  Select an option Guest speaking / Motivational sessions Curriculum and Assessment strategy Faculty professional development VR/AR healthcare simulation tools

• Hands-on activities on your campus

  Would you like to have hands-on activities like these at your school?

  Interest in Hands-On Activities(required)

  Select an option Yes! We would love that Maybe (we would like to learn more) Not right now

  If yes, which topic would be most valuable for your campus?

  Most Valuable Topic

  Select an option Healthcare Career Exploration Masterclass: High-Level Study Methods Motivational Keynote for Future Leaders Other (please specify below)
  If Other, please describe

• Share this with your advisor

  Question 9, point of contact

  Interested in bringing hands-on activities like these to your campus? We recommend having your advisor be the one to submit this survey, so students never need to share personal information. Students: just email this link to your advisor!

  Email this link to my advisor

  Or copy and share: martijaihpe.com/workshop-feedback-survey

  Our information

  Martija Institute for Health Professions Education
  Email: connect@martijaihpe.com
  Phone: (909) 588-3146

  Advisors/Teachers: share your professional email below and we will reach out about hands-on activities for your campus. Students: please leave this blank.

  Advisor Professional Email

No names needed: we never ask students for personal information. Advisors who share a professional email are opting in to hear from MartijaIHPE about bringing hands-on activities to their campus. We respect your privacy and will never share your information.

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