MODULE PILOT TESTING

INSTRUCTOR EVAULUATION FORM

Thank you for participating in the pilot review of Keeping Track, Promoting Health: CDCs
Environmental Public Health Tracking Network Classroom Modules. Upon teaching of the
coursework please complete the following evaluation form. Your input will help us make final
revisions to the modules before they are produced and distributed to environmental and public
health instructors across the country.

KEEPING TRACK, PROMOTING HEALTH: CDCS ENVIRONMENTAL PUBLIC HEALTH TRACKING

NETWORK CLASSROOM MODULES
Instructor:

______________________________________________________

University:

______________________________________________________

Instructor position:

Faculty

Course:

______________________________________________________

Number of Students:

_________

Fellow

Other:____________________

BACKGROUND
1.

How familiar were you with the CDCs National Environmental Public Health Tracking Network
(Tracking Network) prior to reading these modules?
Very familiar: I had used the Tracking Network before
Familiar: I was aware of the Tracking Network and its capabilities
Somewhat familiar: I had only heard of the Tracking Network before
Unfamiliar: I had never heard of the Tracking Network before

2.

What is your comfort level with teaching about CDCs National Environmental Public Health
Tracking Network?
Very Comfortable

Comfortable

Uncomfortable

Very Uncomfortable

TIMING
Which version of the modules did you choose to teach, and why?
One three-hour class because
Three 50-minute classes because
One 50-minute class because
Other _____________________________________________________________________________

YOUR EXPERIENCE: FOR THE NEXT THREE SECTIONS, PLEASE ONLY ANSWER QUESTIONS
PERTAINING TO YOUR EXPERIENCE (EITHER ONE THREE-HOUR CLASS, THREE 50-MINUTE
CLASSES, OR ONE 50-MINUTE CLASS).
ONE THREE-HOUR CLASS
1.

2.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately cover the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

3.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

4.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

THREE 50-MINUTE CLASSES

1.

2.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately cover the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

3.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

4.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

ONE 50-MINUTE CLASS

5.

6.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately cover the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

7.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

8.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

STUDENT ENGAGEMENT
1.

How engaged were students while learning this coursework?

Very engaged
Somewhat engaged
Not at all engaged

2.

How well did the coursework spark student discussion?

Very well
Somewhat well
Not well at all

3.

Do you have any suggestions for improved student engagement?

___________________________________________________________________________________
____________________________________________________________________________________

EASE OF USE
1.

The adaptation guide had:

Too much information
Just the right amount of information
Not enough information

2.

How easy was the adaptation guide to follow?

Very Easy
Somewhat Easy
Difficult

3.

Would you recommend any changes to make it easier? _____________________________

___________________________________________________________________________________

AUDIO VISUAL ELEMENTS

1.

Did you play the YouTube video on slide 5 of the Public Health Tracking presentation in
class? If not, why not?
Yes
No, _______________________________________________________________________________
a.

If you did play the video, did you find it useful? Why or why not?
Yes, ________________________________________________________________________
No,

b.

________________________________________________________________________

Was the video easy to use?

Yes
No, _________________________________________________________________________

c.

Did your students seem to enjoy the video?

Yes
No

2.

Did you play the podcast on slide 35 of the Public Health Tracking presentation in class? If
not, why not?
Yes
No, _________________________________________________________________________
a.

If you did play the podcast, did you find it useful? Why or why not?
Yes, ________________________________________________________________________
No,

b.

________________________________________________________________________

Was the podcast easy to use?

Yes
No, _________________________________________________________________________

c.

Did your students seem to enjoy the podcast?

Yes
No

3.

Did you use the interactive map on slide 55 of the Public Health Tracking presentation in
class? If not, why not?
Yes
No, _______________________________________________________________________________
a.

If you did use the map, did you find it useful? Why or why not?
Yes, ________________________________________________________________________
No,

b.

________________________________________________________________________

Was the interactive map easy to use?

Yes
No, _________________________________________________________________________

c.

Did your students seem to enjoy the interactive map?

Yes
No

4.

Were there times when you thought an additional audio-visual element would have been
helpful? If so, please explain.
________________________________________________________________________________________

SUPPORTING MATERIALS
1.

Did you use the exam questions in tests or quizzes? If not, why not?
Yes
No, _______________________________________________________________________________

2.

Do the exam questions accurately test the most important points of the modules?
Yes, they reflect the modules exactly.
No, the exam questions are too in-depth.
Example: ____________________________________________________________________
No, the exam questions do not delve into the modules deeply enough.
Example: ____________________________________________________________________

3.

Were the exam questions formatted in a way that fit seamlessly into your existing tests and
if not, why?
Yes
No, _________________________________________________________________________

4.

Did you assign the in-class activities or homework assignments?

If not, why not?

Yes
No, _________________________________________________________________________
5.

Do the accompanying activities appropriately highlight the most important points of the
modules?
____________________________________________________________________________________

GENERAL
1.

How likely are you to use this coursework in your regular teaching program?
Very likely
Somewhat likely
Not likely at all

2.

How likely are you to recommend this coursework to a colleague?

Very likely
Somewhat likely
Not likely at all

3.

Were you able to easily navigate the pilot testing microsite?

Yes
No

4.

If you were going to access updates and information to this coursework from a website,
how would you prefer to receive information about updates:
E-mails alerts when the site was updated
Search and find
I would not use a website for this purpose
Other ___________________________________

5.

What did you like best about this coursework? _______________________________________

____________________________________________________________________________________

6.

What did you like least about this coursework? ______________________________________

____________________________________________________________________________________

7.

Additional feedback or recommendations: ___________________________________________

____________________________________________________________________________________

8.

What topics would you like to see covered in future classroom modules? ____________
____________________________________________________________________________________