ARC RESPIRATORY CARE EMPLOYER SURVEY CLASS of 2005

AMERICAN RIVER COLLEGE

RESPIRATORY CARE PROGRAM

PROGRAM #200194 

 

The primary goal of a Respiratory Care Education program is to prepare the graduate to function as a competent Respiratory Care Practitioner. This survey is designed to help the program faculty determine the strengths and areas for improvement for our program. All data will be kept confidential and will be used for program evaluation purposes only. We request that this survey be completed by the graduate’s immediate supervisor. 
Name: 


EMPLOYER SURVEY 

    BACKGROUND INFORMATION:

        Name of Graduate:

 




EMPLOYER SURVEY 

    BACKGROUND INFORMATION:

        Length of employment at time of evaluation: ( years and  months)

 




EMPLOYER SURVEY 

    BACKGROUND INFORMATION:

        Name of person completing the survey:

 




EMPLOYER SURVEY 

    BACKGROUND INFORMATION:

        Graduate’s Eligibility/Credential Status (check all that apply):

 


CRT eligible
CRT
CPFT
RPFT
RRT eligible
RRT
Perinatal/Peds
Other


INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Check the rating that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know about a particular area, please check N/A.

5 = Strongly Agree

4 = Generally Agree

3 = Neutral (acceptable)

2 = Generally Disagree

1 = Strongly Disagree

N/A = Not Applicable 

I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

A.     Has the respiratory care knowledge necessary to function in a healthcare setting.     


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

B.     Has the general medical care knowledge necessary to function in a healthcare setting. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

C.     Is able to collect data from charts and patients. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

D.     Is able to interpret patient data. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

E.     Is able to recommend appropriate diagnostic and therapeutic procedures.       


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

F.     Uses sound judgment while functioning in a healthcare setting.       


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


I. KNOWLEDGE BASE (Cognitive Domain)

THE GRADUATE: 

Comments:




INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Check the rating that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know about a particular area, please check N/A.

5 = Strongly Agree

4 = Generally Agree

3 = Neutral (acceptable)

2 = Generally Disagree

1 = Strongly Disagree

N/A = Not Applicable 

II. CLINICAL PROFICIENCY (Psychomotor Domain)

THE GRADUATE: 

G.     Effectively performs a broad range of clinical skills.     


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


II. CLINICAL PROFICIENCY (Psychomotor Domain)

THE GRADUATE: 

H.     Possesses the skills to perform patient assessment. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


II. CLINICAL PROFICIENCY (Psychomotor Domain)

THE GRADUATE: 

I.     Is able to perform current cardio-pulmonary therapeutic procedures and modalities. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


II. CLINICAL PROFICIENCY (Psychomotor Domain)

THE GRADUATE: 

J.     Is able to perform and interpret diagnostic procedures. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


II. CLINICAL PROFICIENCY (Psychomotor Domain)

THE GRADUATE: 

Comments: 




INSTRUCTIONS: Consider each item separately and rate each item independently of all others. Check the rating that indicates the extent to which you agree with each statement. Please do not skip any rating. If you do not know about a particular area, please check N/A.

5 = Strongly Agree

4 = Generally Agree

3 = Neutral (acceptable)

2 = Generally Disagree

1 = Strongly Disagree

N/A = Not Applicable 

III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

K.     Communicates effectively within a healthcare setting. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

L.     Conducts himself/herself in an ethical and professional manner. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

M.     Functions effectively as a member of the healthcare team. 


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

N.     Accepts supervision and works effectively with supervisory personnel.


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

O.     Is self-directed and responsible for his/her actions.


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

P.     Arrives to work prepared and on time.    


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

Q.     Contributes to a positive environment within the department.   


    1 2 3 4 5 6
5 = Strongly Agree  
4 = Generally Agree  
3 = Neutral (acceptable)  
2 = Generally Disagree  
1 = Strongly Disagree  
N/A = Not Applicable  


III. BEHAVIORAL SKILLS (Affective Domain)

THE GRADUATE: 

Comments:




IV.  ADDITIONAL COMMENTS 

OVERALL RATING:

Please rate the OVERALL quality of this program’s graduate: 

1 = Excellent   2 = Very Good  3 = Good 4 = Fair 5 = Poor

  1 2 3 4 5  
Excellent   Poor


IV.  ADDITIONAL COMMENTS 

OVERALL RATING:

Please comment on the OVERALL quality of this program’s graduate: 




IV.  ADDITIONAL COMMENTS

What qualities or skills did you expect of the graduate upon employment that he/she did not possess?




IV.  ADDITIONAL COMMENTS

Please provide comments and suggestions that would help this program to better prepare future graduates.




IV.  ADDITIONAL COMMENTS

What are strengths of the graduate(s) of this program? 




EMPLOYER SURVEY 

    Rater’s Complete Name:      
    Title:
    Clinical Facility:       
    Date:   

 




EMPLOYER SURVEY 

    Is the above rater the graduate’s immediate supervisor? Check response: YES / NO      

 


Yes
No