Skip to content
Facilitator - Post Survey (DEI/AIAMC)
1.
Please select your GME program from the dropdown menu below.
Addiction Medicine
Cardiovascular Disease
Clinical Informatics
Dermatology
Family Medicine
General Surgery
Geriatric Medicine
Hospice and Palliative Care
Internal Medicine
Physical Medicine and Rehabilitation
Surgical Critical Care
2.
Please select the answer that best describes your role in the program.
Intern
Senior Resident
Fellow
Faculty
Program Director
Administrative Team Member
Clinic Team Member
Other
*
3.
Please select which educational session from the DEI toolkit you just facilitated.
(Required.)
Implicit Bias
Equity, Equality, and Privilege
Inclusive Language
Stereotypes and Intersectionality
Science and Race
Gender Roles and Medicine
Microaggressions
*
4.
Did you facilitate this session in-person or via a virtual platform?
(Required.)
In-person
Virtual
Neither/Other (please specify)
*
5.
Please identify your comfort level in facilitating educational sessions focused on topics related to diversity, equity and inclusion.
(Required.)
Very Comfortable
Comfortable
Neutral
Uncomfortable
Very Uncomfortable
*
6.
How likely are you to recommend facilitating educational sessions like this to colleagues?
(Required.)
Very likely
Likely
Neutral
Unlikely
Very unlikely
*
7.
I think the material provided for this session was helpful in conveying the course objectives.
(Required.)
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
What elements, in particular, were especially helpful or not helpful?
*
8.
I think the course content helped participants to think more clearly about topics related to diversity, equity and inclusivity.
(Required.)
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
9.
Your feedback is very helpful. Please let us know if there were any gaps in the provided material, and if you have any general comments about your experience. Feel free to share future topic ideas and resources as well.
*
10.
Please enter your participant ID. This ID is only used to link your responses longitudinally while protecting your anonymity. (Your ID is first 2 letters of your mom's first name, then two digits of the day you were born (ie 01, 02), and then the first 2 letters of the city you were born in).
(Required.)