<< Back to main link page Smoking Cessation for Pregnancy and Beyond Program Evaluation Questionnaire   1. Please rate how valuable (interesting, useful, realistic, etc.) you found each of the following sections of the program. Feel free to include additional comments in the spaces provided.   Comments a.  Office visits (patient simulations) ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable b.  Case discussions ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable c.  Counseling session ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable d.  Lectures ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable e.  Activities ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable f.  Interviews with real patients ---------- not at all valuable slightly valuable moderately valuable quite valuable extremely valuable Please choose a response to the following statements.       Comments 2. I completed ________ of this program. ---------- very little some most all 3. Overall, the quality of the teaching was ________. ---------- poor fair good excellent 4. The beginning orientation told me ________ I needed to know about using this program. ---------- much less than less than exactly what more than much more than 5. The program contained ________ information. ---------- far too little somewhat too little just the right amount of somewhat too much far too much 6. The information covered in the program was _______ relevant to my practice. ---------- not at all slightly moderately quite extremely 7. The pace of the program was _______. ---------- far too slow a little too slow just right a little too fast far too fast 8. I ______ lost track of where I was in the program. ---------- never rarely sometimes often constantly 9. I experienced _______ technical problems while using the program. ---------- no few frequent constant 10. How many interactive multimedia programs have you used before this one in your medical training? ---------- 0 1 or 2 3 - 5 6 - 12 more than 12 11. I would _______ recommend this program to my colleagues. ---------- definitely not probably not probably definitely 12. This program _______ my expectations of what could be learned from a computer program. ---------- did not meet met exceeded 13. What did you like best about the program? 14. What did you like least about the program? 15. What improvements would you recommend?

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