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2019-2020 ASAP Post Questionnaire
To complete within two days of returning the pager.
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* Indicates required question
Please enter the first two letters of your city of birth, followed by the last two digits of your cell phone number. (For example: "AB12")
*
Your answer
How many times did you go the Emergency Department?
0
1
2
3
4
5
6
7
8
9
10
11-15
>14
Clear selection
How many times did you see tPA administered?
0
1
2
3
4
5
>5
Clear selection
How many times did you observe a thrombectomy?
0
1
2
>2
Clear selection
After participating in this program, how would you rate your knowledge about the risk factors of stroke?
Excellent
Very Good
Good
Fair
Poor
Clear selection
After participating in this program, how would you rate your knowledge about the symtoms and signs of stroke?
Excellent
Very Good
Good
Fair
Poor
Clear selection
After participating in this program, how would you rate your knowledge about acute treatment of stroke?
Excellent
Very Good
Good
Fair
Poor
Clear selection
After participating in this program, how confident would you be in recognizing stroke in a friend or family member?
Very Confident
Somewhat Confident
Neutral
Not Really Confident
Not at all Confident
Clear selection
How would you rate this program overall?
Excellent
Very Good
Good
Fair
Poor
Clear selection
COMMENTS:
Your answer
How would you rate the program training?
Excellent
Very Good
Good
Fair
Poor
Clear selection
COMMENTS:
Your answer
Did you feel welcomed by the team evaluating/managing the patient?
Always
Usually
Sometimes
Rarely
Never
Clear selection
COMMENTS:
Your answer
How likely would you be to recommend this program to other students?
Very Likely
Somewhat Likely
Undecided
Somewhat Unlikely
Very Unlikely
Clear selection
Did participation in this program impact your interest in a career in Neurology?
I am more interested
I am less interested
It did not impact my interest
Clear selection
Did participation in this program impact your interest in a career in Emergency Medicine?
I am more interested
I am less interested
It did not impact my interest
Clear selection
Whad advice do you have for future ASAP participants?
Your answer
How can we improve the program?
Your answer
Do you have any additional feedback? Something your learned? Something you were surprised about?
Your answer
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