Simple Triage and Rapid Treatment (START)Distance Learning
Student Feedback Form
Instructor’s name: ______Date: ______
- Age: ______Sex: M F
2. I have been involved in EMS for ______(please indicate how long)
- Your certification level:
First Responder / EMT-Basic / EMT-Intermediate / EMT-Paramedic / RN
Other: (Please specify):
There are three parts to this training program: the self-study web site, electronic e-mail discussions, and the in-class discussion.
- The self-study web site was valuable in helping me learn the START triage system.
1 / 2 / 3 / 4 / 5
Strongly disagree / Disagree / Unsure / Agree / Strongly agree
- The electronic e-mail discussions were valuable in helping me learn the START triage system.
1 / 2 / 3 / 4 / 5
Strongly disagree / Disagree / Unsure / Agree / Strongly agree
- The in-class discussion was valuable in helping me learn the START triage system.
1 / 2 / 3 / 4 / 5
Strongly disagree / Disagree / Unsure / Agree / Strongly agree
- Overall the training program was valuable in helping me learn the START triage system.
1 / 2 / 3 / 4 / 5
Strongly disagree / Disagree / Unsure / Agree / Strongly agree
- Please circle the number that best describes how you think this program compares to traditional classroom lecture training.
1 / 2 / 3 / 4 / 5
Traditional program far superior to distance program / Traditional program better than distance program / Equally effective / Distance program better than traditional / Distance program far superior to traditional
Please write additional comments in the spaces below. Use the back if you want to. We really need your help in making this program work. THANKS!
9. Please give us your overall impression of the course.
10. If you were the instructor, what would you do differently? Why? / How?
11. Which area of START Triage do you feel the least/most comfortable with? Why?
12. What can we do to improve the course and/or ourselves as instructors?
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