HHS/ASPE. U. S. Department of Health and Human Services.Background

Findings from a Study of the SSI/SSDI Outreach, Access, and Recovery (SOAR) Initiative:

Appendix D:
Stepping Stones to Recovery
Training Evaluation Form

[ Main Page of Report | Main Contents of Report ]

This is the HTML version of the form,
see apd.pdf for the actual form.

Contents

  1. Participant Background
  2. Training Evaluation Questions

Training Evaluation Form
Stepping Stones to Recovery

I. Participant Background

  1. I work at an agency that is primarily a... (circle one)
    1. Mental health agency
    2. Homeless service agency
    3. SSA or DDS office
    4. Other (please specify) __________
  2. At the above agency, my current job is ... (circle one)
    1. Outreach worker
    2. Case Manager
    3. Shelter Worker
    4. Benefits Specialist
    5. Program Coordinator/Supervisor
    6. Other (specify) ______________
  3. My position is PATH-funded?   ___ Yes     ___ No     ___ Don't Know
  4. About how many adults did you assist with SSI or SSDI applications in the past year?
    1. None
    2. Less than 1 per month
    3. About 1 per month
    4. Between 1 and 3 per month
    5. About 1 per week
    6. More than 1 per week
  5. About what proportion of adults who you have assisted with SSI or SSDI applications are typically approved on their initial applications?
    1. None
    2. 1-25 percent
    3. 26-50 percent
    4. 51-75 percent
    5. 76-100 percent
    6. Not applicable
  6. For applications where you have assisted people, what is the approximate length of time between application and initial decision?
    1. 3 months or less
    2. 4-6 months
    3. 7-12 months
    4. More than 12 months
    5. Not applicable

II. Training Evaluation Questions
II. Training Evaluation Questions
To what extent do you agree disagree with each statement below as it relates to this training?		 Circle One
Strongly
Disagree		 Disagree Agree Strongly
Agree
1. I have a better understanding of the differences between SSI and SSDI, including the health insurance offered and eligibility requirements 1 2 3 4
2. I am better able to identify the non-medical criteria for SSI/SSDI eligibility 1 2 3 4
3. I have a better understanding of the disability determination process and how to develop medical evidence to support a disability claim 1 2 3 4
4. I have a clearer understanding of the role of functional information in the determination of disability. 1 2 3 4
5. I feel more equipped to thoroughly interview a client and assess his/her functioning. 1 2 3 4
6. I will be able to write a comprehensive medical summary to be submitted for disability determination 1 2 3 4
7. Overall, I feel this training will help me do a better job assisting individuals with SSI/SSDI applications 1 2 3 4
8. The trainer was knowledgeable and well-prepared 1 2 3 4
9. The trainer was interesting and help my attention 1 2 3 4
10. The trainer presented the information clearly 1 2 3 4
11. The training was organized in a way that was conducive to learning 1 2 3 4
12. Attendees were given numerous opportunities to ask questions and discuss the material 1 2 3 4
13. The trainer provided helpful answers to our questions. 1 2 3 4
14. The pace of the training program was just right — not too fast and not too slow. 1 2 3 4
15. The interactive role play and/or video helped me explore how I will use the information in my own work. 1 2 3 4
16. The written materials supported the presentation. 1 2 3 4
17. The PowerPoint materials supported the presentation 1 2 3 4
18. The balance of information among written materials, slides, and presentation was effective. 1 2 3 4
19. The exercises helped me to better understand the material being covered. 1 2 3 4
20. The worksheets will be useful tools for my work in the field. 1 2 3 4

21. Overall, how satisfied were you with the information provided during the training program? (Circle the box that most closely expresses your opinion)
    Very Dissatisfied    
1		     Dissatisfied    
2		     Neutral    
3		     Satisfied    
4		     Very Satisfied    
5

22. Overall, how satisfied were you wit the way in which the training session was organized and presented?
    Very Dissatisfied    
1		     Dissatisfied    
2		     Neutral    
3		     Satisfied    
4		     Very Satisfied    
5

23. What were two things you liked most about the training?

  1. _______________________________
  2. _______________________________

24. What were two things you disliked most about the training?

  1. _______________________________
  2. _______________________________

25. What specific suggestions would you make to improve the training?

_______________________________________________________

_______________________________________________________

Where to?

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Home Pages:
Human Services Policy (HSP)
Assistant Secretary for Planning and Evaluation (ASPE)
U.S. Department of Health and Human Services (HHS)