MODULE PILOT TESTING

STUDENT EVAULUATION FORM

Thank you for participating in the pilot review of Keeping Track, Promoting Health: CDCs
Environmental Public Health Tracking Network Classroom Modules. Please complete the following
evaluation form. Your input will help shape final revisions to the coursework before it is
produced and distributed to environmental and public health instructors across the country.

KEEPING TRACK, PROMOTING HEALTH: CDCS ENVIRONMENTAL PUBLIC HEALTH TRACKING

NETWORK CLASSROOM MODULES
Student:

______________________________________________________

Instructor:

______________________________________________________

University:

______________________________________________________

Major:

______________________________________________________

Year:

______________________________________________________

BACKGROUND
How familiar were you with the CDCs National Environmental Public Health Tracking Network
(Tracking Network) prior to reading these modules?
Very familiar: I had used the Tracking Network before
Familiar: I was aware of the Tracking Network and its capabilities
Somewhat familiar: I had only heard of the Tracking Network before
Unfamiliar: I had never heard of the Tracking Network before

TIMING
Which version of the coursework did your professor choose?

One three-hour class

Three 50-minute classes

One 50-minute class

Other ______________________________________________

YOUR EXPERIENCE: FOR THE NEXT THREE SECTIONS, PLEASE ONLY ANSWER QUESTIONS
PERTAINING TO YOUR IN-CLASS EXPERIENCE (EITHER ONE THREE-HOUR CLASS, THREE 50MINUTE CLASSES, OR ONE 50-MINUTE CLASS).
ONE THREE-HOUR CLASS
1.

1.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately learn the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

2.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

3.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

THREE 50-MINUTE CLASSES

1.

2.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately learn the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

3.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

4.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

ONE 50-MINUTE CLASS

5.

6.

Please rate how well this suggested scenario

fulfilled the following key learning objectives:

Circle a response below:

Increase knowledge of fundamental aspects of

environmental health

Completely

Somewhat

Not at All

Increase knowledge of the National Environmental

Health Tracking Network

Completely

Somewhat

Not at All

Develop skill at using the Tracking Network to

solve public health problems

Completely

Somewhat

Not at All

Is the time allotted enough time to adequately learn the suggested material?
Too Long I need more material
Just Right I could comfortably cover it all
Too Short There is too much material

7.

If too long or short, what would you do to adjust to the available time? (check all that
apply)
Increase discussion time
Reduce the discussion time
Skip some content, such as________________________________________________________
Other: _____________________________________________________________________________

8.

Would you make any changes to this version of the customized coursework?
Yes, _______________________________________________________________________________
____________________________________________________________________________________
No

STUDENT ENGAGEMENT
1.

How engaged were you and your fellow students during the lesson?
Very engaged
Somewhat engaged
Not at all engaged

2.

How well did this coursework spark student discussion?

Very well
Somewhat well
Not well at all

3.

Do you have any suggestions for making this more engaging for students like you?
____________________________________________________________________________________
____________________________________________________________________________________

AUDIO VISUAL ELEMENTS

1.

Did your instructor play the YouTube video about CDCs Tracking Network in class?
Yes
No
a.

If yes, did you find it the video useful? Why or why not?
Yes, ____________________________________________________________________________
No,

b.

___________________________________________________________________________

Did you enjoy the video? Why or why not?

Yes, ____________________________________________________________________________
No,

___________________________________________________________________________

2.

Did your instructor play the podcast about asthma and air quality (located on slide 35 of
the Public Health Tracking presentation) in class?
Yes
No
a.

If yes, did you find the podcast useful? Why or why not?
Yes, ____________________________________________________________________________
No,

b.

Did you enjoy the podcast? Why or why not?

Yes, ____________________________________________________________________________
No,

3.

___________________________________________________________________________

___________________________________________________________________________

Did your instructor use the interactive map (located on slide 55 of the Public Health
Tracking presentation) in class?
Yes
No
a.

If yes, did you find it the video useful? Why or why not?
Yes, ____________________________________________________________________________
No,

b.

___________________________________________________________________________

Was the interactive map easy to use?

Yes, ____________________________________________________________________________
No, ____________________________________________________________________________

c.

Did you enjoy the interactive map? Why or why not?

Yes, ____________________________________________________________________________
No,

4.

___________________________________________________________________________

Were there times when you thought an additional audio-visual element would have been
helpful? If so, please explain.

________________________________________________________________________________________

ADDITIONAL DOCUMENTS
1.

Do the accompanying activities and homework assignments help you better understand the
materials?
Yes, they reflect the modules exactly.
No, they didnt help me to learn the material.
We did not use any activities or homework assignments

2.

Do the exam questions accurately test the most important points of the modules?
Yes, they reflect the modules exactly.
No, the exam questions are too in-depth.
Example: ____________________________________________________________________
No, the exam questions do not delve into the modules deeply enough.
Example: ____________________________________________________________________
We did not use the exam questions

3.

Were the exam questions formatted in a way that is easy to understand?

Yes
No, _________________________________________________________________________

GENERAL
1.

What did you like best about this coursework? _______________________________________

____________________________________________________________________________________

2.

What did you like least about this coursework? ______________________________________

____________________________________________________________________________________

3.

Additional feedback or recommendations: ___________________________________________

____________________________________________________________________________________

4.

What topics would you like to see covered in future classroom modules? ____________
____________________________________________________________________________________