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Name:
Job Location:
Course:
Job Function:
Specify which
number reflects your
opinion.
Highest (5)
(1 Through 5)
Skill A:
1
never use
1A
use frequently
This skill is never used because, (circle the most appropriate responses),
a.) It isnt part of my job.
b.) It is too difficult.
c.) I forget how to do it.
If your response is a, you can skip questions 2 through 5 for this skill.
2
unable to perform
expert
2A
Answer this question if you are unable to perform this skill. Skip questions 3 through 5 for this skill.
I am unable to perform this skill because (circle the most appropriate responses),
a.) It is too difficult and complicated.
b.) No one else is using it.
c.) No one is available to help.
I was able to perform this skill
immediately after I received the training.
immediately
proficient
learned in
training
obtained the
necessary information
from another source
procedure from
training is completely
wrong
General Comments:
procedure from
training is
exactly right