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2014
October
M
Medical Student Resilience Survey
Medical Student Resilience Survey
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Exit Survey
You are receiving this e-mail as a first-year or second-year medical student. We are evaluating the impact of the medical school curriculum on student well-being, and we would appreciate your feedback in our online surveys. The attached questionnaire will take a total of about 15-20 minutes to complete. We are sending them out now at the beginning of the class year and at the end. Your responses will remain confidential and secure. The surveys are being administered and the data are being maintained independently by QuestionPro. The questionnaire data will be de-identified and a your computing ID will be kept in a separate database so we can link the responses across the surveys. Your participation is voluntary and your professors will not know whether you have chosen to participate or not.
Your completion of this survey is indication of your consent to participate in the study. You may have your data withdrawn at any time. If you choose to do so, please contact Katherine Willson at
[email protected]
. This study was approved by the IRB, #____________.”
Please contact one of us if you have any questions.
Kate Willson
[email protected]
John Schorling, M.D.
[email protected]
ID badge number:
What is your year of training?
First year
Second year
Third year
Fourth year
How old are you?
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What is your gender?
Female
Male
What is your relationship status?
Single
Married
Partnered
Widowed/widower
On a scale of 0 to 10 with 0 being as bad as it can be and 10 being as good as it can be, how would you rate your overall quality of life over the past week?
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10 (as good as it can be)
On a scale of 0 to 10 with 0 being as bad as it can be and 10 being as good as it can be, how would you rate your mental quality of life over the past week?
0 (as bad as it can be)
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10 (as good as it can be)
On a scale of 0 to 10 with 0 being as bad as it can be and 10 being as good as it can be, how would you rate your physical quality of life over the past week?
0 (as bad as it can be)
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10 (as good as it can be)
On a scale of 0 to 10 with 0 being as bad as it can be and 10 being as good as it can be, how would you rate your emotional quality of life over the past week?
0 (as bad as it can be)
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10 (as good as it can be)
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