PSSI Training Program Diagnostic Questionnaire

PSSI Training Program Diagnostic Questionnaire

Share preliminary details about your training program so PSSI can assess priorities and next steps.
This questionnaire gathers preliminary information for the PSSI Training Program Diagnostic. Please provide concise responses and aggregate program data only. The Diagnostic is a focused review and is not a comprehensive curriculum audit, regulatory inspection, or accreditation determination.
Organization Information
Organization Name
Organization Type
Primary Contact Name

First NameLast Name
Primary Contact Title
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organization Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Does the organization have a website?
Website
Training Program Overview
Program Name
Program Type
Length of Time in Operation
Approximate Annual Enrollment
Instructors
Approximate number of instructors
Instructor arrangement
Delivery Format
Program Outcome / Credential Type
Reason for the Diagnostic
Reason for requesting the Diagnostic
Applicable concerns

Other
Most urgent concern
How long has this concern existed?
What changes or improvement efforts have already been attempted?
Are there upcoming regulatory reviews, accreditation deadlines, inspections, or organizational deadlines?
What impact has this had?
Program Performance
Are aggregate performance data available?
Does your organization track enrollment and attendance?
Which performance measures does your organization track?

Other
Are performance results available only in aggregate form?
Please summarize your aggregate performance data.
Do you track remediation for students who need additional support?
Please describe any aggregate evaluation or feedback trends.
Curriculum and Instruction
When was the curriculum last updated?
Who oversees the curriculum?
Are standardized lesson plans and instructor guides used?
How consistent is instruction across instructors?

1

2

3

4

5

6

7

8

9

10

1 is Inconsistent, 10 is Highly consistent
Which teaching methods are used?

Other
How are simulation, feedback, and remediation incorporated?
Assessment and Instructor Support
What assessments are used in the program?

Other
How are passing standards established?
Are assessment results analyzed to identify trends or improvement needs?
If yes, please describe how the results are analyzed.
How are instructors initially prepared and subsequently supported or developed?
What challenges are instructors currently facing?
Program Strengths and Desired Outcomes
What are the program’s strongest features, and what should be preserved during any improvement process?
What does the organization hope to learn from this diagnostic?
What would successful improvement look like?
Which issues should be prioritized?

Other
Is leadership prepared to implement changes?
Document Uploads

Provide aggregate program information only. Do not include student names, patient information, protected health information, personnel records, Social Security numbers, or other personal identifiers.
Which five documents have you selected for review?
Upload documents

Cancelof
Certification
Leadership Consultation
Attendee #1 name

First NameLast Name
Attendee #1 email
example@example.com
Attendee #2 name

First NameLast Name
Attendee #2 email
example@example.com
Attendee #3 name

First NameLast Name
Attendee #3 email
example@example.com
Includes one virtual consultation lasting up to 60 minutes.
First preferred date and time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Second preferred date and time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Third preferred date and time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Questions to be addressed
Acknowledgment
Name
Title
Electronic Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I understand and agree
Should be Empty:

PSSI Training Program Diagnostic Questionnaire

Organization Information

Training Program Overview

Reason for the Diagnostic

Program Performance

Curriculum and Instruction

Assessment and Instructor Support

Program Strengths and Desired Outcomes

Document Uploads

Leadership Consultation

Acknowledgment