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<p align="center">&nbsp;Nova Southeastern University<br>
Instructional Technology and Distance Education<br>
7003/7004 Research and Evaluation</p>
<p>Bruce Roemmelt, Cluster #17</p>
<p>Project #2 Survey Development</p>
<p>&nbsp;</p>
<p>Dear Students/Survey Participants,</p>
<p>The field of adult education is changing.&nbsp; You are part of that change
with your participation in the BS Degree program at the George Washington
University.&nbsp; As you are aware I am pursuing my Doctorate at Nova Southeastern University in
Instructional Technology and Distance Education, and in this quest I have chosen
the evaluation of the Role Play Activity you each completed for your final 104
project to be the focus of my dissertation.</p>
<p>My area of interest in education is training adults to become better leaders
and managers.&nbsp; In this pursuit I have developed and delivered several
Distance Learning Programs.&nbsp;&nbsp; Along the way I have attempted to take
several activities that have proven to be worthwhile in the classroom and adapt
them to the e-learning environment.</p>
<p>This survey is a pilot test of the instrument I intend to use in my
dissertation.&nbsp; Thus you will have two roles in completing this
instrument.&nbsp; First your role is to complete the first two parts of the
survey as a student who has taken the class and participated in the role play
activity.&nbsp; Then please fill out the third part of the survey to give me
some feedback on the instrument itself by answering the structured questions I
have included.</p>
<p>This survey is an attempt to get your feedback on the role play activity in
the course you recently completed and to involve you in this educational
assessment.&nbsp; I have chosen to involve only the IDC members in the class for
several reasons.&nbsp; First and foremost you are a unique group composed of
adults who have similar education, training, and background experience.&nbsp;
Each of you is a Boss in your own way as well, and you have similar goals.</p>
<p>The attached survey is designed to assess your perspective on the Role Play
activity in which you participated in class and to get a sense of the confidence
you feel towards your ability to be a better boss, with specific regard to
subordinate counseling.</p>
<p>The survey is completely voluntary and anonymous.&nbsp; It is composed of two parts.&nbsp; The first
part relates to your level of confidence before and after you conducted the role
play exercise.&nbsp; The second part is composed of five questions that will give some general demographic data on
those taking the survey.&nbsp; </p>
<p>Please fill out the form and click the submit button.&nbsp; If you want to
get the results of the survey please send me a separate e-mail indicating your
wishes.</p>
<p>Your participation will not only allow the body of knowledge of distance
learning to be enhanced, but also will work towards a goal we both share, for
distance learning to, &quot;be all it can be.&quot;</p>
<p>Thank you in advance for your participation.</p>
<p><img border="0" src="assignments/7003-7004/BRUCES_SIgnature.gif" width="142" height="47"><br>
Bruce Roemmelt</p>
<p>&nbsp;</p>
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  <p class="MsoBodyText2" align="center"><u><i><b><font size="6">Role Play Confidence Instrument</font></b></i></u></p>
  <hr>
  <p><b><i>Part 1.&nbsp; Confidence.&nbsp; The following questions relate to your confidence
  level relative to your ability to perform the three primary elements of a
  subordinate counseling session, preparation, actually performing the session,
  and follow-up.</i></b></p>
  <p class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt">1.&nbsp;
  </span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">Please rate your confidence that you would <b><i>obtain a performance
  improvement</i></b> in a subordinate <b><font color="#FF0000">PRIOR TO</font></b>
  your role-play training in class.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q6" value="1">Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q6" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q6" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q6" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">2.<span style="mso-spacerun: yes">&nbsp;
  </span>Please rate your level of confidence in your ability to <b><i>prepare</i></b>
  for a counseling session <b><font color="#FF0000">PRIOR TO</font></b> your
  role playing activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q8" value="1">Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q8" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q8" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q8" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">3.<span style="mso-spacerun: yes">&nbsp;
  </span>Please rate your level of confidence to <b><i>perform</i></b> a
  counseling session <b><font color="#FF0000">PRIOR</font> <font color="#FF0000">TO</font></b>
  your role-playing activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q10" value="1">Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q10" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q10" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q10" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt">4</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">.<span style="mso-spacerun: yes">&nbsp;
  </span>Please rate your level of confidence to <b><i>follow-up</i></b> a
  counseling session <b><font color="#FF0000">PRIOR</font> <font color="#FF0000">TO</font>
  </b>your role-playing activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q12" value="1" checked>Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q12" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q12" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q12" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal">5.&nbsp;&nbsp; P<span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">lease rate your confidence that you would <b><i>obtain a performance
  improvement</i></b> in a subordinate <b><font color="#FF0000">AFTER</font> </b>your
  role-play training in class.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q7" value="1" checked>Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q7" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q7" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q7" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">6.<span style="mso-spacerun: yes">&nbsp;
  </span>Please rate your level of confidence in your ability to <b><i>prepare</i></b>
  for a counseling session <b><font color="#FF0000">AFTER</font></b> your role
  playing activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q9" value="1" checked>Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q9" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q9" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q9" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal">7.&nbsp; <span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">Please rate your level of confidence to <b><i>perform</i></b> a
  counseling session <b><font color="#FF0000">AFTER</font></b> your role playing
  activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q11" value="1" checked>Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q11" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q11" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q11" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal">8<span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">.<span style="mso-spacerun: yes">&nbsp;
  </span>Please rate your level of confidence to <b><i>follow-up</i></b> a
  counseling session <b><font color="#FF0000">AFTER</font> </b>your role-playing
  activity.</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" name="q13" value="1">Not
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q13" value="2">Somewhat
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q13" value="3">Fairly
  confident&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q13" value="4">Very confident</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <hr>
  <p class="MsoNormal"><b><i>Part 2.&nbsp; Demographics.&nbsp; This set of questions are descriptive of
  you, the student.&nbsp; Please answer the following questions.</i></b><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt">9</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">.<span style="mso-spacerun: yes">&nbsp;
  </span>How many years have you been an IDC?<br>
  </span><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt">&nbsp;&nbsp; </span>&nbsp;&nbsp;&nbsp;&nbsp; <span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" value="0-" name="q1" checked><span style="mso-spacerun: yes">
  </span>0-1<span style="mso-spacerun: yes">&nbsp; &nbsp; &nbsp;&nbsp; </span><input type="radio" value="2-" name="q1">2-3<span style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  </span><input type="radio" value="4-" name="q1">4-5<span style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  </span> <input type="radio" value="6-" name="q1">6-7<span style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  </span><input type="radio" value="8+" name="q1">8
  or more</span></p>
  <p class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt">10</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">.<span style="mso-spacerun: yes">&nbsp;
  </span>Gender</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" value="male" name="q2" checked>Male&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="radio" value="female" name="q2">Female&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">11.<span style="mso-spacerun: yes">&nbsp;
  </span>Age&nbsp; </span><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt">Please identify your age in years:&nbsp; &nbsp;<input type="text" name="q3age" size="5"></span></p>
  <p class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt">12</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">.<span style="mso-spacerun: yes">&nbsp;
  </span>Have you been posted to an assignment where you have subordinates?</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" value="sub yes" name="q4" checked>yes&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" value="sub no" name="q4">no</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <p class="MsoNormal"><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">13.<span style="mso-spacerun: yes">&nbsp;
  </span>How many subordinate counseling sessions do you perform every six
  months?</span></p>
  <p class="MsoNormal" style="margin-left:.5in"><span style="font-size:11.0pt;
mso-bidi-font-size:12.0pt"><input type="radio" value="0" name="q5" checked>0&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="radio" value="1-" name="q5">1-2&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="radio" value="3-" name="q5">3-5&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="radio" value="6-" name="q5">6-8&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input type="radio" value="9+" name="q5">9
  or more</span><span style="font-size:11.0pt;mso-bidi-font-size:12.0pt">&nbsp;</span></p>
  <hr><hr>
  <p><i><b>Part 3.&nbsp; Instrument Feedback.&nbsp; Please provide feedback to the
  following questions about the survey itself as a means to improve the
  instrument.</b></i></p>
  <p>14.&nbsp; Were the instrument instructions clear and understandable?</p>
  <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
  <input type="radio" name="q14" value="yes">Yes&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
  <input type="radio" name="q14" value="no"> No</p>
  <p>Comments:<br>
  <textarea rows="6" name="q14_comments" cols="77"></textarea></p>
  <p>15.&nbsp; Were the questions clear and understandable?</p>
  <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
  <input type="radio" name="q15" value="yes">Yes&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;
  <input type="radio" name="q15" value="no"> No</p>
  <p>Comments:<br>
  <textarea rows="6" name="q15_comments" cols="77"></textarea></p>
  <p>16.&nbsp; Please make any other comments about the wording, readability,
  your understanding of the questions, clarity of instructions, and any other
  comments you wish to make about the survey.</p>
  <p>Further Comments:<br>
  <textarea rows="6" name="q16_final_comments" cols="77"></textarea></p>
  <p>By clicking the &quot;Submit&quot; button below you will automatically send the 
  survey responses to me.&nbsp; Thanks for your responses.&nbsp; You're helping 
  to make leadership distance learning fulfill its promise.</p>
  <p>b</p>
  <p><input type="submit" value="Submit" name="B1"><input type="reset" value="Reset" name="B2"></p>
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