Thinking About Taking This Course?

Basic Care for People with Spinal Cord Injury is offered through XYZ Community College on a biannual basis.  It is comprised of a 5 week online component with a weekend of classroom/lab instruction on campus.  If you're interested, please contact course designer and instructor Suzanne Touahria.  As well, please copy and paste the Student Questionnaire into a word or text edit document, fill it out and submit it by e-mail.

Basic Care for People with Spinal Cord Injury (SCI)

Pre-enrollement  Questionnaire

Welcome to the course!  In order to better serve your learning needs, I would like to know a bit more about you – the learner.  I would like to get an overall sense of the experience, education, expectations, goals and future aspirations of my students in order to make this learning experience as rewarding and fulfilling as possible!  A brief synopsis of this anonymous questionnaire, as well as a summary of how I will use this information to better meet your learning needs will be presented to the class on day 2 of the course.  Thanks for your participation!

Date  __________________            Location of Course ___________________

1.    How did you learn about this course?
ο  GF Strong  
ο  Pearson Hospital
ο  Other Hospital (pls specify) __________________________
ο  College or University (pls specify) ____________________________   
ο  Friend/Family
ο  Other (pls specify) ___________________________


2.    Have you ever worked with a person with SCI before?
ο  Yes          ο  No     


3.    Do you know someone with a SCI?
ο  Yes          ο  No


4.     Will you be providing care to a relative or loved one with SCI?
ο  Yes        ο  No


5.    Will you be seeking employment with people with SCI?
ο  Yes        ο  No


6.    Do you have access to a computer?
ο  Yes        ο  No


7.    Are you able to check e-mail and surf the web? 
ο  Yes        ο  No


8.    Do you have any post-secondary education?
ο  College diploma or Certificate
ο  University degree
ο  Masters
ο  Other or additional (pls specify) __________________________________________________________________
__________________________________________________________________


9.    Do you have any work experience in health care? (pls specify number of years)
ο  Care aide/attendant ____
ο  Nurse ___
ο  Physiotherapist ___
ο  Occupational therapist ___
οOther (pls specify area of specialty and number of years) _________________________________________________________________
_________________________________________________________________


10.    What do you hope to get out of this course?
           _________________________________________________________________
        _________________________________________________________________
    _________________________________________________________________
_________________________________________________________________


11.    What do you think three of the biggest challenges faced by people with SCI are?
_________________________________________________________________
        _________________________________________________________________
    _________________________________________________________________
    _________________________________________________________________


12.    What are your greatest fears about providing care to people with SCI?
_________________________________________________________________
        _________________________________________________________________
    _________________________________________________________________
    _________________________________________________________________