Healthcare Provider-Patient Interaction Survey ©


Instructions
This survey was developed to help you identify your strengths as well as areas for development regarding your interactions with patients. Be assured that your responses will remain completely confidential. To gain the maximum benefit, it is important that you answer as honestly and realistically as possible.

The survey has 40 questions and should take approximately ten minutes to complete. You will be asked to take the survey twice in the same sitting to show actual vs. desired behavior. The first time, please base your responses on your actual conduct in your five to ten most recent patient interactions, either in the hospital or an outpatient setting. The second time, please base your responses on your preferred conduct, or on how you hope to act in future interactions.

Once you select a response it cannot be changed, so please consider your choice carefully before making a selection. After a response is selected, the next statement will automatically appear. When your last response is submitted, you will be able to view a chart depicting your personal assessment. A key is also provided to help you interpret your results.


Your Email Address:


Survey created by Alan Belasen, Ph.D. and Nancy Frank, Ph.D.
Technical design and development: Nancy Frank, Ph.D.
Technical Advisor: Larry Frank, MBA, CMA, CPA
In collaboration with Arts Across America