5-Question Survey:

• Please rate your overall experience of this competency.
• Please rate your overall knowledge of cultural competency.

  	Not knowledgeable at all	Not knowledgeable	Neutral	Knowledgeable	Very Knowledgeable
• Please rate your confidence level to successfully execute skills related to the cultural competency in your daily work.

  	Not confident at all	Not confident	Neutral	Confident	Very Confident
• Please tell us how we can improve this learning program (beginning next month!).
• Additional Questions/Comments.
• Please enter your email address so that we can track participation.