Hospital Active Shooter Training Evaluation Survey Form
Evaluate the hospital active shooter training session by rating clarity, realism, instructor effectiveness, and operational readiness, and share suggestions for improvement.
Responder Information
Responder Name
First Name
Last Name
Role in Hospital/Training Context
Please Select
Staff Member
Supervisor
Safety Officer
Other
Department / Unit
Email Address for Follow-up
example@example.com
Training Evaluation
Training Date Attended
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall Training Rating
*
1
2
3
4
5
Preparedness/Confidence Before Training
*
Not at all prepared/confident
1
2
3
4
Extremely prepared/confident
5
1 is Not at all prepared/confident, 5 is Extremely prepared/confident
Preparedness/Confidence After Training
*
Not at all prepared/confident
1
2
3
4
Extremely prepared/confident
5
1 is Not at all prepared/confident, 5 is Extremely prepared/confident
Clarity of Training Content
*
Very unclear
1
2
3
4
Very clear
5
1 is Very unclear, 5 is Very clear
Realism/Usefulness of Scenarios
*
Not realistic/useful
1
2
3
4
Extremely realistic/useful
5
1 is Not realistic/useful, 5 is Extremely realistic/useful
Effectiveness of Instructor/Facilitator
*
Very ineffective
1
2
3
4
Very effective
5
1 is Very ineffective, 5 is Very effective
Pacing/Length Appropriateness
*
Far too short/slow
1
2
3
4
Far too long/fast
5
1 is Far too short/slow, 5 is Far too long/fast
Operational Feedback
Rate the usefulness of each operational area
*
Rows
Very Low
Low
Neutral
High
Very High
Alarm procedures
1
2
3
4
5
Lockdown procedures
6
7
8
9
10
Communication/notification
11
12
13
14
15
Evacuation guidance
16
17
18
19
20
Shelter-in-place guidance
21
22
23
24
25
Coordination with hospital staff/security
26
27
28
29
30
Most valuable part of the training
Suggestions for improvement or additional comments
Submit
Should be Empty: