MUSC IP Day Survey (Part-1)

This portion of the IP Day survey is a component of a research project. Despite growing emphasis on the importance of high-quality teamwork in translational research and clinical care delivery, and despite the wide availability of standardized teamwork training resources, little is known about specific factors that actually predict and promote optimal team functioning and success. This study seeks to examine individual team member characteristics and team composition to predict team performance. You are being asked to complete this survey because you participated in The Sloppy Mountain Medical Center escape room game. This survey is voluntary and anonymous. Responses will not be linked to your individual identity. This survey will take approximately five minutes. Survey results will be stored on a password protected server and accessible only to the IRB approved study team members. The data will be used to inform the practice of teaching team work activities. If you have questions or concerns about this study, you may contact the investigators or the Medical University of South Carolina Institutional Review Board for Human Research IRB Manager or the Office of Research Integrity Director at (843) 792-4148. Investigators are: Kimberly Kascak, MEd, Primary Investigator, 843-792-3409, kascak@musc.edu; Dusti Annan, EdD, Co-Investigator, 843-792-5506, annandu@musc.edu; Mary Mauldin, EdD, Co-Investigator, 843-876-5040, mauldinm@musc.edu, JeffreyBorckardt, Ph.D., Co-Investigator, 843-792-3295, borckard@musc.edu.

You have the option of skipping this part of the IP Day survey and going straight to the IP Day Evaluation by clicking here.

Academic Program:	Cardiovascular Perfusion Dental Medicine Dietetics and Nutrition Graduate Studies Health Administration Health Studies Medicine Nurse Anesthesia Nursing Occupational Therapy Pharmacy Physician Assistant Studies Physical Therapy Public Health
Did you complete IP 711: IP Foundations and TeamSTEPPS in the Fall 2019 semester?	Yes No
Age:	18-21 years 22-25 years 26-29 years 30-33 years 34-37 years 38-41 years 42-45 years 46-49 years 50+ years
Sex:	Male Female Prefer not to answer
Race:	Caucasian Black or African American Native American or American Indian Asian / Pacific Islander More than one race Perfer not to answer
Ethinicity:	Hispanic or Latino Not Hispanic Unknown Perfer not to answer
Do you play video games?	Never Rarely Sometimes Frequently Always

During the Sloppy Mountain Medical Center Activity...

	Never	Rarely	Sometimes	Frequently	Always
I helped to identify team members' roles and responsibilities
I held my team members accountable
I provided brief, clear, specific, and timely information to team members
I sought information from all available sources
I used resources efficiently to maximize team performance
I was a role model of teamwork behaviors
I monitored progress toward the goal and identified changes that could alter the plan of care
I fostered communication to ensure that team members have a shared mental model
I provided task-related support and assistance
I provided timely and constructive feedback to team members

I see myself as someone who:

	Entirely Disagree	Mostly Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Mostly Agree	Entirely Agree
Worries a lot
Gets nervous easily
Remains calm in tense situations
Is talkative
Is outgoing, sociable
Is reserved
Is original, comes up with new ideas
Values artistic, aesthetic experiences
Has an active imagination
Is sometimes rude to others
Has a forgiving nature
Is considerate and kind to almost everyone
Does a thorough job
Tends to be lazy
Does things efficiently

*Sloppy Mountain Team Code:
*Sloppy Mountain Room Code:

*Please enter your team and room code from the sloppy mountain activity code slips if these boxes are not already filled-in for you.