Name Pre Experience Questions 1. Have you participated in Step into My World, or a similar program, before? Y N 2. What do you hope to gain from this experience? 3. How comfortable are you in discussing disabilities with people? 1 2 3 4 Very Uncomfortable 5 Very Comfortable 4. How accessible do you believe campus is? 1 Very Inaccessible 2 3 4 5 Very Accessible 5. Do you think you could still do your current job if you were diagnosed with a disability? Y N Before continuing, please ask the facilitator to present you with your disability. 6. What do you think is the biggest pet peeve of a person with your disability? 7. Do you have any concerns before continuing on with this experience? You will now have a brief introduction to your disability including how to use any assistance devices. Post Experience Questions 1. What new insights do you have now about this particular disability or disabilities in general? 2. How comfortable do you think you would be discussing disabilities with people now that you have experienced it yourself? 1 2 3 4 Very Uncomfortable 5 Very Comfortable 3. How accessible do you believe campus is now? 1 2 3 4 Very Inaccessible 5 Very Accessible 4. Do you feel you could still do your current job with the disability you were given? What changes might need to take place for you to do so? 5. What was the biggest challenge for you in this simulation on campus? 6. What do you think Iowa State University can do to make campus a better place for people with this disability? You will now have a brief discussion with your facilitators that is specific to your disability, and then you may return to your normal activities. Thank you very much for participating in Step into My World!! Name Additional Comments