RACGP logo here RCNA logo here ABN 69 004 271 103 Statistical Clearing House Approval No. XXXXXXXXXXXXX Survey ID………………………… Date form received…….…………………….. Input editing done……………………………. Code Formal/Informal a ..b . .c . .d.. e ..f. Code RRMA ID – a Metropolitan b Rural c Remote…………………… Date data entry done………………………….. RACGP/RCNA Nursing in General Practice Project — Survey of Education Providers About this survey Your organisation has been identified as one that may provide educational opportunities to General Practitioners (GPs) and/or Registered or Enrolled nurses (nurses) to support the role of nurses in general practice. In this voluntary survey we ask you to identify the courses/programs your organisation offers that support the role of nurses in general practice. Please include both courses/programs available now or proposed for 2004 or 2005 that support the role of nursing in general practice and are aimed at GPs and/or nurse participants. Do not include basic nursing or medical undergraduate training, nor any postgraduate training for GPs not related to working with nurses in teams in general practice. Please complete the details for each of the courses/programs you offer for either GPs, nurses or both. You may need to photocopy the survey form for each course/program. (Additional copies are available electronically as a pdf file from AMRS if required). Survey return details The Royal College of Nursing, Australia (RCNA) and the Royal College of General Practitioners (RACGP) have commissioned Australian Marketing and Research Services (AMRS) to conduct this research. You will receive a phone call from an AMRS researcher to make sure the appropriate person in your organisation has received this survey. Contact AMRS Market Research Director Ms Susan Pitt by email susan.pitt@netspeed.com.au or 02 62470632 if you have any queries relating to the return of this survey. DUE DATE: Please return your completed survey form including details of all the courses/programs you have identified by Monday 30 2 June 2003 through the reply paid envelope provided, to RACGP/RCNA Nursing in General Practice Project, PO Box 76 Dickson, ACT, 2602. (Please return the survey even if you have no courses/programs). YOUR CONTACT: Please provide an appropriate contact for any follow up required on this form: Contact Name……………………………..…Position Title………………………………….Phone……………………Email…………………….See over From the RACGP/RCNA Nursing in General Practice Project Policy Advisors This survey is voluntary. Whilst we realise that you may have multiple courses/programs that “support the role of nurses in general practice”, we encourage you to participate. Your survey results will contribute to a database of educational opportunities and the details of the courses/programs your organisation offers will be published in the final report to the Commonwealth. It is expected that this report will be disseminated widely and will offer you an opportunity to promote your courses/programs amongst the wider GP and nursing professions. Whilst the details of your courses/programs will not be confidential or anonymous and in fact will be publicised through the research reports, the identity of the person completing the survey on behalf of your organisation will not be identified in any publication. It should take no longer than 10 minutes per course/program to complete the survey. The survey is designed to be completed for multiple courses/programs. Please photocopy the survey and complete it for each course/program that you have identified as appropriate.. Please add extra sheets or attach any additional information you consider may be useful to us. (Additional copies of the survey are available electronically as a pdf file if required). As stated above RCNA and RACGP have outsourced this survey of educational providers to a market research agency, Australian Market Research Services. They have distributed this survey on our behalf and will collate the results. Please return your completed survey by Monday 22 June 2003 through the reply paid envelope provided. Please do not hesitate to contact the project Policy Advisor/s if you have any questions or would like further information regarding the project. Tessa Pascoe Ronelle Hutchinson Policy Advisor RCNA/RACGP Nursing in General Practice Project Policy Advisor RACGP/RCNA Nursing in General Practice Project Royal College of Nursing, Australia Royal Australian College of General Practitioners PO Box 219 DEAKIN WEST ACT 2600 1 Palmerston Cres South Melbourne VIC 3205 Ph: Ph: 03 8699 0599 Fax: 03 8699 0560 02 6282 5633 Fax: 02 6282 3565 Email: Tessa@rcna.org.au Email: ronelle.hutchinson@racgp.org.au 3 Instructions for the RACGP/RCNA Nursing in General Practice Project Tick this box, complete the contact details and return this survey in the envelope provided if you have no such courses or programs. Thank you for your time. Please complete the following survey for each course/program your organisation offers for nurses or GPs that supports the role of nurses in general practice. (Please photocopy additional survey forms for each course or email susan.pitt@netspeed.com.au or phone 02 62470632 for a pdf file copy). Please provide the following contacts for each course/program to resolve any queries: Name of Institution/Organisation: > Email: > Contact person: > Phone: > _____________________________________________________________________________________________________ Q 1. Full name of course/program name: (please complete) Course/Program name:………………………………………………………………….. Q 2. Please provide a brief description of the course/program content (Please provide about 4or-5 lines). Course/Program description……………………………………………………………………………………………………………………...….………………….... …………………………………………………………………………………………………………………….……….….…..…………………….. ………………………………………………………………………………………………………………………….……………..…………..…….. ……………………………………………………………………………………………………..………………….…………...…………………….. 4 Q 3. Status of Course (circle one) 1. Offered in 2003 2. To be offered in 2004 3. To be offered in 2005 4. Date of offer not yet finalised Q 4. Delivery Mode (circle one only) 1. Face-to-face 2. Distance 3. Electronic/Internet 4. Combined (face to face & distance) 5. Combined (face to face & electronic) 6. Other - please specify………………………….…… Q 5. Usual Length of course – full time equivalent (circle one only) 1. Self paced 2. One day or less 3. 2 – 3 days 4. 4 – 6 days 5. 1 – 2 weeks 6. 3 – 4 weeks 7. 5 – 8 weeks 8. One semester 9. One academic year 10. Other - please specify………………………………. Q6. What is the usual cost of the course? No cost Less than $100 $100 – 199 5 $200-299 $300-399 $400- 499 Over $500 Q 7. Is the course/program a discrete unit or part of a larger curriculum? (circle one only) 1. Discrete unit 2. Part of larger curriculum 3. Both 4. Other - please specify……………………………. Q 8. Frequency of delivery of course (circle all that apply) 1. Weekly 2. Monthly 3. Quarterly 4. Annual 5. On demand 6. Other – please specify……………………………. Q 9. Type of Certification/Qualifications on completion (circle all that apply) 1. Certificate of attendance 2. Accredited Certificate 3. Diploma 4. CPD/ CNE points 5. No formal qualification 6. Other - please specify…………………………………. 6 Q 10. Target Audience (circle all that apply) 1. Health Consumer 2. Nurses in general practice 3. All nurses 4. GPs 5. General practice managers 6. Other – please specify……………………., Q 11. Are there any restrictions to the course/program commencing? (circle all that apply) 1. Sufficient numbers of participants 2. External Funding 3. Staffing 4. Location or delivery 5. No restrictions 6. Other restrictions, please specify Q 12. Have you any other comments? …………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………… Q13. Please provide an estimate of the time taken to complete this form (one form per course). DUE DATE: Please return your completed survey form (even if you have no courses), together with all courses/programs attached, by Monday 7 30 June 2003 through the reply paid envelope provided, to: RACGP/RCNA Nursing in General Practice Project, C/-Australian Marketing and Research Services PO Box 76 Dickson ACT 2602 Thank you for your time