An example of a pre/post feedback evaluation form for Dementia Friendly Training

1. Wessex AHSN Dementia Training Evaluation Form
Please complete this part of the questionnaire before the workshop starts
Name (Optional)
___________________________________________________________________________
Please circle your job
Doctor Practice nurse District nurse Nurse practitioner Receptionist
Secretary Health care assistant Counsellor Manager/Finance
Other, please specify__________________________________________________________
1. Please rate your knowledge of dementia
Very poor 1 2 3 4 5 6 7 8 9 Very good
2. Please rate your knowledge of the services available locally for people with
dementia
Very poor 1 2 3 4 5 6 7 8 9 Very good
3. How confident would you feel dealing with a person with dementia?
Not confident 1 2 3 4 5 6 7 8 9 Very confident
4. Any other comments?
Thank you for completing this part of the questionnaire

2. Post-training questionnaire
Please complete this part of the questionnaire after the workshop has finished, and give to trainer,
so that we can evaluate and improve - Thank you
1. Please rate your knowledge of dementia following this workshop
Very poor 1 2 3 4 5 6 7 8 9 Very good
2. Please rate your knowledge of the services available locally for people with dementia
Very poor 1 2 3 4 5 6 7 8 9 Very good
3. How confident would you feel dealing with a person with dementia now?
Not confident 1 2 3 4 5 6 7 8 9 Very confident
4. Overall, how useful was this workshop?
Not useful 1 2 3 4 5 6 7 8 9 Very useful
Any comments on this?
5. Overall, how would you rate the quality of the presentation?
Very poor 1 2 3 4 5 6 7 8 9 Very good
Any comments on this?
6. Do you have any suggestions on how we can improve patients’ and carers’ dementia experience
here at the surgery?
7. Do you have any further suggestions for future training?
8. Any other comments or questions?