APPENDIX C
Question-Writing Template
| Question Number |
|
| Question Objective |
|
| Question Type |
|
| Question Wording |
|
| Pilot Feedback |
|
| Revised Wording |
|
| Plans for Analysis |
|
Two example questions follow:
| Question Number |
1 |
| Question Objective |
Demographic |
| Question Type |
Multiple response item |
| Question Wording |
Please indicate your position in the organization:
 Team lead
Tier-one customer service representative
Tier-two customer service representative |
| Pilot Feedback |
None |
| Revised Wording |
Not required |
| Plans for Analysis |
Total number respondents by position Mean by position Report using only the mean |
| Question Number |
2 |
| Question Objective |
Overall satisfaction or dissatisfaction with workflow tool |
| Question Type |
Rating scale |
| Question Wording |
Please rate how strongly you agree or disagree with the following statements by circling the appropriate box, where:
| 1 = |
Strongly Agree |
| 2 = |
Agree |
| 3 = |
Neither Agree or Disagree |
| 4 = |
Disagree |
| 5 = |
Strongly Disagree |
The workflow tool is easy to use.
The information available to me when completing a work request is acceptable.
The training provided helped me feel confident using the workflow tool.
My ability to complete my work has improved since the workflow tool was implemented. |
| Pilot Feedback |
None |
| Revised Wording |
Not required |
| Plans for Analysis |
Mean based on number of respondents answering disagree and strongly disagree Look at responses by position to determine any trends |
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