Alumni Survey | Department of Physical Therapy

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UNIVERSITY OF MARYLAND EASTERN SHORE
DEPARTMENT OF PHYSICAL THERAPY

ALUMNI SURVEY

You have the option to remain anonymous (if this option is chosen, please place an “X” in the required field).

Name

Phone

Email Address

I. BACKGROUND INFORMATION

A. In what year did you graduate from the University of Maryland Eastern Shore?

B. In which of the following physical therapy settings have you been employed since graduation? (check all that apply)General HospitalRehabilitation FacilitySkilled Nursing FacilityHome Health AgencyOutpatient Clinic or Private PracticePublic School SystemU.S. Public Health ServiceArmed ForcesH.M.O.Veterans AdministrationOther (please specify)Not employed in Physical Therapy

C. Please provide the following information on your first and present employment situations:

1. First Position | Location:City

State

SettingFull-TimePart-TimeSuburban

RadioOption 1Option 2

2. Present Position | Location: City

State

Setting:UrbanRuralSuburban

Full-TimePart-Time

Not currently employed in PT

3. Have any of your positions been in management/administration?YesNo

If yes, for how many years?

If yes, please describe your position

II. GENERAL INFORMATION:

A. Are you satisfied with your current abilities to examine, evaluate, and devise plans of care for patients/clients?YesNo

B. Are you satisfied with your contributions to society through your physical therapy practice and other professional activities?YesNo

C. Are you currently a member of the American Physical Therapy Association (A.P.T.A.)?YesNo

D. Are you currently a member of any other professional organizations related to physical therapy?YesNo

If yes: Please identify the organization

E. Have you served on committees or as an officer for the A.P.T.A. at the regional, state and/or national level?YesNo

If yes: Please describe

F. Are you currently an American Board of Physical Therapy Certified Clinical Specialist?YesNo

If yes, in which specialty area?

G. Have you received any awards, special recognition, specialized training, and/or certifications?YesNo

If yes, please describe:

H. Have you been a Clinical Instructor for physical therapy or physical therapist assistant students?YesNo

If yes:

Number of P.T. students

Number of P.T.A. students

I. Are you an A.P.T.A. Credentialed Clinical Instructor?YesNo

If yes: Date of training

J. Have you been involved in presenting workshops, lectures, seminars, or in-service presentations for any of the following groups?Your DepartmentOther DisciplinesProfessional GroupsCommunity GroupsEntry-level P.T. or P.T.A. program(s)

K. Have you earned an advanced degree (beyond entry-level) or are you presently seeking an advanced degree in physical therapy or any related area since graduation from UMES?Have earned advanced degreeSeeking advanced degreeDegree awarded/seeking

L. Have you participated in any clinical research projects since graduation from UMES?YesNo

If yes, please describe research projects, publications, presentations:

M. Have you participated in any physical therapy-related community service projects including health promotion and prevention programs in response to the needs of your community?YesNo

If yes, please describe

N. Since graduation from UMES, have you participated in continuing education courses which have enhanced and/or updated your knowledge and/or skills for professional practice?YesNo

If yes, please describe

O. Please provide any comments that you would like to express regarding areas that have not been addressed in this survey.

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