ALUMNI/AE FEEDBACK QUESTIONNAIRE If you are a graduate of a CPE program that is/was connected to The Hospital of the University of Pennsylvania's Department of Pastoral Care, please use this on-line questionnaire to provide feedback to the CPE Advisory Committee. To submit this form electronically, click on the button at the end. Your responses will be sent anonymously unless you identify yourself. Name (optional): Address (optional): E-mail (optional): Phone (optional): Today's Date: Primary Program Site: Please choose one HUP Pennsylvania Hospital Sayre Ancora Fort Dix Presbyterian Med Ctr NewCourtland Network Inglis House Program Type: Please choose one Summer Internship Full-Time Residency Part-Time Externship Supervisory Unit Year You Graduated: Please choose one pre-1990 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Present ministry capacity: a) Imam / Pastor / Priest / Rabbi   b) Associate / Assistant   c) Pastoral Visitor   d) Health Care Chaplain   e) Other Institutional Chaplain   f) Pastoral Counselor   g) Seminarian   h) Lay Visitor   i) Parish Nurse   j) Health Minister   k) Secular   l) Other (describe): Upon completion of my CPE program(s), I returned to my previous: Educational setting   YES     NO Ministry   YES     NO List CERTIFICATIONS received since participating in CPE: List ORDINATION or LICENSURES obtained since participating in CPE: List DEGREES completed (and the DEGREE-GRANTING INSTITUTIONS) since participating in CPE: Reason for participating in CPE was for academic credit:   YES     NO If you received CPE credits toward a degree, provide: Name of Degree: Seminary: Check which category applies to the CPE units you completed at this center: 1-4 units of CPE   5 or more units of CPE   Supervisory Education   1. CPE as a component in the development of my pastoral identity was: Please choose one very helpful helpful not helpful harmful 2. Pastoral diagnostic skills learned during CPE continue to be: Please choose one very helpful helpful not helpful harmful 3. The process of setting goals by use of a learning contract was: Please choose one very helpful helpful not helpful harmful 4. CPE as an important step for me in pursuing my career goals was: Please choose one very helpful helpful not helpful harmful 5. CPE as a component in developing my authority was: Please choose one very helpful helpful not helpful harmful 6. CPE as a process to identify my limitations was: Please choose one very helpful helpful not helpful harmful 7. CPE as a process to identify my strengths was: Please choose one very helpful helpful not helpful harmful 8. CPE has helped me appreciate the value of ongoing consultation or supervision in ministry. Please choose one agree somewhat agree somewhat disagree disagree 9. CPE was helpful in developing basic listening and counseling skills. Please choose one agree somewhat agree somewhat disagree disagree 10. CPE contributed to my process of self-understanding. Please choose one agree somewhat agree somewhat disagree disagree 11. CPE has helped me appreciate the value of peer group learning. Please choose one agree somewhat agree somewhat disagree disagree 12. CPE has assisted me in preparing for hospital/institutional visitation in my ministry. Please choose one agree somewhat agree somewhat disagree disagree 13. CPE has assisted me in the present use of crisis intervention skills. Please choose one agree somewhat agree somewhat disagree disagree 14. My CPE experiences enhanced my ability to reflect theologically now about the issues of death, dying, and loss in ministry. Please choose one agree somewhat agree somewhat disagree disagree 15. The team approach to ministry I experienced during CPE has influenced how I presently work with professionals. Please choose one agree somewhat agree somewhat disagree disagree 16. CPE has enabled me to better understand the ethical issues in health care. Please choose one agree somewhat agree somewhat disagree disagree 17. CPE helped me to integrate theological beliefs with everyday experiences of people. Please choose one agree somewhat agree somewhat disagree disagree 18. What I learned from the closure process in CPE has better enabled me to deal with termination and loss in my life and ministry. Please choose one agree somewhat agree somewhat disagree disagree 19. CPE has impacted my spiritual journey positively. Please choose one agree somewhat agree somewhat disagree disagree 20. CPE has challenged my images of God and of human nature. Please choose one agree somewhat agree somewhat disagree disagree 21. Identify program components you felt were particularly strong. Indicate all that apply. a) quality and challenge of clinical assignments   b) use of verbatim and other clinical material   c) didactic sessions   d) interpersonal group experiences   e) individual supervisory experiences   f) interaction with interdisciplinary staff   g) interaction with staff of chaplaincy service   h) theological reflection   i) integration of theology, ethics, and the sciences   j) worship / spiritual reflection   k) emphasis on personal identity (formation and/or development)   l) emphasis on personal growth   22. Identify program components you felt were particularly not helpful. Indicate all that apply. a) quality and challenge of clinical assignments   b) use of verbatim and other clinical material   c) didactic sessions   d) interpersonal group experiences   e) individual supervisory experiences   f) interaction with interdisciplinary staff   g) interaction with staff of chaplaincy service   h) theological reflection   i) integration of theology, ethics, and the sciences   j) worship / spiritual reflection   k) emphasis on personal identity (formation and/or development)   l) emphasis on personal growth   23. If offered the opportunity, I would do CPE again.   YES     NO 24. I would recommend CPE to a potential ministry candidate.   YES     NO 25. General comments: 26. Specific recommendations: