Download - Cancer Care Nova Scotia

Appendix V
Field Test Evaluation of a Patient Education
Resource
Note to developer: please contact CCNS for an electronic version of this evaluation form
which you can tailor to the nature of your resource and the type of evaluation you are
conducting (eg. 1:1, group, self directed)
Title: Note to developer: insert title here______________________
1. Please review the resource and circle any words or ideas that are hard to understand.
If this is a video or web based resource, write the words or ideas that are hard to
understand on a separate sheet of paper.
2. Refer to the resource and tell us how easy it is to find this information:
(Note to developer: remove lines and insert topic headings, add or delete space as needed)
Easy to find
_________________________ 1 2 3 4 5
_________________________ 1 2 3 4 5
_________________________ 1 2 3 4 5
_________________________ 1 2 3 4 5
_________________________ 1 2 3 4 5
Hard to Find
3. Refer to the resource and tell us how what you would do in each situation:
(Note to developer: remove lines and insert situations (eg fever, pain), add or delete space as needed)
Situation
_________________________
_________________________
_________________________
_________________________
What I would do
_________________________
_________________________
_________________________
_________________________
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