CLINICAL PASTORAL EDUCATION ALUMNI(AE) QUESTIONNAIRE Name: 1. Did your Chattanooga CPE training leave a general lasting impression on you? YES NO (If yes, circle all applicable) Emotionally Intellectually Spiritually Professionally Personally No 2. What area of your CPE training in Chattanooga had the strongest emotional impact on you? (Circle the strongest one.) Unsure Peer group Individual supervision Didactics Informal interactions with peers Interactions with patients 3. Interactions with the supervisors impacted me significantly because they: (Circle all that apply.) Did not impact me Focused me on spiritually Helped me confront my own emotions Stimulated me intellectually Helped me to better handle interpersonal interactions Helped me understand how to effectively help others Encouraged me to empathize with those suffering and/or confused 4. Upon completion of my Chattanooga CPE program(s), I returned to my previous: Educational setting Yes No Ministry Yes No
5. Your Present Ministry Capacity: Imam/Pastor/Priest/Rabbi Seminarian Associate/Assistant Lay visitor Pastoral visitor Parish nurse Health care chaplain Military Chaplain Other institutional chaplain Secular Pastoral counselor Seminary Professor Other, Describe 6. What certifications have you received since participating in CPE in Chattanooga: (please list types of certification) 7. Degrees completed since participating in CPE in Chattanooga: Degree: Year: Institution: Degree: Year: Institution: Degree: Year: Institution: 8. Was academic credit your reason for participating in CPE? Yes No
9.Have you been ordained or licensed since participating in the Chattanooga CPE program? Yes No (Please list types of licensure) 10. If you received CPE credit towards a degree or CEU units provide: Name of degree: Seminary: Number of CEU Units: Organization: 11. How many units of CPE did you complete at this center: 12. Did your additional unit(s) of CPE training enable you to further develop your (circle all that apply): Pastoral identity Pastoral role Pastoral functioning 13. Did your additional CPE unit(s) enable you to further develop your ability to function as a (Circle all that apply): Imam/Pastor/Priest/Rabbi Associate/Assistant Seminarian Military Chaplain Hospital Chaplain Hospice Chaplain Geriatric Facility Chaplain Other Institutional Chaplain Lay visitor Pastoral visitor Parish nurse Seminary Professor Pastoral Counselor Secular Answer next series of Questions using the following scale. Please check the correct answer. 1. Harmful 2. Not helpful 3. Helpful 4. Very helpful 14. CPE as a component in the development of my pastoral identity was: N/A 15. Learning during CPE to assess individuals in crisis has been: N/A 16. The process of setting goals using a learning contract was: N/A
17. As an important step in pursuing my career goals, CPE was: N/A 18. CPE, as a component in developing my authority, was: N/A 19. Identifying my limitations during CPE training was: N/A 20. Identifying my strengths during CPE training was: N/A (Answer next series of Questions using the following scale. 1. Disagree 2. Somewhat disagree 3. Somewhat agree 4. Agree 21. CPE has helped me appreciate the value of ongoing consultation or supervision in ministry. 22. CPE was helpful in developing basic listening and counseling skills. 23. CPE contributed to my self-understanding. 24. CPE has helped me appreciate the value of peer group learning. 25. CPE has assisted my preparation for hospital/institutional visitation in my ministry. 26. CPE has assisted me in my present use of crisis intervention. 27. My CPE experiences enhanced my present pastoral ability to theologically reflect on issues of death, dying and loss. Answer next series of Questions using the following scale. Please check the correct answer. 1. Disagree 2. Somewhat disagree 3. Somewhat agree 4. Agree 28. The team approach to ministry, which I experienced during CPE, has influenced how I work with professionals today.
29. CPE helped me to better understand health care ethical issues. 30. CPE has helped me to integrate my theological beliefs with the everyday experiences of people. 31. Experiencing the closure process during CPE has enabled me to better deal with termination and loss in my life and ministry. 32. CPE has positively impacted my spiritual journey. 33. CPE has challenged my images of God and human nature. 34. Identify program components you felt were particularly strong (indicate with +)or not helpful (-). (Indicate all that apply.) + quality and challenge of clinical assignments use of verbatims and other clinical material didactic sessions interpersonal group experiences individual supervisory experiences interaction with interdisciplinary staff interaction with staff of chaplaincy service theological reflection integration of theology, ethics and the sciences worship/spiritual reflection emphasis on pastoral identity (formation/ development) emphasis on personal growth
35. What suggestions can you make to enhance the CPE program in Chattanooga? 1. 2. 3. 36. What else would you like to tell us? The Board of CACPC certainly appreciates your time filling out this questionnaire, giving us important information, to be used to continue the program s accreditation of the, to bring about improvements, and to develop the program for the future. God bless you and your ministry.