Appendix J: Follow-Up Evaluation Form

[Instructor note: Consider sending this survey via an online survey tool to participants at 120
days post workshop.]

In [insert month], you had the opportunity to participate in a Physician Time Management workshop
led by [insert instructor(s)]. We are interested in learning about any impact that this workshop may
have had on personal time management practices with respect to stress, productivity, and physician
wellbeing. Regardless of whether you completed the 60 day check-in challenge following the
workshop, please take 10 minutes to complete our 120 day check-in.

1) In the 4 months since this workshop, what differences have you noticed relative to stress,
productivity, and wellbeing as a physician?

2) Have you incorporated any specific elements from this workshop into personal time management
practices?
a) Preparing a mission statement
b) Identifying individual values and priorities
c) Generating effective goals
d) Capturing ideas & tasks
e) Defining specific goal-related tasks
f) Scheduling tasks & allocating time
g) Leveraging technology
h) Task prioritization
i) No, I have not incorporated any
j) Other (please specify)

3) What barriers have impeded implementation of recommended time management practices?

a) Lacking goals or goal clarity
b) “Hijacked” time or competing priorities
c) Time wasters
d) Procrastination
e) Recommendations felt overwhelming & I didn’t know where to begin
f) No perceived barriers
g) Other (please specify)

4) What additional resources could this workshop have provided to better promote effective time
management practices?

Appendix J: Follow-Up Evaluation Form

Physician Time Management