Stage,Question,Type,Answer choices,Use note
Before,"How confident are you in giving specific, useful feedback?",Rating,1 Not confident|2|3|4|5 Very confident,Repeat unchanged after training
Before,How often have you given feedback in the past two weeks?,Single choice,Never|Once|2–3 times|4 or more times,Use a consistent reference period
Before,What would you most like to improve?,Open text,,Optional
After,"How confident are you in giving specific, useful feedback?",Rating,1 Not confident|2|3|4|5 Very confident,"Self-report, not an objective skill test"
After,What will you try in the next two weeks?,Open text,,Optional
Follow-up,Have you used the feedback technique in the past two weeks?,Single choice,Yes|Not yet|No opportunity,Keep every category
Follow-up,What helped or prevented you from using it?,Open text,,Do not request identifying details