Qualtrics Example Survey

In this survey, you are invited to provide feedback on your learning experience in [insert course] so far. Specifically, I've made some changes in [insert area of interest, e.g., "how I run the computer labs this year"]. [Insert rationale, e.g., "Since will be holding similar labs throughout the year, it would be helpful to know how the existing format is and isn't beneficial for your learning."]

Please rate the following indicating how helpful they have been for your learning. When adding open-ended comments, please be specific in your descriptions of how activity is or is not supporting your learning. Your answers will be anonymous.

Participating in class by tossing & passing the microphone (in a padded cube):

very helpful to my learning
helpful to my learning
neutral
not very helpful to my learning
not helpful at all

Comment on the above (Why was the microphone helpful or not):

Working in groups to answer Poll Everywhere questions during class:

very helpful to my learning
helpful to my learning
neutral
not very helpful to my learning
not helpful at all

Comment on the above (Why were the Poll Everywhere questions helpful or not):

Viewing a video before class:

very helpful to my learning
helpful to my learning
neutral
not very helpful to my learning
not helpful at all

Comment on the above (Why were the videos helpful or not):

Taking a quiz to test my knowledge before class:

very helpful to my learning
helpful to my learning
neutral
not very helpful to my learning
not helpful at all

Comment on the above (Why were the quizzes helpful or not):