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It would be helpful if you would take the time to answer the following questions. The information you give will enable Blackpool Teaching Hospitals to continue to support supervision of work placements and improve work experience placements for future participants.

Name:
Name of School/College/University:
Date of Work Experience:
Placement Area

1Did your placement achieve your aims?

Yes
No

If you answered No, please comment.

2 Has your placement given you a better understanding of the work undertaken at Blackpool Teaching Hospitals?

Yes
No

If you answered No, please comment.

3Do you feel your placement was well organised?

Yes
No

If you answered no, please comment.

4Are there any additional aspects which you feel should be included in future work experience placements?

Yes
No

If you answered yes, please comment.

5Is there any other information you would have liked prior to the start of your placement?

Yes
No

If you answered yes, please comment.

6Has your placement influenced your choice of career in any way?

Yes
No

If you answered yes, please comment

7Was the support given by your supervisor and other members of staff:

Excellent
Good
Fair
poor

Any other comments:

8Have you applied to be considered for voluntary (unpaid) work at Blackpool Teaching Hospitals? (Over 16 years of age only)

Yes
No
N/A

If you answered no, would you like to be considered for voluntary work at Blackpool Teaching Hospitals? (Over 16 years of age only)

Yes
No

Please return completed form to: Michelle Pearson, Work Experience, Blackpool Teaching Hospitals NHS Foundation Trust, L & D, 42 Whinney Heys Road, Blackpool, FY3 8NR or email back to: michelle.pearson@bfwh.nhs.uk
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