*0a. What is your Identification Number?

*1a. What is your licensure status? Choose only one of the following 1. Non-licensed nursing student 2. LVN 3. RN 4. Nurse Practitioner 5. Certified Nurse Midwife Other

*1b. Site for survey? Choose only one of the following 1. Parkland Hospital 2. John Peter Smith Hospital 3. TWU graduate class 4. TWU undergraduate class Other

*2a. How often do you generally perform cervical assessment? (Make your best estimate.) Choose only one of the following 1. Never performed (never) 2. Less than once a month (infrequently) 3. One to two times a month (occasionally) 4. Several times a month (often) 6. On a daily basis (frequently)

*2b. How long have you been performing cervical assessments? (Make your best estimate.) Choose only one of the following 1. Never performed 2. Less than one year 3. Over one year

*3. What manikin did you use? Choose only one of the following 1. A 2. B 3. C 4. D 5. E 6. F

*4. Did you have a CxAL-Guide for your examination of this manikin? Yes No

*5. How dilated was the cervix of the manikin you assessed? Choose only one of the following Please choose.. 1 cm 2 cm 3 cm 4 cm 5 cm 6 cm 7 cm 8 cm 9 cm 10 cm

*6. How effaced was the manikin you assessed? Choose only one of the following Please choose.. 0% 25% 50% 75% 100%

*7. How lifelike does this manikin feel? Choose only one of the following Very life-like Life-like Somewhat life-like Not at all life-like