Learner's Perception (LP) Survey

Forms and Documents

Document Name	Status
Form 10-0439 Learner's Perception (LP) Survey Form and Instruction	Modified
doc09c_Justification B_2900-0691_2015.pdf Supporting Statement B	2015-10-22
LPS_Instructions Manual_v001_ed13.pdf Supplementary Document	2015-10-22
Justification Statement A_032916.doc Supporting Statement A	2016-03-29
TOC_Response note from Michael Kashner_VHACO.docx Justification for No Material/Nonsubstantive Change	2012-05-16
Kashner_Henley_Golden_Effects ACGME duty hours on Resident Satisfaction_2010.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Kaminetzky_Keitz_Kashner_LPS subspecialty fellows_2011.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Cannon_Keitz_Holland_Factors satisfaction med student resident LPS_2008.pdf Justification for No Material/Nonsubstantive Change	2012-05-16
Lam_O'Toole_Arola_Factors associated dental residents_in press (2).pdf Justification for No Material/Nonsubstantive Change	2012-05-16
4944_001.pdf Supplementary Document	2011-02-28
(LPS) Poster.pdf Supplementary Document	2009-09-23
2013 letter to trainees[1].doc Supplementary Document	2012-12-06

IC Document Collections

IC ID	Document Title	Status
44140	Learner's Perception (LP) Survey Form and Instruction	Modified

ICR Details

OMB Control No: 2900-0691	ICR Reference No: 201510-2900-002
Status: Historical Active	Previous ICR Reference No: 201212-2900-006
Agency/Subagency: VA	Agency Tracking No: 2900-0691
Title: Learner's Perception (LP) Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/12/2016
	Date Received in OIRA: 04/29/2016
Terms of Clearance: VA is to update BLS information and re-upload as a non-substantive change.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved	09/30/2016
Responses	15,000	0	14,000
Time Burden (Hours)	3,750	0	3,500
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the LP Survey is to assist in identifying strengths and opportunities for improvement in the clinical training experience thus allowing continuous assessment of VA's teaching mission.

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Authorizing Statute(s): US Code: 38 USC Section 527 Name of Law: Evaluation and data collection
   US Code: 38 USC Section 7302 Name of Law: Functions of Veterans Health Administration: healthcare personnel education and training programs.
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 77083	12/11/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 22516	04/29/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Learner's Perception (LP) Survey	10-0439, 10-0439	Learners' Perceptions Survey - AH ,   Learners' Perceptions Survey - PR

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	15,000	14,000	0	1,000	0	0
Annual Time Burden (Hours)	3,750	3,500	0	250	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The public burden hours in item 12 on a per person basis remained unchanged at 15 minutes.

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Annual Cost to Federal Government: $61,258

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/29/2016

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