HOW TO MAKE A SURVEY QUESTIONNAIRE

GENERAL TIPS AND REMINDERS:

• The survey questionnaire always comes with a cover letter. (Refer to the provided sample letter template.)
• The use of correct standard English is a basic rule. This includes correct spelling, proper punctuations, and the like.
• Observe parallelism in composing/presenting your statements. If you use declarative statement, stick to it and do not
shift to interrogative (question) statement. If you start your statements with a pronoun, stick to it and do not shift to a
verb or an adjective. (See sample question items below.)
• Always provide instructions as to how the respondents would answer each part of your questionnaire.
• Fit group of items and/or tables on a page. Do not cut them. Move them if necessary, like that of an instruction being
separated with the items it is referring to. This is to ensure continuity so that the respondents do not have to keep on
flipping pages. See the examples below on how set A and set B questions were presented.
• Make sure that the questionnaire reflects organization as to how the items are presented and arranged. This is not only
for your respondents to easily understand your questionnaire but this is also a crucial part of your questionnaire’s face
validity.

EXAMPLE 1 (USE OF TABLES):

A. Check the column that indicates how much you are aware with the idea presented in each number. Be guided with the
interpretation of each degree of agreement/disagreement.

LEVELS INTERPRETATION
Fully Aware I am highly knowledgeable with this brain function that caters to meaningful learning.
Moderately Aware I am sufficiently knowledgeable with this brain function that caters to meaningful learning.
Slightly Aware I am poorly knowledgeable with this brain function that caters to meaningful learning.
Not Aware I am not knowledgeable with this brain function that caters to meaningful learning.

ITEMS Fully Moderately Slightly Not

I am aware of how… Aware Aware Aware Aware
1. the feeling of fear and helplessness (i.e., stress) sabotage the ability
of students to make use of their higher-order thinking.
2. socialization influences how students’ brain works.
3. meaningful learning engages the whole body and mind of the
students in the learning process.
4. positive emotions affect the brain which enable effective learning.
5. the brain deals with the difference between parts and wholes of a
concept.
6. the body, brain, and mind operate as an integrated system.
7. the brain perceives and generates patterns and resists having
meaningless patterns imposed on it.
8. human development varies in each person which affects the brain
functions and learning capacities of the students.
9. the unique genetic heritage and unique experiences ensure that
everyone’s brain and physiology is organized differently.
10. the different types of memory and different memory system engage
higher-order thinking.
11. critical attention is for the brain/mind that is immersed all the time in
a field of sensations, images, and input.
12. metacognition and reflective thinking enhance higher-order thinking.
B. The following items will help you determine the factors that affect your practice of Brain-Based Learning (BBL).
Check YES if the condition/factor contributes to your practice of BBL. Check NO if the condition/factor does not
contribute to your practice of BBL.

CONDITIONS/FACTORS YES NO
Training
1. I have learned the theory of brain-based learning in my undergraduate and/or graduate course.
2. I have attended a seminar/training/workshop on how to incorporate brain-based learning in my
language teaching.
3. I have been joining regular focus group discussions (peer mentoring and coaching, etc.) with other
language teacher on the different brain-based learning practices that we can employ and adopt.
Facilities
4. I have a classroom big enough for group activities and other task-based lessons.
5. I have media facilities available for use (internet connection, audio-visual room, library, etc.)
6. I have an appropriate knowledge on how to use the facilities for brain-based language learning.
Materials
7. I have media materials for classroom use (television, laptop/desktop, LCD projectors, CD/DVD
players, cellular phone, newspapers/magazines, etc.)
8. I have students who, in majority, can access the internet, have televisions, and have educational
materials at home.
9. I have access to reading materials (either printed or online) on brain-based learning both at home and
at school.

EXAMPLE 2:

A. Check the blank that indicates how much you are aware with the idea presented in each number. Be guided with the
interpretation of each degree of agreement/disagreement.

LEVELS INTERPRETATION
Fully Aware I am highly knowledgeable with this brain function that caters to meaningful learning.
Moderately Aware I am sufficiently knowledgeable with this brain function that caters to meaningful learning.
Slightly Aware I am poorly knowledgeable with this brain function that caters to meaningful learning.
Not Aware I am not knowledgeable with this brain function that caters to meaningful learning.

1. I am aware of how the feeling of fear and helplessness (i.e., stress) sabotage the ability of students to make use of
their higher-order thinking.
__ Fully Aware __ Moderately Aware __ Slightly Aware __ Not Aware

2. I am aware of how socialization influences how students’ brain works.

__ Fully Aware __ Moderately Aware __ Slightly Aware __ Not Aware

3. I am aware of how meaningful learning engages the whole body and mind of the students in the learning process.
__ Fully Aware __ Moderately Aware __ Slightly Aware __ Not Aware

4. I am aware of how positive emotions affect the brain which enable effective learning.
__ Fully Aware __ Moderately Aware __ Slightly Aware __ Not Aware

5. I am aware of how the brain deals with the difference between parts and wholes of a concept.
__ Fully Aware __ Moderately Aware __ Slightly Aware __ Not Aware
B. The following items will help you determine the factors that affect your practice of Brain-Based Learning (BBL).
Check YES if the condition/factor contributes to your practice of BBL. Check NO if the condition/factor does not
contribute to your practice of BBL.

Trainings
1. I have learned the theory of brain-based learning in my undergraduate and/or graduate course.
__ YES __ NO

2. I have attended a seminar/training/workshop on how to incorporate brain-based learning in my language teaching.

__ YES __ NO

Facilities
3. I have a classroom big enough for group activities and other task-based lessons.
__ YES __ NO

4. I have classroom facilities such as desks and chairs that can be moved or rearranged for different types of activities.
__ YES __ NO

Materials
5. I have students who, in majority, can access the internet, have televisions, and have educational materials at home.
__ YES __ NO

6. I have access to reading materials (either printed or online) on brain-based learning both at home and at school.
__ YES __ NO