Thank you for trying our Pediatric Pain Scale! We’re so excited to hear your feedback and ideas. This will only take five minutes. Name First Name Last Name Email Your facility and practice area What's your professional role? Physician (MD/DO) Nurse or Nurse Practitioner Child Life Specialist Psychologist / Behavioral Health Educator / Researcher Other Experience with the FeelWise Pain Scale Did you display or use the poster in a patient care area? Yes – regularly with patients Yes – briefly or for a limited trial No – not yet used If used, approximately how many children or families interacted with it? 1–5 6–10 11–25 More than 25 Unsure How did patients respond to the Pain Scale? Very positively — it encouraged communication Somewhat positively Neutral Mixed or unclear Negatively — it caused confusion or disinterest Can you describe what you observed? Did it make your patient communication about pain easier or more effective? Yes Somewhat Not Really If yes, can you describe how? Design and Content Feedback Were the emotion faces/words clear and relevant? Yes, completely Mostly Some were confusing Too many / overwhelming Too few / missing emotions Which emotions would you add or remove? Was the reading level appropriate for your patient population? Yes Mostly Too Advanced Too Simple Thank you!
