Human Resources Department
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KU School of Medicine-Wichita
Exit Interview


We have been notified of your intent to leave KUSM-W. To help us continue efforts to improve our work culture, please complete the following questions. Your honest and candid answers are important to us. This questionnaire is for the school’s development and will not be filed in your personnel file. It will not be used in determining eligibility for future employment with KUSM-W. Following receipt of your responses in Human Resources, you will be contacted for an exit interview.

Name


Department


Date completed


Last day of work


Supervisor

General Questions

1. What prompted your decision to leave?

In lieu of termination
Personal reasons
Retired
Spouse relocate
Dismissed
Family reasons
Non-reappointed
No promotional opportunities
New position
Pay/Benefits
Dissatisfaction, please elaborate below

2. How did you feel about your pay?

Excellent
Above average
Average
Below average
Poor

3. How did you feel about your benefits?

Excellent
Above average
Average
Below average
Poor
Not applicable

4. Did you receive adequate training to perform your job duties?

Yes
No

5. Did you receive adequate orientation to:KUSM-W?

Yes
No

Your department?

Yes
No

Your position?

Yes
No

6. What does your new job offer to you that your job with KUSM-W did not?

Better use of job skills
Increase in salary
Promotion
Closer to home
Flexible work schedule
Not applicable

7. How would you describe the employment conditions at KUSM-W?

Excellent
Above average
Average
Below average
Poor

8. How would you describe employee morale in your department?

Excellent
Above average
Average
Below average
Poor

9. Would you refer a friend to work here?

Yes
No
Yes, but not in my department

10. How supportive was your work environment to you in your role as a “caregiver”, i.e., sick kids, school event participation, elder care, etc.

Excellent
Above average
Average
Below Average
Poor
Not applicable

11. Did your performance evaluations provide feedback to assist you in the performance of your job?

Yes
No

The following questions are in reference to your direct supervisor

12. Did your supervisor: Treat employees with courtesy and respect?

Yes
No

Work with employees to solve problems and respond to needs, i.e., time off, scheduling?

Yes
No

Explain policies clearly and apply them in the same way to all employees?

Yes
No

Look for solutions and new ideas rather than just react to problems after they happen?

Yes
No

Show recognition and reward employees when they do extra work?

Yes
No

Encourage employees to advance even if it means transferring from the department?

Yes
No

Provide a good orientation and help new employees feel welcome?

Yes
No

Give employees timely and helpful feedback on how they are doing?

Yes
No

Create a feeling of teamwork in the department?

Yes
No

Keep employees informed about new/important events on campus?

Yes
No

Give employees the information they need to do their jobs?

Yes
No

When possible, involve employees in solving problems?

Yes
No

Deal fairly and quickly with employees who are not performing their jobs satisfactorily?

Yes
No

Act as a positive role model?

Yes
No

Items to be taken care of before your last day

13. Have you contacted the payroll department with instruction for your final paycheck?

Yes
No

14. Have you turned in your keys, ID card, Business Travel Card?

Yes
No

15. Have you given HR your forwarding address if applicable for W-2 purposes?

Yes
No

16. Do you have any additional comments about KUSM-W? Please feel free to elaborate openly and honestly; your comments will be appreciated.

For questions call 3-2615.

 

 

Last Modified: September 17, 2007