As part of continuing your work on your EBP proposal, you create a demographics tool that you use to capture data on participants who will be part of your EBP project. Here is a Demographics Questionnaire (Word) example of a demographics tool section. Keep in mind that you should include only information that is important to include in data analysis and write-up. Asking extraneous questions is burdensome for participants; thus, your demographics questions need to be meaningful, relevant, and as brief as possible. Assignment Instructions Using a Word document, create a demographics tool that has a minimum of eight questions but a maximum of 20 questions. Writing Assignment Rubric Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric. Writing Assignment Rubric – 100 PointsCriteriaExemplary Exceeds ExpectationsAdvanced Meets ExpectationsIntermediate Needs ImprovementNovice InadequateTotal PointsContent of PaperThe writer demonstrates a well-articulated understanding of the subject matter in a clear, complex, and informative manner. The paper content and theories are well developed and linked to the paper requirements and practical experience. The paper includes relevant material that fulfills all objectives of the paper. Cites five or more references, using at least two new scholarly resources that were not provided in the course materials. All instruction requirements noted. 30 points The writer demonstrates an understanding of the subject matter, and components of the paper are accurately represented with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Course materials and scholarly resources support required concepts. The paper includes relevant material that fulfills all objectives of the paper. Cites four references. All instruction requirements noted. 26 points The writer demonstrates a moderate understanding of the subject matter as evidenced by components of the paper being summarized with minimal application to evidence-based practice, theory, or role-development. Course content is present but missing depth and or development. Cites three references. Most instruction requirements are noted. 23 points Absent application to evidence-based practice, theory, or role development. Use of course content is superficial. Demonstrates incomplete understanding of content and/or inadequate preparation. Content of paper is inaccurately portrayed or missing. Cites two or fewer references. Missing some instruction requirements. 20 points30 Analysis and Synthesis of Paper Content and MeaningThrough critical analysis, the submitted paper provides an accurate, clear, concise, and complete presentat.

1. As part of continuing your work on your EBP proposal, you
create a demographics tool that you use to capture data on
participants who will be part of your EBP project. Here is a
Demographics Questionnaire (Word)
example of a demographics tool section. Keep in mind that you
should include only information that is important to include in
data analysis and write-up. Asking extraneous questions is
burdensome for participants; thus, your demographics questions
need to be meaningful, relevant, and as brief as possible.
Assignment Instructions
Using a Word document, create a demographics tool that has a
minimum of eight questions but a maximum of 20 questions.
Writing Assignment Rubric
Note:
Scholarly resources are defined as evidence-based practice,
peer-reviewed journals; textbook (do not rely solely on your
textbook as a reference); and National Standard Guidelines.
Review assignment instructions, as this will provide any
additional requirements that are not specifically listed on the
rubric.
Writing Assignment Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate

2. Needs ImprovementNovice
InadequateTotal PointsContent of PaperThe writer demonstrates
a well-articulated understanding of the subject matter in a clear,
complex, and informative manner. The paper content and
theories are well developed and linked to the paper
requirements and practical experience. The paper includes
relevant material that fulfills all objectives of the paper.
Cites five or more references, using at least two new scholarly
resources that were not provided in the course materials.
All instruction requirements noted.
30 points
The writer demonstrates an understanding of the subject matter,
and components of the paper are accurately represented with
explanations and application of knowledge to include evidence-
based practice, ethics, theory, and/or role. Course materials and
scholarly resources support required concepts. The paper
includes relevant material that fulfills all objectives of the
paper.
Cites four references.
All instruction requirements noted.
26 points
The writer demonstrates a moderate understanding of the

3. subject matter as evidenced by components of the paper being
summarized with minimal application to evidence-based
practice, theory, or role-development. Course content is present
but missing depth and or development.
Cites three references.
Most instruction requirements are noted.
23 points
Absent application to evidence-based practice, theory, or role
development. Use of course content is superficial.
Demonstrates incomplete understanding of content and/or
inadequate preparation.
Content of paper is inaccurately portrayed or missing.
Cites two or fewer references.
Missing some instruction requirements.
20 points30
Analysis and Synthesis of Paper Content and MeaningThrough
critical analysis, the submitted paper provides an accurate,
clear, concise, and complete presentation of the required
content.

4. Information from scholarly resources is synthesized, providing
new information or insight related to the context of the
assignment by providing both supportive and alternative
information or viewpoints.
All instruction requirements noted.
30 points
Paper is complete, providing evidence of further synthesis of
course content via scholarly resources.
Information is synthesized to help fulfill paper requirements.
The content supports at least one viewpoint.
All instruction requirements noted.
26 points
Paper lacks clarification or new information. Scholarly
reference supports the content without adding any new
information or insight. The paper’s content may be confusing or
unclear, and the summary may be incomplete.
Most instruction requirements are noted.
23 points
Submission is primarily a summation of the assignment without
further synthesis of course content or analysis of the scenario.

5. Demonstrates incomplete understanding of content and/or
inadequate preparation.
Missing some instruction requirements.
Submits assignment late.
20 points30
Application of KnowledgeThe summary of the paper provides
information validated via scholarly resources that offer a
multidisciplinary approach.
The student’s application in practice is accurate and plausible,
and additional scholarly resource(s) supporting the application
is provided.
All questions posed within the assignment are answered in a
well-developed manner with citations for validation.
All instruction requirements noted.
30 points
A summary of the paper’s content, findings, and knowledge
gained from the assignment is presented.
Student indicates how the information will be used within their
professional practice.

6. All instruction requirements noted.
26 points
Objective criteria are not clearly used, allowing for a more
superficial application of content between the assignment and
the broader course content.
Student’s indication of how they will apply this new knowledge
to their clinical practice is vague.
Most instruction requirements are noted.
23 points
The application of knowledge is significantly lacking.
Student’s indication of how they will apply this new knowledge
to their clinical practice is not practical or feasible.
Demonstrates incomplete understanding of content and/or
inadequate preparation.
Application of knowledge is incorrect and/or student fails to
explain how the information will be used within their personal
practice.
Missing several instruction requirements.

7. Submits assignment late.
20 points30
OrganizationWell-organized content with a clear and complex
purpose statement and content argument. Writing is concise
with a logical flow of ideas.
5 points
Organized content with an informative purpose statement and
supportive content and summary statement. Argument content is
developed with minimal issues in content flow.
4 points
Poor organization, and flow of ideas distract from content.
Narrative is difficult to follow and frequently causes reader to
reread work.
Purpose statement is noted.
3 points
Illogical flow of ideas. Missing significant content. Prose
rambles. Purpose statement is unclear or missing.
Demonstrates incomplete understanding of content and/or
inadequate preparation.
No purpose statement.

8. Submits assignment late.
2 points5
APA, Grammar, and SpellingCorrect APA formatting with no
errors.
The writer correctly identifies reading audience, as
demonstrated by appropriate language (avoids jargon and
simplifies complex concepts appropriately).
Writing is concise, in active voice, and avoids awkward
transitions and overuse of conjunctions.
There are no spelling, punctuation, or word-usage errors
5 points
Correct and consistent APA formatting of references and cites
all references used. No more than two unique APA errors.
The writer demonstrates correct usage of formal English
language in sentence construction. Variation in sentence
structure and word usage promotes readability.
There are minimal to no grammar, punctuation, or word-usage
errors.

9. 4 points
Three to four unique APA formatting errors.
The writer occasionally uses awkward sentence construction or
overuses/inappropriately uses complex sentence structure.
Problems with word usage (evidence of incorrect use of
thesaurus) and punctuation persist, often causing some
difficulties with grammar. Some words, transitional phrases,
and conjunctions are overused.
Multiple grammar, punctuation, or word usage errors.
3 points
Five or more unique formatting errors or no attempt to format in
APA.
The writer demonstrates limited understanding of formal written
language use; writing is colloquial (conforms to spoken
language).
The writer struggles with limited vocabulary and has difficulty
conveying meaning such that only the broadest, most general
messages are presented.
Grammar and punctuation are consistently incorrect. Spelling
errors are numerous.
Submits assignment late.

10. 2 points5
Total Points
100
Example of a word Document:
Demographic Questionnaire
1. Are you male or female?
1. Male
2. Female
2. Do you consider yourself Hispanic or Latino/Latina?
1. Yes
2. No
3. What race do you consider yourself to be? Please select one
or more of the following:
1. White
2. Black/African American
3. American Indian/Alaska Native
4. Asian

11. 5. Hawaiian Native/Pacific Islander
6. Some other race
(specify): ___________________
4. What is your primary language?
1. English
2. Spanish
3. Some other language
(specify): ______________
5. What is your date of birth?
__ __ / __ __ / __ __ __ __ Mo Day Year
6. Which of the following educational credentials do you have
(check all that apply):
a. A high school diploma
b. A GED certificate
c. An Associate’s degree
d. A technical credential or degree
e. A Bachelor’s degree
f. A Master’s degree

12. g. Another advanced degree
7. What is your current employment status?
1. Working for pay at a job or business
2. Looking for work, not currently employed
3. Not currently working and not looking for work
(Specify): ________________
(Specify): ________________
8. In 2006, what was your total family income from all sources?
Was it:
1. Less than $25,000,
2. $25,000 to $49,999,
3. $50,000 to $100,000, or
4. More than $100.000?
9. What is your current marital status?
a. Are you currently married or unmarried?
· Married (SKIP TO b)
· Unmarried (SKIP TO c)
b. If married, are you and your spouse currently living together
or living separately?

13. · Living together (SKIP OUT)
· Living separately (SKIP TO e)
c. If not married, have you ever been married?
· Yes (SKIP TO d)
· No (SKIP TO e)
d. Are you widowed or divorced?
· Widowed
· Divorced
e. Are you currently living with a partner, boyfriend, or
girlfriend as married?
· Yes
· No
10. How many children do you have? (specify)
______ Biologic or adopted children
______ Step children
______ Foster children
11. How many children with muscular dystrophy do you have?
(specify) ______________________
12. How old is/are your child/children with muscular
dystrophy? (specify) ______________________

14. 13. At what age was your child with muscular dystrophy first
assessed by a primary care provider? (specify)
______________________
14. How much of the care, roughly, do you provide to your
child with muscular dystrophy?
1. 0-24%
2. 25-49%
3. 50-74%
4. 75-99%
5. 100%
15. How would you rate your health?
1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
16. Have you ever been diagnosed with one of the following
disorders (select all that apply):
1. Bipolar disorder

15. 2. Schizophrenia
3. Dissociative Identity Disorder (Multiple Personality
Disorder)
4. Physical addiction (alcohol, drugs)
5. None of the above
17. Does anyone in your family or household have an illness or
disability that demands a lot of your attention and makes it hard
for you to work or go to school?
1. Yes
2. No