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Demographic Questionnaire (Monograph) - Redefining Insomnia: State-of-the-Science in Insomnia Management
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1. What is your profession? Check all that apply.
MD
DO
RN
NP
PharmD
RPh
Other

2. Clinical Research Specialty:

3. Please evaluate how well the following learning objectives were met:
Rating Scale: 1=Poor 2=Fair 3=Good 4=Very Good 5=Excellent

(A): Understand the recommendations for current practice found in the National Institutes of Health State-of-the-Science Conference Statement on Manifestations and Management of Chronic Insomnia

1     2     3     4     5    

(B): Define normal sleep, insomnia, and insomnia consequences

1     2     3     4     5    

(C): Identify comorbidities and risk factors for chronic insomnia

1     2     3     4     5    

(D): Describe approaches to diagnosis and assessment

1     2     3     4     5    

(E): Analyze non-pharmacologic and pharmacologic interventions for managing chronic insomnia

1     2     3     4     5    

4. Was all data reported objectively and with appropriate referencing?
Yes
No

5. Was the overall content of this educational activity presented objectively and free of bias?
Yes
No

6. If you answered “No” to question 4 or 5, please explain:

7. Was the subject matter relevant to your clinical practice?
Yes
No

8. Was the educational format an effective learning method?
Yes
No

9. Was the environment conducive to learning?
Yes
No

10. If you answered “No” to question 7, 8 or 9, please explain:

11. What one question remains unanswered after having participated in this activity?

12. Cite one new piece of information learned from this activity.

13. What related topics would you like to have offered as future CME activities?

14. What are your preferred learning methods? (Check as many as applicable)
Live conferences
CD-ROM
Print materials (eg, monographs)
Internet/Web-based

15. Additional Comments:

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