Sleep Disorders in Older Adults

Program Evaluation

We appreciate your participation in this continuing education activity. Your responses to our survey will allow us to improve our program offerings and services. Thank you for your time!

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* How would you rate this educational activity overall?

	Poor 1	2	3	4	Excellent 5
Overall Rating	Overall Rating Poor 1	Overall Rating 2	Overall Rating 3	Overall Rating 4	Overall Rating Excellent 5

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* Did you find that the activity was balanced, promoted improvements and/or quality in healthcare/public health, and was not unduly biased toward a specific commercial interest?

Yes

No

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* If no, please explain:

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* How will information that you received during this activity impact your practice behavior?
Please list 1-3 changed that you will make.

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* Besides time and/or money, what barriers do you anticipate encountering as you make changes in your practice?

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* How well were the overall learning objectives of this activity met?
After attending this activity, I feel that I am better able to:

	Strongly Disagree 1	2	3	4	Strongly Agree 5
Describe the epidemiology of sleep disturbances	Describe the epidemiology of sleep disturbances Strongly Disagree 1	Describe the epidemiology of sleep disturbances 2	Describe the epidemiology of sleep disturbances 3	Describe the epidemiology of sleep disturbances 4	Describe the epidemiology of sleep disturbances Strongly Agree 5
Discuss mechanisms that underlie sleep disturbances	Discuss mechanisms that underlie sleep disturbances Strongly Disagree 1	Discuss mechanisms that underlie sleep disturbances 2	Discuss mechanisms that underlie sleep disturbances 3	Discuss mechanisms that underlie sleep disturbances 4	Discuss mechanisms that underlie sleep disturbances Strongly Agree 5
Review management of sleep disturbances, including hypnotic use	Review management of sleep disturbances, including hypnotic use Strongly Disagree 1	Review management of sleep disturbances, including hypnotic use 2	Review management of sleep disturbances, including hypnotic use 3	Review management of sleep disturbances, including hypnotic use 4	Review management of sleep disturbances, including hypnotic use Strongly Agree 5

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* How would you rate the presenters overall (knowledge, organization, effectiveness, etc)?

	Poor 1	2	3	4	Excellent 5
Julio Defillo Draiby, MD	Julio Defillo Draiby, MD Poor 1	Julio Defillo Draiby, MD 2	Julio Defillo Draiby, MD 3	Julio Defillo Draiby, MD 4	Julio Defillo Draiby, MD Excellent 5

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* How much did you learn as result of this activity?

	Very Little 1	2	3	4	Great Deal 5
Select one:	Select one: Very Little 1	Select one: 2	Select one: 3	Select one: 4	Select one: Great Deal 5

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* Which of the following core competency areas do you feel have been improved as a result of this activity?
Check all that apply

Patient Care

Professionalism

Practice Based Learning

Medical Knowledge

System Base Practice

Communication Skills

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* What is the most important thing you learned by attending this activity and how will it affect you and your practice?

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* Please share any additional comments and suggestions. Your feedback is extremely valuable to us.

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* Please indicate what type of CE credit you are requesting:

Nursing

Social Work

Certificate of Attendance

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* Please list your information below so we may send you a Certificate:

Name and Credentials

Company

State

Email Address