Complete the Post-test and Evaluation Form - American College ...

Sexual Dysfunction in Male College Students
Presenter: David Mellinger, MD; Steven Kraushaar, PsyD
Note: Completion of this post-test and evaluation is mandatory if you are requesting continuing
education credit. An asterisk indicates a required field. Print a copy of the completed PDF form and fax
to (410) 859-1510. Users of Adobe Reader 8 and above should be able to save the PDF form locally,
however it is recommended to print a copy of the form before closing the file. If you are able to save
the form, please submit it via email, rather than fax, to kmcginnis@acha.org.
Last Name* _________________________________________ First Name* _________________________________________
Degree(s) _____________________________________
Title ____________________________________________________
Address* ________________________________________________________________________________________________
________________________________________________________________________________________________________
City* ____________________________________________________ State* _________ Zip Code* ____________________
Telephone Number _________________________________
Email Address* _______________________________________
Type of credit requested:* (required)
◦ CME for physicians
◦ CME for non-physicians
◦ CNE for nurses
◦ NBCC for national certified counselors
◦ PsyCE for psychologists
◦ CHES for Certified Health Education Specialists
If requesting CHES for Certified Health Education Specialists or
MCHES for Master Certified Health Education Specialists,
please enter ID#* __________________________________
Post-test
1. Erectile dysfunction is the most common sexual dysfunction seen in men.
◦ True
◦ False
2. There are no FDA approved prescription treatment options for premature ejaculation.
◦ True
◦ False
3. The physical examination is the most helpful aspect in diagnosing premature ejaculation.
◦ True
◦ False
4. Paroxetine, clomipramine, and sudenafil have all been used to treat premature ejaculation in
select cases.
◦ True
◦ False

ACHA Online CE Post-test and Evaluation | Sexual Dysfunction in Male College Students | page 2 of 4
5. A psychological assessment is important for most patients with sexual dysfunction.
◦ True
◦ False
6. Unlike premature ejaculation, erectile dysfunction prevalence rates increase with age.
◦ True
◦ False
7. Surgical options should be the first therapies considered in treating erectile dysfunction.
◦ True
◦ False
8. All of the Phosphodiesterase Type 5 Inhibitors have equivalent efficacies in treating erectile
dysfunction.
◦ True
◦ False
9. By using Phosphodiesterase Type 5 Inhibitors, 95% of men with erectile dysfunction will regain
normal erectile function.
◦ True
◦ False
10. There are more than 300 different medications that have been associated with erectile
dysfunction, so a medication history is important when evaluating men with this disorder.
◦ True
◦ False

ACHA Online CE Post-test and Evaluation | Sexual Dysfunction in Male College Students | page 3 of 4
11. Please evaluate this online CE activity.
Strongly
agree
Overall Evaluation
Agree No opinion Disagree Strongly
disagree
Overall, I would rate this
◦ ◦ ◦ ◦ ◦
activity positively
The activity effectively
◦ ◦ ◦ ◦ ◦
targeted my needs
The activity was
appropriate for my
knowledge/skill level.
The format (e.g., lecture,
discussion) of the
activity was effective.
The presenter(s)
delivered the
information in an
effective manner.
The presenter(s)
appropriately addressed
issues of diversity.
◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦
The activity met my
◦ ◦ ◦ ◦ ◦
expectations.
Learning this content
will positively impact
how I deliver care.
◦ ◦ ◦ ◦ ◦
I would recommend this
◦ ◦ ◦ ◦ ◦
activity to a colleague.

ACHA Online CE Post-test and Evaluation | Sexual Dysfunction in Male College Students | page 4 of 4
12. The program met the learning objectives for the following:
Strongly
agree
Agree No opinion Disagree Strongly
disagree
Describe the relevant
parts of the history and
physical examination in
a male with sexual
dysfunction.
Compare the available
medications used in the
treatment of erectile
dysfunction in terms of
selection.
Discuss various
psychological
interventions useful in
treating males with
sexual dysfunction.
◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦
◦ ◦ ◦ ◦ ◦
13. Will you change how you practice as a result of this activity?
◦ Yes
◦ No
14. If yes, how?
15. Did you perceive commercial bias during this activity?
◦ Yes
◦ No
16. If yes, please specify:
17. How could this activity be improved?
To submit:
1) Print completed form and fax to (410) 859-1510
OR
2) Save form (need Adobe Reader 8 or above) and email to kmcginnis@acha.org
Please remember to print a copy of the completed form for your records.