Form Driver Form 6 Driver Form 6 Driver Debriefing Questionnaire

Flexible Sleeper Berth Pilot Program – Debriefing Script Participant ID: _________

OMB NO: XXXX-XXXX

Expiration Date: mm/dd/yyyy

Study Completion Date: ____/____/____

Reason for exiting study (if provided by driver, may not ask them directly):_________________________ _________________________________________________________________________________________

Equipment Returned:

OBMS: __________/__________/__________ Serial Number: ____________________________

Smartphone: __________/__________/__________ Smartphone Number: _______________________

Actigraph: __________/__________/__________ Actigraph Number: _________________________

Pro400 ELD: __________/__________/__________ Serial Number: ____________________________

ELD Tablet: __________/__________/__________ Serial Number: ____________________________

Notes:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Final data download and review prior to debrief: ____/____/____ _____:_____ RA: ___________

Any discrepancies to be discussed with the driver in the debriefing session: _____________________________ ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Debriefing Session Date/Time: ____/____/____ ____:______

Research Assistant (RA):__________

Thank you for your participation in this research study. We appreciate the time and effort you put forth.

As a reminder, your participation in this study was not connected to employment with your company. We have not shared your data with anyone at your company, including your individual PVT data, subjective sleepiness ratings, caffeine consumption, sleep/wake log responses, or actigraphically measured sleep and wake times. While your company and the FMCSA were aware of your participation in the study in order to grant you the necessary exemption, the data we collected from this study will continue to be kept confidential to the extent allowed by law.

I am now going to ask you a few questions about your experience with the study.

Thinking back of the whole study period, what did you think of this study?

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Did you frequently use the flexible sleeper berth option to split your sleep period? _______________________

Why or why not?

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How did you feel on days when you chose to split your sleep? Do you think it had a positive or negative impact on your alertness or performance?

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Have you taken any modules of the North American Fatigue Management Program since the beginning of this study?

____________________________________________________________________________________________________________________________________________________________________________________

Is there anything we haven’t already discussed that you’d like to share about your experiences with the smartphone (including the sleep/wake caffeine log and the PVT testing), with the truck data collection equipment, with the wrist actigraph, or with anything else?

____________________________________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________

Your study participation has officially come to an end. You are no longer allowed to operate under the flexible sleeper berth exemption. You must now resume compliance with the consolidated sleeper berth regulation found in Part 395—Hours of Service of Drivers, as defined by the FMCSA. Do you understand? _________

Notes: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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