Faculty Mentoring Guide

Appendix A: Assessment Forms

Suggested Assessment Form for Mentors*

(Complete after first year of mentoring relationship.)

Circle the response that best suits your feeling toward the question. The key is as follows:

1 Strongly agree     2 Agree     3 Neutral     4 Disagree     5 Strongly Disagree

  • I think mentoring is a good idea.
    1     2     3     4     5

  • I believe that my mentee has benefited from the relationship.
    1     2     3     4     5

  • I have personally benefited from the relationship.
    1     2     3     4     5

  • My mentee and I have similar values.
    1     2     3     4     5

  • My mentee respects me as a person.
    1     2     3     4     5

  • The relationship requires too much of my time.
    1     2     3     4     5

  • I have the support of my department/division chair for my mentoring activities.
    1     2     3     4     5

  • I have referred my mentee to other faculty for help in a specific area.
    1     2     3     4     5

  • My mentee doesn't really need a mentor.
    1     2     3     4     5

The best thing about mentoring is:




I would suggest the following changes/modifications:




* All Assessment Forms in this appendix are adapted from University of Arkansas for the Medical Sciences The Mentor's Mentor: The Mentoring Handbook, a Guide to Mentoring.10



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Virginia Commonwealth University | School of Medicine | Faculty Mentoring Guide
carol.hamptonl@vcu.edu | Updated 03.05.02