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  5. HOM 504 Hospital Mentor Program Evaluation Survey
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This evaluation survey is a tool intended to define important issues regarding the Hospital Mentoring Program and suggest areas to improve.  You are invited to participate in the survey.  In this survey, you will be asked to complete the Mentor/Mentee survey that asks questions about the Hospital Mentor Program.  It will take approximately 10-15 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project.  However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important that you take the time to complete all sections of the survey.

Your survey responses will be strictly confidential. The overall results will be reviewed by the Hospital Mentor Program Committee and used to make modifications to the program as necessary. If you have questions at any time about the survey or the procedures, you may contact the Hospital Mentor Program Committee chairman at 712-396-4242 or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
I. Compatibility

How compatible was your mentor/mentee in the following areas:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
General Knowledge
Schedule/Availability
Personality/Style
Support of Personal Life/Balance
 
 
 
What characteristics of the mentor/mentee pairing do you believe to be most important? Why?
   
 
 
 
Have there been any difficulties/issues? If so, do you have any suggestions for improvement in this area?
   
 
 
 
II. Meeting Time - How often were you able to meet?
   
 
 
 
Was this frequently enough to be valuable to both you and your mentor/mentee? If no, what was the barrier?
   
 
 
 
When were you able to confer?  Check all that apply:
 
Before Work
 
During Work Time
 
After Work
 
Lunch
 
E-mails
 
Other
 
 
 
 
IV. Impact - What impact has the Hospital Mentor Program had on you?
   
 
 
 
Please describe some specific ways in which the mentor/mentee assisted you.
   
 
 
 
What impact do you believe the Hospital Mentor Program has had on your mentor/mentee?
   
 
January 31, 2015
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