CCPMN Mentee Evaluation Form for Mentees



C C P M NCommissioned Corps Pharmacy Mentoring NetworkCCPMN Evaluation Form for MenteesIn an effort to evaluate the effectiveness of the Commissioned Corps Pharmacy Mentoring Network, please complete and return this evaluation form 6 months after the start of your mentoring relationship. Your comments and suggestions will be carefully reviewed and considered for incorporation into the mentoring program. Thank you for your input and support.1.Have you had contact with your mentor?______16202533309Yes(Go to Question 2a) No(Go to Question 2b)2a. Who made the first contact?______162025310344Mentor Mentee16202531455992b. Why have you not had contact with your mentor?___I’m waiting for my mentor to contact me.______I’ve tried to initiate contact, but my mentor has not responded. Other, specify (Go to question #5)On the average, how often do you interact with your mentor?____________3 or more times per month Once or twice per month Once or twice per quarter Initial contact onlyOn which of the following topics have you received information from your mentor? (Check all that apply)______Mission Statement and How Implemented Names and Ranks of Corps Leadership______Name and Rank of CPO for Pharmacist Category Uniforms___Resources such as: Organizational Offices of the CC and their roles, RedDOG, PharmPAC, TRICARE, Benefits, eDOC-U, eCORPS___Career Development topics such as: Readiness Standards, Benchmarks, COERs, CVs, Promotions, Billets, Training, Awards, eOPF______162025312554Advocacy and Pharmacy Associations (COA, MOAA, APhA, ASHP) Other, please specify For each of the following, please indicate how important you consider similarity in these characteristics to be for a successful mentor/mentee match (Circle the appropriate choice: V = very important; S = somewhat important; N = not important)VSNAgencyVSNGeographic Location VSNGenderVSNCareer TrackVSNOther, specify ___1614717186292Did the mentoring relationship meet your expectations? Yes___NoPlease describe how or why not?List 3 things you learned as a direct result of being in this mentoring relationship.List 3 things you liked about your mentor.What was least satisfying about the mentoring relationship?Was an initial six month mentor/mentee match with the option of renewing the mentoring contract satisfactory?______16147175180Yes NoYour Name (for tracking purposes only) Other comments and or suggestions:Note: All comments and suggestions made on this form will be kept confidential. All information collected will be used to identify problems and develop ways to improve the program.Please email this form to:LCDR Julie Neshiewat, Coordinator CCPMNFood and Drug Administration, Center for Drug Evaluation and Research Office of Generic Drugs10903 New Hampshire Ave. WO 75, Room 3640Silver Spring, MD 20993Email: Julie.Neshiewat@fda.Thank you for participating!Revised 5/2019 ................
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