Information about yourself
Age? Gender? Teaching Certification?
What degrees do you hold?
How long have you been teaching?
Describe the grade levels and populations you have worked with.
Information about the student (Obtain during first meeting)
Age? Physical Appearance? Medications? Dose/how often? Side effects? Hobbies? Music? Exercise? Relaxation? Sleep pattern? Did the student play sports in high school or college? Describe. Does the student belong to any clubs? Which ones? Self-advocacy skills? Current GPA. Summarize information from Qualtrics pre-intervention survey.
What courses is the student enrolled in? Course related strengths? Course related challenges? Grades thus far? Exam dates?
Social skills? Friends? Parent/family influence? Peer mentors? Career mentors? Helpful Technologies?
Goals for Coaching Experience:
Learning styles inventory results
SuccessNavigator Pre & Post (when available)
(1 – 3 range with 1=low, 2=moderate, 3=high)
Meeting Class Expectations
Commitment to College Goals
Sensitivity to Stress
Barriers to Success
What the scores means –
Describe the coaching strategies you are using (e.g., non directive questioning, positive self talk)
Describe learning strategies you introduced and the student is using
How are they working?
Evidence (i.e., test scores)
How has the online platform worked for you and your student?
How often did you actually meet?
What was the total time you met with the student in minutes?
Reference: Peer Mentor Evaluation Form
Holland, J. M., Major, D. A., & Orvis, K. A. (2012). Understanding how peer mentoring and capitalization link STEM students to their majors. The Career Development Quarterly, 60(4), 343-354.
Landgraf, L. M., Salmon-Stephens, T., & Ul-Haq, I. (n.d.). An ABC Sampler of Best Practices NSF STEM Scholar Program at UW-Platteville. Retrieved from http://rube.asq.org/edu/2012/06/best-practices/an-abc-sampler-of-best-practices.pdf