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Unsuccessful: trainee showed no evidence of the skill (Kansas Judicial Branch)

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Mentee & Mediator Information
Mentor Mediator
Name
Mentee Mediator
Name
Mediation File No.
Date of
Mediation
Type of Mediation
Core
Parent-Adolescent
General Civil
Juvenile Dependency
Co-Mediation (actual case)
Role-play Simulation
Demonstration of Mediation Skills, Knowledge, and Understanding
KEY:
• Unsuccessful: trainee showed no evidence of the skill or ability
• Needs Improvement: trainee showed some skill or ability but was not used consistently
• Satisfactory: skill or ability was evident and used consistently and appropriately
• Unable to Determine: mentor doesn’t know, was unable to determine, or the skill or ability was not applicable
Opening Statement
Unsuccessful
Needs
Improvement
Satisfactory
Unable to Determine or
Not Applicable
Welcome/Introductions
Described the mediation process
Described mediator role
Described participant role
Explained confidentiality & limits
Set ground rules
Encouraged Legal advice/review
Explained Caucus
Explained rules re: Notes and
recording
Described Agreement writing
Invited Questions
Comments:
Mediation Skills
Unsuccessful
Needs
Improvement
Satisfactory
Unable to Determine or
Not Applicable
Built rapport with the parties
Helped parties identify issues
Developed an agenda
Attempted to help parties understand
each other's positions and interests
Used specific active listening
techniques during the mediation
Focused on concerns of parties
Maintained confidentiality of caucus
& individual meetings
Raised & helped parties evaluate
potential settlement options
Avoided taking sides
Kept the mediation focused on the
issues
Helped parties express and manage
strong emotions
Attempted to develop trust between
the parties
Mediation Skills (cont.)
Unsuccessful
Needs
Improvement
Satisfactory
Unable to Determine or
Not Applicable
Balanced power as needed so
parties could negotiate as equals
Assisted the parties to feel safe
during the mediation
Worked to help parties reach a clear
& fair agreement
Wrote a comprehensive, well-
organized & clear summary of the
parties’ agreement
Comments:
Co-Mediation (skip for role-
plays or simulations)
Unsuccessful
Needs
Improvement
Satisfactory
Unable to Determine or
Not Applicable
Checked-in with mentor mediator
throughout the mediation
Worked on building a rapport with
mentor mediator
Demonstrated efforts to collaborate
Open to sharing notes and
paperwork
Comments:
Overall Comments
What strengths does this trainee bring to the mediation process?
What challenges does this trainee face in the mediation process?
Verification
I recommend this candidate be approved as a mediator.
YES
NO
IF CANDIDATE IS NOT BEING RECOMMENDED FOR APPROVAL: The following steps are recommended for the
candidate to increase skills or knowledge (e.g. additional training, skill development, additional co-mediations or simulations,
coaching, attend to specific problem areas):
Mentor Mediator
(print)
Date
(sign)
Mentee
(print)
Date
(sign)
Download
Save PDF to desktop
Email
Email completed PDF
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Email for others to sign
Print
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Unsuccessful: trainee showed no evidence of the skill (Kansas Judicial Branch)

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Completed 20 March 2021

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