ReMend Mentor Training Questionnaire

Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Birth

MM

DD

YYYY

1. Your role as a peer mentor is to?

a. Only talk about yourself.

b. Encourage your peer to be engaged and active in his or her care decisions.

c. Tell your peer which decision they should make based on your experience.

d. Go to their doctor's appointments with them.

2. What is Active Listening?

a. Truly being present and engaged while someone is talking to you.

b. Interjecting and sharing your experience.

c. Talking while walking.

e. None of the above

3. What is Passive Listening?

a. Listening while researching resources.

b. Not providing any response.

c. Letting the other person know you're listening without saying much, nodding your head and/or saying "really" or "that is interesting".

d. Not really paying attention to what's being said.

4. Mentors should encourage Mentees to find new providers.

a. Yes

b. No

5. If the new mentee asks for medical advice, you should...

a. Find the answer on Google or YouTube.

b. Respond to the best of your knowledge.

c. Refer the patient to the healthcare team for answers to medical questions.

d. Admonish the patient not to ask medical questions.

6. It is the mentor's role to help the new patient to understand that...

a. The physician has the final say on all medical questions.

b. The patient doesn't need to do anything him/herself regarding treatment since it is all in the hands of the facility staff.

c. She/he is the most important member of the healthcare team and that a good knoledge of one's condition and options will be helpful.

d. Both A and B

7. Information that is shared by the new patient needs to be...

a. Reported to the social worker in detail.

b. Shared only with persons in the dialysis facility.

c. Held in confidence, unless it is information that the mentor feels needs to be reported to the social worker.

d. Treated with skepticism since the new patient usually has unrealistic fears.

8. Being an effective Mentor entails:

a. Giving medical advice.

b. Tell the Mentee's physician they aren't pleased with their treatment plan.

c. Never show emotion.

d. None of the above.

9. As a ReMend Mentor, it is important that you...

a. Are an empathetic listener.

b. Remain in control of the situation.

c. Demonstrate that you have an exceptional knowledge of ESRD.

d. All of the above.

10. When speaking with a mentee, it is best to...

a. Try not to share too much information about your experience.

b. Use as much kidney disease "jargon" as possible to familiarize the patient.

c. Never direct the patient back to their physician or social worker.

d. None of those things.