Tool Kit Assessment Form
Campus Conflict Resolution and Mediation Programs
Program Evaluation Tool Kit
Assessment Form
We need your help. Your feedback on the usefulness of these evaluation
tools is critical to their success. Please circle the appropriate
response and feel free to provide written comments or suggestions.
Thank you.
There are four Modules in the evaluation kit.
Please answer questions about those modules that you used.
Module I: Needs Assessment
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1. Did you use the Needs Assessment Module?
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1. Yes
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2. No
Go to Q.9
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2. If yes, did this module meet your program evaluation
needs?
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1. Yes
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2. No
Please explain why not on the lines below.
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Please indicate which of the tools within the module you
utilized, and rate its usefulness.
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Have you ever used?
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If yes, how useful?
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Evaluation Tools
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Yes
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No
2
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Very Useful
1
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Useful
2
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Not
Useful
3
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3. Where Would They Go?
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2
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2
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3
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4. Hot Spot Mapping of Conflict
on Your Campus
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2
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3
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5. Conflict Typology Matrix
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2
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1
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2
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3
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6. Stakeholder Analysis Chart
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2
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1
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2
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3
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7. Conflict Management Inventory
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2
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8. Comments/suggestions:
Module II: Process Monitoring-Evaluating
Program Implementation
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9. Did you use the Process Monitoring Module?
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1. Yes
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2. No
Go to Q.15
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10. If yes, did this module meet your program evaluation
needs?
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1. Yes
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2. No
Please explain why not on the lines below.
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Please indicate which of the tools within
the module you utilized, and rate its usefulness.
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Have you ever used?
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If yes, how useful?
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Yes
1
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No
2
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Very Useful
1
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Useful
2
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Not
Useful
3
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11. Review Standard Operating
Procedures
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2
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3
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12. Design New Policies and
Procedures
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3
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13. Structures of Responsibility
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1
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14. Comments/suggestions:
Module III: Summative Evaluation-Assessing
Outcomes and Impact
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15. Did you use the Summative Evaluation Module?
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1. Yes
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2. No
Go to Q. 21
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16. If yes, did this module meet your program evaluation
needs?
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1. Yes
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2. No
Please explain why not on the lines below.
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Please indicate which of the tools within
the module you utilized, and rate its usefulness.
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Have you ever used?
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If yes, how useful?
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Yes
1
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No
2
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NA
3
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Very Useful
1
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Useful
2
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Not
Useful
3
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17. Case Characteristics
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3
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3
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18. Participant Characteristics
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3
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3
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19. Does Mediation Work?
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2
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3
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1
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2
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3
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20. Comments/suggestions:
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Module IV: Evaluation
of Mediation Training
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21. Did you use the Evaluation of Mediation Training
Module?
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1. Yes
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2. No
Go to Q. 28
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22. If yes, did this module meet your program evaluation
needs?
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1. Yes
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2. No
Please explain why not on the lines below
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Please indicate which of the tools within
the module you utilized, and rate its usefulness.
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Have you ever used?
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If yes, how useful?
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Yes
1
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No
2
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Very Useful
1
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Useful
2
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Not
Useful
3
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23. Mediation Selection Checklist
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2
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1
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2
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3
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24. Conflict Orientation Survey
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1
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2
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3
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25. Mediation Training Evaluation
Survey
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2
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1
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3
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26. Mid-Training Evaluation
Feedback
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2
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1
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3
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27. Comments/suggestions:
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Overall Assessment
of Program Evaluation Kit
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Strongly Disagree
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Disagree
2
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Neither Agree or
Disagree
3
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Agree
4
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Strongly Agree
5
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28. The information in the program evaluation kit was
presented in a useful format.
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4
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5
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29. The information in the program evaluation kit was
easy to understand.
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5
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30. The methods and tools provided in the kit produced
data that are helpful to the program.
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2
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3
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4
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5
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31. Can you briefly describe any modifications/personalization
you did to any of the evaluation kit
tools (and provide examples).
32. Do you have any final comments
or suggestions for improving the Program Evaluation Tools Kit?
Institutional & Program Demographics
(Please circle the information that applies to your program)
33. Type of institution:
1. Public 2. Private
34. Student Enrollment:
- Less than 1000 students
- 1,001-5,000
- 5,001-10,000
- 10,001-15,000
- 15,001-20,000
- More than 20,000
35. Type of CR program (circle
all that apply):
- Campus-wide Mediation Service (serving all populations)
- Student Mediation Service
- Faculty Mediation Service
- Staff Mediation Service
- Ombuds
- Other:
Thank you so much for
taking the time to help us improve this tool!
Please return completed
survey to:
Campus Conflict Resolution Resources Evaluation
attn: Bill Warters
Wayne State University, CULMA
656 W. Kirby
Detroit, MI 48202
Fax: 313 577-8800
Email: staff@campus-adr.org
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