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Continuing Mediator Education Report Form. This is a North Carolina form and can be use in Dispute Resolution Commission (DRC) Statewide.
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Continuing Mediator Education Report Form
The Dispute Resolution Commission encourages all certified superior court and family financial mediators to complete at least three
hours of continuing education every year. This policy is intended to encourage mediators to reflect on the mediation process and to
improve their skills. Mediators will be "on their honor," i.e., the Commission will not seek to verify information reported. The Commission
will, however, contact those who do not report. Please report hours accumulated in the appropriate categories below.
1. Course Work or Independent Study. The mediator has completed course work or engaged in independent study to improve
his/her communication, negotiation, facilitation, or mediation skills. The Commission offers the following suggestions for courses
or self-study; 1) attendance at NCBA or State Bar programs or workshops focused on the development of skills germane to
mediation, such at the NCBA Dispute Resolution Section's Annual Meeting; 2) training or workshops on active listening; 3) training
in large meeting facilitation; 4) workshops in Neuro Linguistic Programming; 5) advanced mediator training; 6) Parent
Effectiveness Training; 7) reading articles in periodicals such as Conflict Resolution Quarterly, the Journal of Dispute Resolution
(University of Missouri-Columbia School of Law), the Ohio Journal of Dispute Resolution (Ohio State University College of Law),
Negotiation Journal, or other dispute resolution publications; 8) viewing mediation training tapes obtained through national
trainers, and 9) diversity training. (CLE courses designed only to update the attendee in a specific area of the law will not be
accepted.)
Courses attended, titles of articles read, or description of other education activities undertaken:
Dates courses attended, articles read, or other activities undertaken:
Total hours spent in training, independent study, or other educational activity:
2. Observations or Peer-Sharing. The mediator has completed observations of mediated settlement conferences conducted by a
certified mediator. Observations should be of cases filed in the NC Superior or District Courts, NC Industrial Commission, NC
Office of Administrative Hearings, or US District Courts for NC. Conferences must be observed through settlement or impasse.
Observations should be meaningful learning experiences and cases that settle or impasse almost immediately should not be
reported. Mediators observed should be experienced individuals. Mediators may also submit role-plays conducted and critiqued as
part of a peer-sharing exercise.
File numbers of cases observed:
Mediators observed:
Dates of observation or peer-sharing exercises:
Total hours spent observing or role-playing:
3. Serving as a Mentor. The mediator has served as a mentor, i.e., permitted a less experienced mediator to observe him/her, and
de-briefed the less experienced mediator post-mediation. A mediator may mentor one or more individuals for purposes of this rule.
Names of mediators mentored:
Dates during which mentoring occurred:
Total hours spent serving as a mentor:
* This form is available in fillable format on the Commission's website at www.nccourts.org. Click on "Continuing Education for Mediators," then click on
"Reporting Forms." The applicant may not submit for credit in any of the categories above training or other activities completed more than a year ago.
Also, an applicant may not submit an activity for credit in more than one category, e.g., an applicant may not count an observation submitted under
subsection (2) for credit under subsection (4). Training, observations, or other activities completed for the purposes of the applicant's original
certification to conduct mediated settlement conferences in either superior or district court may not be applied toward continuing mediator education
credits. (Dually certified mediators need to complete only three hours.)
AOC-DRC-06, Rev. 3/11
© 2011 Administrative Office of the Courts
(Over)
American LegalNet, Inc.
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4. Being Mentored. The mediator has been mentored by a more experienced mediator, including having his/her performance
critiqued, observing the more experienced mediator, and/or contacting the more experienced mediator for advice or feedback. It is
expected that there will have been significant give and take between the mediator and his/her mentors.
Names of experienced mediators who mentored you:
Dates during which you were mentored:
Total hours you were mentored:
5. Serving as a Trainer. The mediator has served as a principal trainer or presenter in workshops, seminars, or training courses
covering topics germane to the development of mediator skills.
Titles of training courses in which you served as a principal trainer or presenter:
Dates and locations of training:
Total hours spent serving as a trainer:
Name of Mediator Completing Report Form:
(please print or type)
Address of Mediator
(street address or post office box)
(city)
Telephone No.
(
(state)
(zip code)
)
Date Report Completed:
AOC-DRC-06, Side Two, Rev. 3/11
© 2011 Administrative Office of the Courts
American LegalNet, Inc.
www.FormsWorkFlow.com