AIHC Mentoring Program - Mentor Application

Apply to become an AIHC Mentor!

The American Interprofessional Health Collaborative and the National Center for Interprofessional Practice and Education invite applicants who are willing to serve as AIHC Mentors. Details about the program, criteria for applicants, and requirements for participants selected can be found here.

Your email address

Are you a current AIHC member? You must be a current AIHC member in order to apply.

Yes

Name:

First

Last

Degrees and credentials listed after your name (e.g. MD, RN, MPH, etc.):

Current institution of employment:

City and State (e.g. Los Angeles, California):

Time Zone:

Eastern

Central

Mountain

Pacific

Other…

Professional Affiliation (e.g. Dentistry, Health Administration, Occupational Therapy, etc.)

In what areas of interprofessional practice and education do you feel you could provide support as a mentor? (select all that apply)

Building an IPE program

Leading an IPE center

Curriculum development

Clinical team development

Learner assessment

Program evaluation

Research/scholarship

Other…

Describe your reasons for applying to be a mentor? (~200 words)

Mentors must have experience with interprofessional practice, education, or scholarship. How does your experience meet the criteria?

Examples might include designing and teaching interprofessional coursework, developing interprofessional programs and/or centers, going through promotion and tenure review with an interprofessional component or guiding others through the process, mentoring faculty in clinical and tenure track positions, evaluating interprofessional programs, leading and/or serving as a member of an interprofessional grant team, or any combination of these.

What do you see as the most pressing needs in interprofessional practice and education?

Briefly state your primary goals if you are chosen to participate. (~200 words)

Are you able to commit to the responsibilities below if selected?

Mentors must have time and willingness to commit as a volunteer to the mentor role and complete all learning activities with the mentee (approximately 2-3 hours per month); and be willing to counsel and guide the mentee on interprofessional career development, which may include providing resources, assisting mentees to network with the IPE community, and to solicit feedback about the effectiveness of the mentorship.

Yes

Would you be willing to consider mentoring more than one individual if there is a need?

Yes

Please upload your CV or resume.

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