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Ad d -‐ O n & D u a l L i c e n s u r e P r a c t i c um H a n d b o o k Simmons College Department of Education
Initial License Practicum Handbook Dual Licensure Program
Director of Clinical Programs: Helen Guttentag 2015 – 2016
Simmons College
300 The Fenway, C316 Boston, MA 02115
617-‐521-‐2553
All of the Candidate Assessment of Performance (CAP) forms are posted on the following link:
http://internal.simmons.edu/students/ssw/for-‐education-‐students/forms-‐and-‐resources
revised 10/20/15
Contact Information
Jane Hardin: Coordinator of the SPED Add On Program 617-‐521-‐2556 [email protected] Helen Guttentag: Coordinator of the Dual Licensure Program 617-‐521-‐2553 [email protected]
Table of Contents
Dual License General Description 3
MTEL Information 3
Endorsement Procedure 3
Site Approval 3
Seminars 3
SPED Add On Practicum Requirements 4
Sources of Evidence 5
Positive Behavior Plan Format 6
Guidelines for Reflection on IEP Meetings 7
Guidelines for Evaluating the Practicum 8
Documentation of 100 Hours of Full Responsibility 12
Documentation of Engagement with English Language Learners 13
Lesson Plan Format and Template 14
Media Consent Form 17
Video/Audio Recording Form 18
Suggestions for SPED Portfolio 19
Practicum Confirmation Form 20
Announced , Unannounced, and Extra Observation Forms 21
Candidate Assessment of Performance (CAP) 26
Three-‐Way Meeting Checklist 34
Pre-‐Observation Conference Form 36
Post-‐Observation Conference Form 37
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Student Forms:
-‐ Self Assessment 39
-‐ Self Reflection 43
-‐ Preliminary Goal Setting 44
-‐ Goals and Implementation Plan 45
-‐ Model Student Feedback Surveys 46
All of the Candidate Assessment of Performance (CAP) forms are posted on the following link:
http://internal.simmons.edu/students/ssw/for-‐education-‐students/forms-‐and-‐resources
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THE DUAL LICENSURE MAT PROGRAM Simmons College has developed a graduate program leading to the Master of Arts in Teaching degree, which prepares candidates for the general education and the special education license. Candidates can prepare for the Elementary license and the Moderate Special Needs PreK-‐8 license, or a secondary license and the Moderate Special Needs 5-‐12 license. This is a 46-‐50 credit program consisting of course work in general and special education and a year long classroom internship.* The first half of the internship fulfills the requirements for the general education practicum and the second half of the internship fulfills the requirements for the special education practicum. Interns remain in the same classroom for the full year, and the classroom must have two or more learners who have been identified as having special needs. Candidates who complete this program will be eligible for a general classroom teaching position or a position as a special education teacher. Teachers with dual licensure are highly sought after by public schools and will be strong competitors for teaching positions in the growing number of inclusive classrooms. *Simmons Dunn Scholars may be able to complete this program with reduced credits at the graduate level, depending on their undergraduate programs. Massachusetts Tests for Educator Licensure (MTELs) Elementary and SPED Pre-‐K students take the same MTELs: -‐Communication and Literacy -‐General Curriculum -‐Math Subtest -‐Multi-‐Subject Subtest -‐Foundations of Reading Secondary students take the following MTELs: -‐Communication and Literacy -‐Subject Matter test in their fields -‐Foundations of Reading Endorsement Procedure Upon completion of the program Simmons will endorse the candidate for the general license in the candidate’s field and level. The candidate will then apply on his/her own to add on the Moderate Special Needs license. Site Approval The intension is for the candidate to remain in the same classroom for both practicums. Thus, it is important to confirm ahead of time that the placement will provide the opportunity to fulfill the requirements for both practicums. This requires the school administrator to complete the Practicum Confirmation Form in order to insure that the candidate will have sufficient access to learners with special needs. (See the Simmons Confirmation Form on page 20) Seminars In the fall candidates will attend seminars with general education students at the level of the license sought. In the spring candidates will attend seminars with dual licensure students.
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SPED ADD ON PRACTICUM REQUIREMENTS The SPED Add On Practicum was originally designed for fully licensed teachers working full time in their own classrooms and using their classrooms to fulfill the requirements for the special education practicum. It is thus assumed that candidates in the special education practicum will be doing an appropriate amount of general classroom teaching while also implementing the special education practicum competencies. The degree and amount of teaching should be determined on an individual basis by the school supervising practitioner, the Simmons supervisor, and the candidate. The following are the specific requirements for the special education practicum:
1. Work closely with classroom teacher and serve all children. 2. Continue to send weekly journals to supervisors 3. Develop and teach a minimum of six lessons.
a. Use lesson plan format in Handbook (page 14) and on line. b. Submit copies to Supervisor.
4. Attend at least one IEP meeting and write a reflection on the meeting (Handbook page 7). a. If appropriate the intern may participate in the IEP process. b. This can be done in the fall during the elementary practicum if the opportunity arises.
5. For the seminar interns write a Philosophy of Education. This goes to the seminar leader (Guidelines given in seminar).
6. The Portfolio from the fall is expanded to include the SPED practicum experience. 7. Documentation of the following: (All forms are in the Handbook and on line.)
a. 100 hours of full responsibility. Instruction must include learners with special needs. (page 12) b. Log of Engagement with ELL students (page 13)
8. Interns need to obtain a copy of the license of their supervising practitioner and give it to their supervisor. If the supervising practitioner does not also hold a moderate special needs license, the Simmons supervisor needs to be informed. A statement from the appropriate school administrator is then needed, confirming that the teacher has the appropriate skills and experience to fulfill this role. This statement along with a copy of the teacher’s resume must also be submitted to Helen Guttentag so that a waiver can be completed.
9. Make a videotape or audiotape of one lesson. a. This should have a complete lesson plan b. Student must obtain consent form (Handbook page 17) c. The student views the tape and submits a reflection and critique to the supervisor Handbook
(page 18). d. If the supervising practitioner has not actually observed the lesson, he/she should view the
tape and discuss with the intern. 10. One Positive Behavior Plan
a. If the fall plan was in an academic area, the spring plan must be in a behavioral area. b. If the fall plan was in a behavioral area, the spring plan must be in an academic area.
11. The CAP Form must be completed 12. Three 3-‐Way Meetings must be held.
a. Attended by the supervising practitioner, the college supervisor, and the teaching candidate b. Students should take notes during each three-‐way.
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Materials that go to Supervisor 1. The audio/visual summary 2. Lesson Plans 3. Documentation of 100 Hours of Full Responsibility 4. Documentation of hours of Engaging with ELL students 5. The CAP Form 6. Additional Forms
a. Self Assessment Form (at the start of the practicum) b. Self Reflection Form (after each observed lesson) c. Preliminary Goal Setting (toward the end of the practicum) d. Goals and Implementation Plan (at the end of the practicum)
Supervisors submit the above forms to the SPED seminar leader at the end of the semester along with their Observation Forms. Supervisors make three announced observations during the semester. Responsibilities of Supervising Practitioner
1. Minimum of two formal announced observations with written feedback and two formal unannounced observations with written feedback (Handbook page 21.)
2. Provide copy of license number to Simmons College Supervisor 3. Provide required experiences (IEPs; student assessments; progress reports; inclusion
experiences) 4. Weekly oral feedback and consultation and frequent planning sessions 5. Complete the CAP Form
a. Formative Evaluation at the halfway point. b. Summative Evaluation at the conclusion of the practicum.
6. Participate in three 3-‐Way meetings with the college supervisor and the teacher candidate. 7. Prior to each announced observation hold a pre-‐observation conference with the teacher
candidate (handbook page 36) 8. After each formal announced and unannounced observation hold a post observation conference
with the teacher candidate (handbook page 37) Four Sources of Evidence for the CAP
1. Observations by the supervising practitioner and college supervisor (written notes during observations)
2. Impact/Measure of Student Learning (Contained in Evaluation section of every lesson plan) 3. Student Feedback Surveys
a. Administered half-‐way through the practicum b. Geared to different levels (PrK-‐2; 3-‐5; 6-‐12)
4. Artifacts a. Lesson Plans b. Curriculum Units c. Curriculum Materials d. Sample Student Work e. Rubrics f. Quizzes/Tests g. Video/Audio Recordings h. Behavior Plans and Behavior Data
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Positive Behavior Plan
1. Learner Description:
a. First name and age b. Grade c. Previous special services and/or grade repetitions if any
2. Educational Setting:
a. Classroom size and population b. Classroom structure/organization
3. Target: Specific Observable Behavior
4. Entry Level or Baseline Data:
a. Procedure used in obtaining baseline/ entry level b. Current level of skill or behavior
5. Goals:
a. Social 1) Reasonable reduction of non productive behavior 2) Replacement with positive alternative
b. Academic 1) Realistic goals for development of skills 2) Sequence of skills paired with time of attainment
6. Development of Plan:
a. Consider causes of behavior or academic challenge b. Identify on how to build on student’s strengths c. Consider use of effective reinforcers and eventual thinning of reinforcers d. Specific teaching steps
7. System of Measuring and Recording Progress:
a. Daily data b. Graphs of data (optional) c. Consider self monitoring and recording of data
8. Results:
a. Number of sessions and length of program (beginning and ending dates) b. Goals mastered c. Data that demonstrates progress
9. Discussion:
a. Evaluation of student’s progress and effectiveness of program b. Recommendations
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GUIDELINES FOR REFLECTION ON IEP MEETING
1. Who attended the meeting (roles, not names)?
2. Did the meeting flow smoothly or were there points of contention?
3. From your observation, did the team reach agreement?
4. How did the team leader wrap up the meeting?
5. Any other comments or impressions.
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Guidelines for Evaluating the Practicum Practicum Rubric (adapted from: www.hopton.ca/Practicum%20Rubric_ED2_2006.pdf)
Responsibility Does not meet the Standard
At Risk Meets the Standard
Exceeds the Standard
Lesson Planning Incomplete/Disorganized, Plans are uninspired, Provides little variety in teaching/learning strategies selected
Incomplete, expectations unclear, Plans reflect little originality or creativity
Complete and Organized, Includes some original elements in plans, Varies strategies in most lessons
Plans are logically organized, identifies imaginative and creative teaching approaches
Learning Materials Materials are disorganized and not readily accessible to students, Fails to locate relevant learning resources
Materials are somewhat organized, Has difficulty choosing relevant learning resources
Chooses age appropriate & relevant resources, Materials reflect attention to students’ interests and differences
Chooses a variety of innovative resources, materials are organized to promote students’ responsibility
Implementing Lesson Fails to use effective introductions to lessons, Students remain passive and uninvolved, Lessons drag
Designs weak introductions, Students moderately involved, Pacing is too fast or too slow
Uses a limited range of strategies to engage learners, Promotes good student involvement, Pacing and timing are acceptable
Introduces lessons using a range of strategies that meet student needs, Lesson ends with opportunity to extend learning, Uses initiative to adjust pacing and time appropriately
Teaching Strategies Fails to differentiate instruction
Beginning to use instructional time purposefully, Learning to differentiate instruction
Uses instructional time purposefully most of the time, Differentiates instruction to meet students’ needs
Strategies promote student ownership of learning, Differentiates instruction to meet all student’s needs
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Responsibility Does not meet the Standard
At Risk Meets the Standard
Exceeds the Standard
Student Interactions/Development
Demonstrates difficulty in maintaining positive interactions with students, Demonstrates limited rapport with students
Beginning to maintain positive interactions with students, Demonstrates effective rapport with students
Maintains positive interactions with students most of the time, Demonstrates effective rapport with students most of the time
Maintains positive interactions with students consistently, Demonstrates effective rapport with students in a variety of settings consistently
Oral Communication Communicates with inappropriate level of vocabulary, Speech is very hesitant or rapid; monotonous or harsh, Directions are unclear and inaccurate
Demonstrates some difficulty in communication with errors in form and structure, Speech is often too hesitant or rapid, Directions are occasionally clear
Communicates well with adequate levels of vocabulary, Speech is pleasant and natural, Directions are clear and accurate
Communicates effectively, Uses animated voice that is well-‐modulated and projects well, Directions are consistently clear and accurate
Classroom Management Fails to maintain routines, Students off-‐task, Demonstrates difficulty in setting behavior standards, Fails to involve students in learning, Demonstrates inability to anticipate problems
Maintains somewhat negative tones in classroom, Some students are on task, Sets inconsistent behavior standards, Anticipate some problems
Maintains positive tone in classroom, Most students are on task, Maintains consistent behavior standards, Anticipates problems and plans to avoid situations
Maintains high class morale with clearly defined roles, All students are on task and focused, Uses appropriate consequences for behavior consistently, Acts proactively to manage behavior and anticipate problems.
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Responsibility Does not meet the Standard
At Risk Meets the Standard
Exceeds the Standard
Student Learning Demonstrates difficulty addressing student needs, Fails to encourage student participation
Beginning to consider student needs, Provides limited student participation
Considers student needs most of the time, Provides for regular student participation
Considers student needs consistently, Provides for consistent meaningful student participation
Quantifiable Assessment Demonstrates problems in aligning assessment strategies to expectations, Demonstrates difficulty in identifying appropriate evaluation criteria
Relies on limited range of quantifiable assessment strategies, Learning to identify evaluation criteria
Utilizes comprehensive range of quantifiable assessment strategies, Aligns assessment with expectations
Collects formative, quantifiable assessment data on an ongoing basis, Aligns assessment with expectations consistently
Collaboration, Professionalism
Demonstrates marked difficulty in relating to others, Rarely collaborates, Demonstrates difficulty in meeting deadlines
Demonstrates difficulty in relating to others, Sometimes collaborates with others, Meets most deadlines
Relates to others, Collaborates with others regularly, Meets all deadlines
Relates extremely well to others, Takes initiative to work collaboratively with others, Meets all deadlines confidently
Attendance Has missed an excessive number of practicum days
Attends most practicum days, Inconsistently informs supervisor or SP
Has missed few practicum days Contacts supervisor and SP regarding missed days
Has missed very few practicum days, is consistently punctual, contacts supervisor and SP regarding absences
Personal Qualities Lacks confidence or is overly confident
Sometimes lacks confidence or is overly confident
Acts as a pleasant, dependable and conscientious member of staff most of the time
Consistently demonstrates cooperation, enthusiasm and initiative
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Responsibility Does not meet the Standard
At Risk Meets the Standard
Exceeds the Standard
Continuous Improvement Demonstrates difficulty in indentifying best practice, Demonstrates difficulty in assessing personal progress
Learning to identify best practice with support, Learning to assess personal strengths with support
Identifies best practice independently, Sets personal goals independently
Aligns personal growth goals with knowledge of best practice, Sets and meets personal and professional goals consistently
Reflective Practice Demonstrates difficulty in accepting constructive feedback
Learning to accept constructive feedback
Accepts constructive feedback willingly and implements it most of the time
Uses and implements constructive feedback to improve practice
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DOCUMENTATION OF 100 HOURS OF FULL RESPONSIBILITY Full responsibility is defined in the following way: The intern plans and teaches a lesson taking full responsibility for instruction and classroom
management. The supervising practitioner may be in the room, but does not intervene in the lesson. Lessons may be one-‐on-‐one, small group, or whole class format. Full responsibility extends to supervisory activities as well such as overseeing transitions, recess, or other activities where the intern is fully in charge and responsible for the students, class and instruction.
Time Date Description of Activity
Total Hours Use additional pages as needed. The total number of logged hours must be equal to or exceed the number of hours required for the license sought. Student’s Signature:_________________________________________________________ Date: __________
Supervising Practitioner’s Signature:____________________________________________ Date: __________
Students please keep a copy for your records
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DOCUMENTATION OF ENGAGEMENT WITH ENGLISH LANGUAGE LEARNERS
An English Language Learner (ELL) is a student whose first language in not English. World-‐class Instruction and Design and Assessment (WIDA) defines English language learners as “linguistically and culturally diverse students who have been identified as having levels of English language proficiency that require language support to achieve grade-‐level content in English (http://www.wida.us/standards/eld.aspx). In addition, an ELL can be described as a student whose English language environment needs to be sheltered in order for him/her to be successful academically. Sheltered English Instruction may be defined by information at: http://www.alliance.brown.edu/tdl/tl-strategies/mc-principles.shtml.
Engagement with English Language Learns can be describe as, but not limited to the following activities: Creating instructional materials that support students with diverse cultural and linguistic backgrounds; using appropriately designed visual and contextual aides when communicating with ELLS; using effective strategies and techniques for making content accessible to ELLs; differentiating instruction to accommodate learners who are at various levels of English language proficiency and literacy; collaborating with families to create strategies for supporting student learning both at home and at school.
Interns must document a minimum of 15 hours of engagement with ELLs as part of the pre-‐practicum or practicum experience
Time Date Description of Activity
Total Hours this
Page
Use additional pages as needed. Student’s Signature:_________________________________________________________ Date: __________
Supervising Practitioner’s Signature:____________________________________________ Date: __________
Students please keep a copy for your records
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Simmons College Programs in Special Education
Lesson Plan Format (Moderate, Severe)
Practicum Student: Date: Subject/Skills _____________Grade Level: Number of Learner(s): Time of Lesson (Period)____________________________ Length of Lesson _______________ Curriculum Frameworks (use only Common Core) that would be taught to same age non-‐disabled peers) Grade Level __________: Subject _________________Strand: _______________________________ Standard: ______________________________Page Number___________ Publication Date _______ 1. Purpose/Objective/Function a. Identify the purpose of the lesson b. Identify how this lesson is linked to a sequential unit of study 2. Pre-‐requisite skills/knowledge a. Identify any pre-‐requisite skills or abilities necessary for this lesson b. Identify how formal and informal assessments have informed decisions in determining what and how to teach to
individual students 3. Schedule and Pacing a. Outline and sequence the lesson in the proposed order that it will be taught (an agenda) b. Include the approximate pacing of each step 4. Materials a. List materials used in the lesson 5. IEP Goals/Objectives/Benchmarks -‐ (minimum 2 per lesson plan) a. Record the IEP goals/objectives/benchmarks, verbatim, to be addressed within the lesson b. In addition, rewrite objectives goals/objectives/benchmarks as observable and measureable (when necessary) c. Identify how these IEP objectives or benchmarks inform instruction, selection of materials or selection of
approaches 6. Specially – Designed Instruction a. Identify specially designed instruction (content, methodology, and/or performance criteria) necessary to help
individual students learn the academic content b. Identify any assistive technology that will be used to help individual students learn and access the academic
content c. Identify any behavioral intervention strategies to help individual students learn and access the academic content. 7. Accommodations/Adaptations a. Identify accommodations necessary to help individual students better access the curriculum 8. Possible Problems and Solutions a. Brainstorm possible problems with the lesson/learners b. For each possible problem, write a theoretical solution in advance of the lesson 9. Lesson Closure a. Identify the process and procedure for closure of the lesson 10. Assessment a. Identify assessment tool, process or procedure b. Specify anticipated achievements in qualitative or quantitative terms c. Assessment linked to the purpose of the lesson 11. Extension of the Lesson a. Identify how the lesson will be extended through activities such as: Homework, Assignments, Follow-‐up activities,
Future lesson, etc.
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Lesson: _____________________________________ Date: ___________________ General Goal: Objective/Function:
MA Frameworks/Common Core Standards: Materials (include any assistive technology):
Specially Designed Instruction (taken from the IEP)
Connection (to previous lessons and/or other content areas):
Accommodations and/or Adaptations:
Possible Problems and Solutions (Brainstorm possible problems and write a theoretical solution in advance of the lesson):
Scheduling and Pacing of the Lesson (include an agenda and approximate pacing of each step): Intro- How will you engage the students?
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Scheduling and Pacing of the Lesson (include an agenda and approximate pacing of each step): Lesson Closure-How will you wrap up this lesson?
I.E.P. Goals/Objectives/Benchmarks (minimum of 2 for each lesson) (Include IEP goals as written but when necessary, rewrite the goals/objectives/benchmarks as observable and measureable. The rewritten goals should be in parenthesis.):
Differentiation (think about learners of various levels and ELLs):
Assessment: How is your assessment linked to the purpose of this lesson? Identify assessment tool, process or procedure ( e.g. a quiz, exit ticket, data collection in discrete trial, etc.)
Extension of the Lesson:
Reflection:
Plan for Subsequent Lessons:
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Simmons College Programs in Special Education
Media Consent Form (to be used in the absence of a site-‐based consent form)
I have been informed that sound recordings and/or videotape footage of my child may be used as part of a training module for teachers serving learners with disabilities. I understand that my child’s name will not be used or any other information that may identify my child. I understand that the videotape will be used for instructional purposes only, and the Department and the student will not release the videotape to the public. The tape will be erased by the student at the conclusion of the assignment.
Name of Learner:
Signature of Parent/Guardian: Date:
(Student, if over 18) School Name:
Street Address:
Town: State:_________________ Zip:
School Telephone:
Name of Supervising Practitioner: Signature of Supervising Practitioner: Date:
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Video/Audio Recording Form Attach this form to your typed self-‐reflection document along with the formal lesson plan.
Date of Recording:______________ Topic of Lesson:___________________________ Length of the Recording: ______________________ Examples of concepts to reflect upon for the recording summary:
• Curriculum Frameworks Addressed • How you began the lesson in an engaging manner • An agenda was posted and referred to, and the steps that were to occur in the lesson were explicitly
identified • How male and female students were called upon equally • Strategies that were used to engage reluctant learners • Specialized instruction that was employed to help achieve the goals of the lesson for learners on IEPs • Strategies that were employed to improve behavior of the class. Strategies that were employed to
maintain the flow of instruction • Teaching skills relative to the license sought • What part(s) of the lesson might you do in a different (same) manner? • What do you feel went especially well? On what do you base that? • When you reviewed the recording, what surprised you most about your instruction/teaching style, or
presentation? We verify that all necessary consent was obtained for students prior to the recording of this lesson. ______________________________ ___________________________________ Intern signature Supervising Practitioner signature I have reviewed the recording and offer the following comments, suggestions:
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Suggestions for Your Special Education Portfolio
1. NO IEP’s in the portfolio – no removing names, etc. These documents are VERY confidential. You may however, use a fictitious IEP that you might have written for a previous Simmons class. If this is the case, you MUST add a notation somewhere on the page explaining this.
2. Attendance to an IEP meeting – remember to white out and/or delete student names, date of birth, parents/family names, etc. Black marker does not work.
3. Copy of a page of an assessment, management guidelines, etc. – proof read again that all names have been deleted and/or use white out. Sometimes the name also appears in the footer along with the path on the network—delete this too.
4. Explanatory notes – anywhere that you can explain a document in your portfolio helps the viewer. Each item should have an explanatory note.
Highly Recommended!
Each section of the portfolio must be specifically defined with tabs. Each piece of evidence must be clearly labeled and/or an explanation of what the reader is observing should be included on the page.
1. Table of contents 2. Current Resume 3. Philosophy of Education 4. Letters of Recommendation 5. Licensure: For now, include your MTEL scores to show that you are eligible for licensure. Later, replace
this with a copy of your license. 6. Several samples of your lesson plans. The plans should clearly show how you have modified or adapted
instruction to meet the needs of the learners with special needs. 7. Examples of behavior management strategies you have used or tried. 8. How you developed and implemented classroom rules. 9. Attendance at IEP meetings. 10. Participation in Parent/Teacher conferences.
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SIMMONS COLLEGE PRACTICUM CONFIRMATION FORM DUAL LICENSURE PROGRAM
Dual Licensure Intern: ________________________________________________ Licensure Program: (check one) □ Teacher of Students with Moderate Disabilities, Pre K – 8 □ Teacher of Students with Moderate Disabilities, 5 – 12 Supervising Practitioner: ________________________________________________ The above named student will be doing a year long internship at your school with the above named supervising practitioner. During the first half of the year the student will be fulfilling the requirements for the General Education practicum in his/her field and level. During the second half of the internship the student will be fulfilling the requirements for the Moderate Special Needs practicum. To insure that students will have sufficient access to learners with moderate special needs so that they can have an adequate amount of time spent in direct contact with these learners, please confirm that the following conditions will be met:
1. The Dual Licensure Intern will have access to a minimum of three or more students with special needs at the level of the license sought.
2. The Supervising Practitioner holds a Moderate Special Needs License or can be recommended by the school principal or department chair as having the skills and experience to serve in this role.
3. The Supervising Practitioner understands his/her role and responsibilities and can provide the support necessary for the practicum experience.
Name of Administrator: _______________________________________________ Role and Title: _______________________________________________________ Signature of Administrator: _____________________________________________ Date: _______________________________________________________________
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Candidate Assessment of Performance (CAP): Observation Forms
Observation Form
Pre-‐Observation Conference
Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Active Evidence Collection occurred during the observation and is synthesized and categorized below. Element Evidence
1.A.4
1.B.2
2.A.3
2.B.1
2.D.2
4.A.1
Focused Feedback
Reinforcement Area/Action: (strengths)
Refinement Area/Action: (areas for improvement)
Supervising Practitioner Date:
Program Supervisor Date:
What: How:
Who:
Focus Elements:
Focus Elements:
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Candidate Assessment of Performance (CAP): Observation Forms
CAP Observation Form: Announced Observation #1
Pre-‐Observation Conference Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Active Evidence Collection occurred during the observation and is synthesized and categorized below. Element* Evidence**
1.A.4*
1.B.2
2.A.3
2.B.1
2.D.2*
4.A.1
Focused Feedback
Reinforcement Area/Action: (strengths)
Refinement Area/Action: (areas for improvement)
Supervising Practitioner Date:
Program Supervisor Date:
What: Observation # 1 How: Announced
Who: Program Supervisor & Supervising Practitioner
Focus Elements: 1.A.4 Well-‐Structured Lessons; 2.D.2 High Expectations
Note: As this is the first observation, assessors should attempt to collect evidence for all elements in order to provide a baseline for future observations
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Candidate Assessment of Performance (CAP): Observation Forms
CAP Observation Form: Unannounced Observation #1
What: Observation # 1 How: Unannounced
Who: Supervising Practitioner
Focus Elements: 1.A.4: Well Structured Lessons; 2.B.1: Safe Learning Environment
Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Active Evidence Collection occurred during the observation and is synthesized and categorized below.
Element* Evidence**
1.A.4*
1.B.2
2.A.3
2.B.1*
2.D.2
4.A.1
Focused Feedback
Reinforcement Area/Action: (strengths)
Refinement Area/Action: (areas for improvement)
Supervising Practitioner Date:
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Candidate Assessment of Performance (CAP): Observation Forms
CAP Observation Form: Announced Observation #2
What: Observation # 2 How: Announced
Who: Program Supervisor
Focus Elements: 1.B.2: Adjustments to Practice; 2.A.3: Meeting Diverse Needs
Pre-‐Observation Conference Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Active Evidence Collection occurred during the observation and is synthesized and categorized below. Element* Evidence**
1.A.4
1.B.2*
2.A.3*
2.B.1
2.D.2
4.A.1
Focused Feedback
Reinforcement Area/Action: (strengths)
Refinement Area/Action: (areas for improvement)
Supervising Practitioner Date:
Program Supervisor Date:
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Candidate Assessment of Performance (CAP): Observation Forms
Observation Form: Unannounced Observation #2
What: Observation # 2 How: Unannounced
Who: Supervising Practitioner & Program Supervisor
Focus Elements: 1.B.2: Adjustment to Practice & Others as identified during the Formative Assessment
Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Active Evidence Collection occurred during the observation and is synthesized and categorized below.
Element* Evidence**
1.A.4
1.B.2*
2.A.3
2.B.1
2.D.2
4.A.1
Focused Feedback
Reinforcement Area/Action: (strengths)
Refinement Area/Action: (areas for improvement)
Supervising Practitioner Date:
Program Supervisor (Optional) Date:
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Candidate Assessment of Performance (CAP) Form & Rubric 1
Candidate Assessment of Performance Form and Rubric
Section 1: General Information (to be completed by the Candidate) Candidate Information
First Name: Last Name:
Street Address:
City/Town: State: Zip:
MEPID #:
Massachusetts license number(if applicable):
Program Information
Sponsoring Organization:
Program Area & Grade Level:
Have any components of the approved program been waived? 603 CMR 7.03(1)(b)
Yes No
Practicum Information
Practicum
Practicum Equivalent
Practicum/Equivalent Course Number: Credit hours:
Practicum/Equivalent Seminar Course Title:
Practicum/Equivalent Site: Grade Level(s) of Students:
Total Number of Practicum Hours: Number of hours assumed full responsibility in the role:
Supervising Practitioner Information (to be completed by the Program Supervisor)
Name:
School District: Position:
License Field(s): MEPID or License #
# of years experience under license:
Initial
Professional
To the best of my knowledge (per the Supervising Practitioner’s Principal/Evaluator), the Supervising Practitioner has received a summative evaluation rating of proficient or higher in his most recent evaluation.
Yes
No
26
Candidate Assessment of Performance (CAP) Form & Rubric 2
Section 2: CAP Rubric (to be completed by the Program Supervisor and Supervising Practitioner ) I.A.4: Well-‐Structure Lessons
I-‐A-‐4. Well-‐Structured Lessons
Unsatisfactory Needs Improvement Proficient Exemplary Develops lessons with inappropriate student engagement strategies, pacing, sequence, activities, materials, resources, and/or grouping for the intended outcome or for the students in the class.
Develops lessons with only some elements of appropriate student engagement strategies, pacing, sequence, activities, materials, resources, and grouping.
Develops well-‐structured lessons with challenging, measurable objectives and appropriate student engagement strategies, pacing, sequence, activities, materials, resources, technologies, and grouping.
Develops well-‐structured and highly engaging lessons with challenging, measurable objectives and appropriate student engagement strategies, pacing, sequence, activities, materials, resources, technologies, and grouping to attend to every student’s needs. Is able to model this element.
Formative Assessment Quality *
Scope * Consistency * Evidence:
Summative Assessment Quality *
Scope * Consistency * Evidence:
27
Candidate Assessment of Performance (CAP) Form & Rubric 3
I.B.2: Adjustment to Practice
I-‐B-‐2. Adjustment to Practice
Unsatisfactory Needs Improvement Proficient Exemplary Makes few adjustments to practice based on formal and informal assessments.
May organize and analyze some assessment results but only occasionally adjusts practice or modifies future instruction based on the findings.
Organizes and analyzes results from a variety of assessments to determine progress toward intended outcomes and uses these findings to adjust practice and identify and/or implement appropriate differentiated interventions and enhancements for students.
Organizes and analyzes results from a comprehensive system of assessments to determine progress toward intended outcomes and frequently uses these findings to adjust practice and identify and/or implement appropriate differentiated interventions and enhancements for individuals and groups of students and appropriate modifications of lessons and units. Is able to model this element.
Formative Assessment Quality *
Scope * Consistency * Evidence:
Summative Assessment Quality *
Scope * Consistency * Evidence:
28
Candidate Assessment of Performance (CAP) Form & Rubric 4
II.A.3: Meeting Diverse Needs
II-‐A-‐3. Meeting Diverse Needs
Unsatisfactory Needs Improvement Proficient Exemplary Uses limited and/or inappropriate practices to accommodate differences.
May use some appropriate practices to accommodate differences, but fails to address an adequate range of differences.
Uses appropriate practices, including tiered instruction and scaffolds, to accommodate differences in learning styles, needs, interests, and levels of readiness, including those of students with disabilities and English learners.
Uses a varied repertoire of practices to create structured opportunities for each student to meet or exceed state standards/local curriculum and behavioral expectations. Is able to model this element.
Formative Assessment Quality *
Scope * Consistency * Evidence:
Summative Assessment Quality *
Scope * Consistency * Evidence:
29
Candidate Assessment of Performance (CAP) Form & Rubric 5
II.B.1: Safe Learning Environment
II-‐B-‐1. Safe Learning Environment
Unsatisfactory Needs Improvement Proficient Exemplary
Maintains a physical environment that is unsafe or does not support student learning. Uses inappropriate or ineffective rituals, routines, and/or responses to reinforce positive behavior or respond to behaviors that interfere with students’ learning.
May create and maintain a safe physical environment but inconsistently maintains rituals, routines, and responses needed to prevent and/or stop behaviors that interfere with all students’ learning.
Uses rituals, routines, and appropriate responses that create and maintain a safe physical and intellectual environment where students take academic risks and most behaviors that interfere with learning are prevented.
Uses rituals, routines, and proactive responses that create and maintain a safe physical and intellectual environment where students take academic risks and play an active role—individually and collectively—in preventing behaviors that interfere with learning. Is able to model this element.
Formative Assessment Quality *
Scope * Consistency * Evidence:
Summative Assessment Quality *
Scope * Consistency * Evidence:
30
Candidate Assessment of Performance (CAP) Form & Rubric 6
II.D.2: High Expectations
II-‐D-‐2. High Expectations
Unsatisfactory Needs Improvement Proficient Exemplary
Gives up on some students or communicates that some cannot master challenging material.
May tell students that the subject or assignment is challenging and that they need to work hard but does little to counteract student misconceptions about innate ability.
Effectively models and reinforces ways that students can master challenging material through effective effort, rather than having to depend on innate ability.
Effectively models and reinforces ways that students can consistently master challenging material through effective effort. Successfully challenges students’ misconceptions about innate ability. Is able to model this element.
Formative Assessment Quality * Scope * Consistency * Evidence:
Summative Assessment Quality * Scope * Consistency * Evidence:
31
Candidate Assessment of Performance (CAP) Form & Rubric 7
IV.A.1: Reflective Practice
IV-‐A-‐1. Reflective Practice
Unsatisfactory Needs Improvement Proficient Exemplary
Demonstrates limited reflection on practice and/or use of insights gained to improve practice.
May reflect on the effectiveness of lessons/ units and interactions with students but not with colleagues and/or rarely uses insights to improve practice.
Regularly reflects on the effectiveness of lessons, units, and interactions with students, both individually and with colleagues, and uses insights gained to improve practice and student learning.
Regularly reflects on the effectiveness of lessons, units, and interactions with students, both individually and with colleagues; and uses and shares with colleagues, insights gained to improve practice and student learning. Is able to model this element.
Formative Assessment Quality *
Scope * Consistency * Evidence:
Summative Assessment Quality *
Scope * Consistency * Evidence:
32
Candidate Assessment of Performance (CAP) Form & Rubric 8
Candidate Assessment of Performance Form and Rubric
Section 3: Summary and Signatures Three-‐Way Meetings
1st Three-‐Way Meeting Date:
Candidate
Supervising Practitioner
Program Supervisor
2nd Three-‐Way Meeting Date:
Candidate
Supervising Practitioner
Program Supervisor
Final Three-‐Way Meeting Date:
Candidate
Supervising Practitioner
Program Supervisor Summary Ratings Element Quality Consistency Scope Readiness Thresholds Met? 1.A.4: Well-‐Structured Lessons 1.B.2: Adjustment to Practice 2.A.3: Meeting Diverse Needs 2.B.1: Safe Learning Environment 2.D.2: High Expectations 4.A.1: Reflective Practice
Based on the candidate’s performance as measured on the CAP Rubric, we have
determined this candidate to be: Ready to Teach
Not Yet Ready
Supervising Practitioner Date:
Program Supervisor Date:
Mediator (if necessary see: 603 CMR 7.04(4)) Date:
33
Candidate Assessment of Performance (CAP): Three-Way Meeting Checklist
First Three-Way Meeting (occurs within first three weeks)
During 45- 60 min Before After
TC Complete Self-Assessment & Goal-
Setting Forms Share with PS/SP Conduct a Post-Conference for
Announced Obs. #1
Share baseline ratings
Finalize professional practice goal(s)
Agree on implementation plan
Sign-off at conclusion of meeting
Share goals and plan with practicum seminar instructor
SP a
nd
PS
Calibrate feedback from Announced Obs. #1
Review Candidate Self-Assessment & Goal-Setting Form
Prepare to share baseline ratings on CAP Rubric
Act on commitments made in implementation plan
Form
s
Required:
Observation Form: Announced Observation #1
Candidate Self-Assessment & Goal-Setting Form
Optional:
Model Observation Protocol: Post-Conference Planning Form
Candidate Self-Assessment & Goal Setting Form (used by SP/PS to prepare baseline)
Required:
Observation Form: Announced Observation #1
CAP Rubric & Form ((Section 1 & 3)
Optional:
Finalized Goal(s) & Implementation Plan Form
Optional:
Finalized Goal(s) & Implementation Plan Form
Second Three-Way Meeting (occurs half-way through)
During
30-45 min Before After
TC
Administer Student Feedback Surveys Share results with PS/SP
Share formative ratings and discuss
Revisit candidate goals and implementation plan; adjust accordingly (including potentially
modifying the goal, increasing supports, adding additional observations, etc.)
Sign-off at conclusion of meeting
Share formative assessment and updated goals and plan with practicum seminar instructor
SP a
nd
PS
Review all available evidence (including observations, student feedback, measures of student learning, self-reflections forms etc.).
Individually assess candidate performance using the CAP Rubric
Calibrate formative assessment ratings
Schedule/conduct additional observations
Act on commitments made in implementation plan
Form
s
Required:
CAP Rubric & Form (Section 2: Formative Assessment)
Required:
CAP Rubric & Form (Section 3)
Optional:
Finalized Goal(s) & Implementation Plan Form
Optional:
Finalized Goal(s) & Implementation Plan Form
Unannounced Observation #1 (SP) and Announced Observation #2 (PS)
Announced Observation #1 (PS & SP)
34
Candidate Assessment of Performance (CAP): Three-Way Meeting Checklist
Final Three-Way Meeting (in final two weeks)
During
30-45 min Before After
TC
Share evidence of performance including, but not limited to: candidate artifacts, measures of student learning, student feedback Share summative ratings and
discuss
Sign-off at conclusion of meeting
Draft a professional practice goal to use during first (or next) year of employment
SP a
nd
PS
Review all available evidence
Individually assess candidate performance using the CAP Rubric
Calibrate summative assessment ratings
Ensure all documents are retained in candidate files
Submit summative assessment data
Form
s
Required:
CAP Rubric & Form (Section 2: Summative Assessment &, Section 3)
Required:
CAP Rubric & Form (section 3)
Unannounced Observation #2 (SP – PS optional but encourage)
35
CAP Model Protocol: Pre-‐Conference Planning Form
Observation Protocol: Pre-‐Conference Planning Form
Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Whole Group
Small Group
One-‐on-‐One
Other
Element Evidence
1.A.4: Well-‐Structured Lessons
1.B.2: Adjustments to Practice
2.A.3: Meeting Diverse Needs
2.B.1: Safe Learning Environment
2.D.2: High Expectations
4.A.1: Reflective Practice
Refinement areas previously identified
Questions to ask in pre-‐conference
Supervising Practitioner Date:
Program Supervisor Date:
36
CAP Model Protocol: Post-‐Conference Planning Form
Model Observation Protocol: Post-‐Conference Planning Form
Observation Details
Date: Time (start/end):
Content Topic/Lesson Objective:
Refinement Area #1
1.A.4: Well Structured Lessons
2.B.1 Safe Learning Environment
1.B.2: Adjustments to Practice
2.D.2 High Expectations
2.A.3: Meeting Diverse Needs
4.A.1 Reflective Practice
Self-‐Reflection Question(s) to prompt candidate
Evidence from Observation
Recommended Action
Potential Resources/Guided Practice/Training to support
Refinement Area #2
1.A.4: Well Structured Lessons
2.B.1 Safe Learning Environment
1.B.2: Adjustments to Practice
2.D.2 High Expectations
2.A.3: Meeting Diverse Needs
4.A.1 Reflective Practice
Self-‐Reflection Question(s) to prompt candidate
Evidence from Observation
Recommended Action
Potential Resources/Guided Practice/Training to support
37
CAP Model Protocol: Post-‐Conference Planning Form
Reinforcement Area #1
1.A.4: Well Structured Lessons
2.B.1 Safe Learning Environment
1.B.2: Adjustments to Practice
2.D.2 High Expectations
2.A.3: Meeting Diverse Needs
4.A.1 Reflective Practice
Evidence from Observation
Recommended Action
Reinforcement Area #2
1.A.4: Well Structured Lessons
2.B.1 Safe Learning Environment
1.B.2: Adjustments to Practice
2.D.2 High Expectations
2.A.3: Meeting Diverse Needs
4.A.1 Reflective Practice
Evidence from Observation
Recommended Action
Upcoming Steps in the CAP Process • Type of Next Observation: • Focus of Next Observation: • Date/topic of next three-‐way meeting: • Other:
Supervising Practitioner Date:
Program Supervisor Date:
38
Candidate Assessment of Performance (CAP): Self-‐Assessment Form
Dimensions of Readiness: Quality: ability to perform the skill, action or behavior; Consistency: the frequency (e.g., all the time, sometimes, once) that the skill, action or behavior is demonstrated with quality; Scope: the scale of impact (e.g., one student, subset of children, all students) to which the skill, action or behavior is demonstrated with quality
Candidate Self-‐Assessment Form Directions: Independently, reflect on your performance in each dimension of an element. Use the performance descriptors from the CAP Rubric to help ground your assessment. Authenticity is encouraged. Consider the following in rating your current level of performance (as applicable):
• Skills acquired in coursework • Experiences in pre-‐practicum • Targeted feedback you have received about your practice • Evidence of impact with students • Reflection on performance in Announced Observation #1
I.A.4: Well-‐Structure Lessons
I-‐A-‐4. Well-‐
Structured Lessons
Unsatisfactory Needs Improvement Proficient Exemplary Develops lessons with inappropriate student engagement strategies,
pacing, sequence, activities, materials, resources, and/or grouping for the intended outcome or for the students
in the class.
Develops lessons with only some elements of appropriate student
engagement strategies, pacing, sequence, activities, materials, resources, and
grouping.
Develops well-‐structured lessons with challenging, measurable objectives and
appropriate student engagement strategies,
pacing, sequence, activities, materials, resources,
technologies, and grouping.
Develops well-‐structured and highly engaging lessons
with challenging, measurable objectives and
appropriate student engagement strategies,
pacing, sequence, activities, materials, resources,
technologies, and grouping to attend to every student’s needs. Is able to model this
element.
Quality Scope Consistency
I.B.2: Adjustment to Practice
I-‐B-‐2. Adjustment to Practice
Unsatisfactory Needs Improvement Proficient Exemplary Makes few adjustments to practice based on formal and informal assessments.
May organize and analyze some assessment results but only occasionally
adjusts practice or modifies future instruction based on
the findings.
Organizes and analyzes results from a variety of assessments to determine progress toward intended outcomes and uses these findings to adjust practice
and identify and/or implement appropriate
differentiated interventions and enhancements for
students.
Organizes and analyzes results from a
comprehensive system of assessments to determine progress toward intended outcomes and frequently uses these findings to
adjust practice and identify and/or implement
appropriate differentiated interventions and enhancements for
individuals and groups of students and appropriate modifications of lessons and units. Is able to model
this element.
Quality Scope Consistency
39
Candidate Assessment of Performance (CAP): Self-‐Assessment Form
Dimensions of Readiness: Quality: ability to perform the skill, action or behavior; Consistency: the frequency (e.g., all the time, sometimes, once) that the skill, action or behavior is demonstrated with quality; Scope: the scale of impact (e.g., one student, subset of children, all students) to which the skill, action or behavior is demonstrated with quality
II.A.3: Meeting Diverse Needs
II-‐A-‐3. Meeting Diverse Needs
Unsatisfactory Needs Improvement Proficient Exemplary Uses limited and/or
inappropriate practices to accommodate differences.
May use some appropriate practices to accommodate differences, but fails to
address an adequate range of differences.
Uses appropriate practices, including tiered instruction
and scaffolds, to accommodate differences in learning styles, needs, interests, and levels of
readiness, including those of students with disabilities
and English learners.
Uses a varied repertoire of practices to create
structured opportunities for each student to meet or
exceed state standards/local curriculum
and behavioral expectations. Is able to model this element.
Quality Scope Consistency
II.B.1: Safe Learning Environment
II-‐B-‐1. Safe
Learning Environment
Unsatisfactory Needs Improvement Proficient Exemplary Maintains a physical
environment that is unsafe or does not support
student learning. Uses inappropriate or ineffective rituals, routines, and/or responses to reinforce positive behavior or
respond to behaviors that interfere with students’
learning.
May create and maintain a safe physical environment
but inconsistently maintains rituals, routines, and responses needed to
prevent and/or stop behaviors that interfere
with all students’ learning.
Uses rituals, routines, and appropriate responses that create and maintain a safe physical and intellectual environment where
students take academic risks and most behaviors that interfere with learning
are prevented.
Uses rituals, routines, and proactive responses that create and maintain a safe physical and intellectual environment where
students take academic risks and play an active role—individually and
collectively—in preventing behaviors that interfere with learning. Is able to model this element.
Quality Scope Consistency
40
Candidate Assessment of Performance (CAP): Self-‐Assessment Form
Dimensions of Readiness: Quality: ability to perform the skill, action or behavior; Consistency: the frequency (e.g., all the time, sometimes, once) that the skill, action or behavior is demonstrated with quality; Scope: the scale of impact (e.g., one student, subset of children, all students) to which the skill, action or behavior is demonstrated with quality
II.D.2: High Expectations
II-‐D-‐2. High
Expectations
Unsatisfactory Needs Improvement Proficient Exemplary Gives up on some students or communicates that some cannot master challenging material.
May tell students that the subject or assignment is challenging and that they need to work hard but does little to counteract student misconceptions about
innate ability.
Effectively models and reinforces ways that students can master challenging material
through effective effort, rather than having to
depend on innate ability.
Effectively models and reinforces ways that
students can consistently master challenging material through effective effort. Successfully challenges
students’ misconceptions about innate ability. Is able to model this element.
Quality Scope Consistency
IV.A.1: Reflective Practice
IV-‐A-‐1. Reflective Practice
Unsatisfactory Needs Improvement Proficient Exemplary Demonstrates limited reflection on practice and/or use of insights
gained to improve practice.
May reflect on the effectiveness of lessons/ units and interactions with
students but not with colleagues and/or rarely uses insights to improve
practice.
Regularly reflects on the effectiveness of lessons,
units, and interactions with students, both individually and with colleagues, and uses insights gained to improve practice and student learning.
Regularly reflects on the effectiveness of lessons,
units, and interactions with students, both individually and with colleagues; and uses and shares with
colleagues, insights gained to improve practice and
student learning. Is able to model this element.
Quality Scope Consistency
41
Candidate Assessment of Performance (CAP): Self-‐Assessment Form
4
Candidate Self-‐Assessment: Summary Sheet
Name: Date:
Directions: In the table below, please record the rating for each element. Use the following key: Exemplary (E), Proficient (P), Needs Improvement (NI), Unsatisfactory (U)
Self-‐Assessment Summary Element Quality Consistency Scope 1.A.4: Well-‐Structured Lessons 1.B.2: Adjustment to Practice 2.A.3: Meeting Diverse Needs 2.B.1: Safe Learning Environment 2.D.2: High Expectations 4.A.1: Reflective Practice
Based on your Self-‐Assessment, briefly summarize your areas of strength and high-‐priority areas for growth. Area(s) of Strength Evidence/Rationale Element/Dimension
Area(s) for Growth Evidence/Rationale Element/Dimension
Please share your Self-‐Assessment Summary as well as the Goal Setting & Plan Development Forms with your Program Supervisor and Supervising Practitioner at least three days in advance of the initial Three-‐Way Meeting, or earlier upon request.
42
CAP Protocol: Candidate Self-‐Reflection Form
Candidate Self-‐Reflection Form Directions: Following an announced or an unannounced observation, please use the form below to reflect on the lesson. Submit the form to your Supervising Practitioner/Program Supervisor within 24 hours of the observation.
Observation Details
Date: Time (start/end):
Content Topic/ Lesson Objective:
Type of Observation: Observed by:
Announced
Unannounced
Supervising Practitioner
Program Supervisor
Reflection Prompt: What do you think went particularly well? How did this strength impact your students’ learning?
Reflection Prompt: If you could teach this lesson again, is there anything you would do differently? How would this have impacted your students’ learning?
Essential Element Evidence: Where possible, provide one piece of evidence that you believe demonstrates your performance relative to the quality, consistency or scope of each element.
1.A.4: Well-‐Structured Lessons
1.B.2: Adjustments to Practice
2.A.3: Meeting Diverse Needs
2.B.1: Safe Learning Environment
2.D.2: High Expectations
Candidate Date:
Supervising Practitioner Date:
Program Supervisor Date:
43
Candidate Assessment of Performance (CAP): Goal-‐Setting & Plan Development
Preliminary Goal-‐Setting & Plan Development
Name: Date: Prompt: Identify/Clarify a Focus or Goal Topic (Essential Element, See Self-‐Assessment Form)
Strategic Prompt: Why is this topic/focus area important?
Objective:
Specific, Rigorous, Results-‐Focused Prompt: What skills, knowledge, or practice will I acquire or develop through achieving this goal?
Realistic, Timed Prompt: When will I achieve this goal?
Action-‐Oriented, Tracked Prompt: How will I demonstrate progress toward this goal?
Measured Prompt: How will I know the goal has been achieved?
Draft Professional Practice Goal:
What actions will you take to achieve the goal? What actions/supports/resources will you need from your Program Supervisor and Supervising
Practitioner? • •
44
Candidate Assessment of Performance (CAP): Candidate Goal(s) & Implementation Plan
Candidate Professional Practice Goal(s) & Implementation Plan Name: Date: Goal(s): Based on the candidate’s self-‐assessment and the baseline ratings determined by the Program Supervisor and Supervising Practitioner, the candidate has set the following S.M.A.R.T goal(s):
Implementation Plan: In support of attaining the goal(s), the candidate, Program Supervisor and Supervising Practitioner agree on the following actions (add more rows as needed):
Action Supports/Resources from Timeline/Frequency
Measure of Student Learning: In addition to attaining the professional practice goal, the candidate will also be assessed based in part on their impact on student learning. The Supervising Practitioner, in coordination with the Program Supervisor, has set the following measures of student learning.
Measure of Student Learning Impact Rating Parameters High
Moderate
Low
CAP Professional Practice Goal(s)
Essential Element
45
ESE Model Student Feedback Survey Grades 3-5: Short Form
School Year 2014-15 Page 1 of 3 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
Name of teacher: _____________________________________ Date: ______________________
Directions: Read each statement and then choose one answer choice that you think fits best. There are no right or wrong answers. Your teacher will use your class’s answers to better understand what it’s like to be a student in this class. Your teacher will not see your individual answers.
Strongly Agree Agree Disagree
Strongly Disagree
1. In this class, students help each other to learn.
○ ○ ○ ○
2. When my teacher is talking, he or she asks us if we understand.
○ ○ ○ ○
3. My teacher asks me to improve my work when he or she knows I can do better.
○ ○ ○ ○
4. When we can't figure something out, my teacher gives us other activities to help us understand.
○ ○ ○ ○
5. My teacher uses our mistakes as a chance for us all to learn.
○ ○ ○ ○
6. The work in this class is challenging but not too difficult for me.
○ ○ ○ ○
7. When asked, I can explain what I am learning and why.
○ ○ ○ ○
8. I use evidence to explain my thinking when I write, answer questions, and talk about my work.
○ ○ ○ ○
9. I can show my learning in many ways (e.g., writing, graphs, pictures).
○ ○ ○ ○
10. I can do more challenging work when I am waiting for other students to finish.
○ ○ ○ ○
11. My teacher shows us how to respect different opinions in class.
○ ○ ○ ○
46
ESE Model Student Feedback Survey Grades 3-5: Short Form
School Year 2014-15 Page 2 of 3 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
Strongly Agree Agree Disagree
Strongly Disagree
12. My teacher usually knows when I am confused and helps me understand.
○ ○ ○ ○
13. After I talk to my teacher, I know how to make my work better.
○ ○ ○ ○
14. When we read in class, I can think of several possible answers to my teacher’s questions.
○ ○ ○ ○
15. If I am sad or angry, I can talk to my teacher.
○ ○ ○ ○
16. I look over my classmates' work and suggest ways to improve it.
○ ○ ○ ○
17. My classmates behave the way my teacher wants them to.
○ ○ ○ ○
18. My teacher encourages us to think of more than one way to solve a problem.
○ ○ ○ ○
19. Students encourage each other to do really good work in this class.
○ ○ ○ ○
20. My teacher explains what good work looks like on assignments and projects.
○ ○ ○ ○
21. My teacher asks us to share what we have learned in a lesson.
○ ○ ○ ○
22. My teacher uses things that interest me to explain hard ideas.
○ ○ ○ ○
23. My teacher lets me teach other students how I solved a problem.
○ ○ ○ ○
24. In this class, other students take the time to listen to my ideas.
○ ○ ○ ○
25. My teacher uses my ideas to help my classmates learn.
○ ○ ○ ○
47
ESE Model Student Feedback Survey Grades 3-5: Short Form
School Year 2014-15 Page 3 of 3 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
OPTIONAL: If you have any additional feedback for your teacher, please share it here.
48
ESE Model Student Feedback Survey: ITEM KEY Grades 3-5: Short Form
Page 1 of 1 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
This item key is not intended for distribution to students. The following table provides a crosswalk between survey items and the Standards and Indicators of Effective Teaching Practice addressed in the model survey. You may sort the table differently by selecting it and finding the Sort function in the Table Layout tab.
Standard I: Curriculum, Planning & Assessment Standard II: Teaching All Students
I.A: Curriculum & Planning I.B: Assessment I.C: Analysis
II.A: Instruction II.B: Learning Environment II.C: Cultural Proficiency II.D: Expectations
Standard/ Indicator
# Item
II.B 1. In this class, students help each other to learn.
I.B 2. When my teacher is talking, he or she asks us if we understand.
II.A 3. My teacher asks me to improve my work when he or she knows I can do better.
II.D 4. When we can't figure something out, my teacher gives us other activities to help us understand.
II.B 5. My teacher uses our mistakes as a chance for us all to learn.
II.D 6. The work in this class is challenging but not too difficult for me.
II.D 7. When asked, I can explain what I am learning and why.
I.A 8. I use evidence to explain my thinking when I write, answer questions, and talk about my work.
II.A 9. I can show my learning in many ways (e.g., writing, graphs, pictures).
II.A 10. I can do more challenging work when I am waiting for other students to finish.
II.C 11. My teacher shows us how to respect different opinions in class.
I.A 12. My teacher usually knows when I am confused and helps me understand. I.C 13. After I talk to my teacher, I know how to make my work better. I.A 14. When we read in class, I can think of several possible answers to my teacher’s questions. II.B 15. If I am sad or angry, I can talk to my teacher. I.C 16. I look over my classmates' work and suggest ways to improve it. II.B 17. My classmates behave the way my teacher wants them to. I.A 18. My teacher encourages us to think of more than one way to solve a problem. II.D 19. Students encourage each other to do really good work in this class. II.D 20. My teacher explains what good work looks like on assignments and projects. I.A 21. My teacher asks us to share what we have learned in a lesson. II.A 22. My teacher uses things that interest me to explain hard ideas. II.A 23. My teacher lets me teach other students how I solved a problem. II.C 24. In this class, other students take the time to listen to my ideas. II.A 25. My teacher uses my ideas to help my classmates learn.
49
ESE Model Student Feedback Survey Grades 6-12: Short Form
Page 1 of 2 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
Name of teacher: _________________________________________ Date: ______________________
Directions: Read each statement and then choose one answer choice that you think fits best. There are no right or wrong answers. Your teacher will use your class’s responses to better understand what it’s like to be a student in this class. Your teacher will not see your individual answers.
Strongly Agree
Agree
Disagree
Strongly Disagree
1. My teacher demonstrates that mistakes are a part of learning.
○ ○ ○ ○
2. My teacher asks us to summarize what we have learned in a lesson.
○ ○ ○ ○
3. Students push each other to do better work in this class.
○ ○ ○ ○
4. My teacher asks me to improve my work when he or she knows I can do better.
○ ○ ○ ○
5. My teacher uses open-ended questions that enable me to think of multiple possible answers.
○ ○ ○ ○
6. Examples of excellent work are provided by my teacher so I understand what is expected of me.
○ ○ ○ ○
7. In this class, students review each other's work and provide each other with helpful advice on how to improve.
○ ○ ○ ○
8. When asked, I can explain what I am learning and why.
○ ○ ○ ○
9. After I get feedback from my teacher, I know how to make my work better.
○ ○ ○ ○
10. The work in this class is challenging but not too difficult for me.
○ ○ ○ ○
11. During our lessons, I am asked to apply what I know to new types of challenging problems or tasks.
○ ○ ○ ○
12. In this class, other students take the time to listen to my ideas.
○ ○ ○ ○ 13. When material in this subject is confusing, my
teacher knows how to break it down so I can understand.
○ ○ ○ ○
14. In my class, my teacher is interested in my well-being beyond just my class work.
○ ○ ○ ○
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ESE Model Student Feedback Survey Grades 6-12: Short Form
Page 2 of 2 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
Strongly Agree
Agree
Disagree
Strongly Disagree
15. If we finish our work early in class, my teacher has us do more challenging work.
○ ○ ○ ○
16. My teacher asks me to rate my understanding of what we have learned in class.
○ ○ ○ ○
17. I use evidence to explain my thinking when I write, present my work, and answer questions.
○ ○ ○ ○
18. In this class, students work together to help each other learn difficult content.
○ ○ ○ ○
19. My teacher helps us identify our strengths and shows us how to use them to help us learn.
○ ○ ○ ○
20. In this class, students are asked to teach other classmates a part or whole lesson.
○ ○ ○ ○
21. Our class stays on task and does not waste time.
○ ○ ○ ○
22. During a lesson, my teacher is quick to change how he or she teaches if the class does not understand (e.g., switch from using written explanations to using diagrams).
○ ○ ○ ○
23. My teacher encourages us to accept different points of view when they are expressed in class.
○ ○ ○ ○
24. I can show my learning in many ways (e.g., writing, graphs, pictures) in this class.
○ ○ ○ ○
25. In this class, students are allowed to work on assignments that interest them personally.
○ ○ ○ ○
OPTIONAL: If you have any additional feedback for your teacher, please share it here.
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ESE Model Student Feedback Survey: ITEM KEY Grades 6-12: Short Form
Page 1 of 2 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
This item key is not intended for distribution to students. The following table provides a crosswalk between survey items and the Standards and Indicators of Effective Teaching Practice addressed throughout the survey. You may sort the items by Standard/Indicator by selecting the table and finding the Sort function in the Table Layout tab.
Standard I: Curriculum, Planning & Assessment Standard II: Teaching All Students
I.A: Curriculum & Planning I.B: Assessment I.C: Analysis
II.A: Instruction II.B: Learning Environment II.C: Cultural Proficiency II.D: Expectations
Standard/ Indicator
# Item
II.B 1. My teacher demonstrates that mistakes are a part of learning.
I.A 2. My teacher asks us to summarize what we have learned in a lesson.
II.D 3. Students push each other to do better work in this class.
II.A 4. My teacher asks me to improve my work when he or she knows I can do better.
I.A 5. My teacher uses open-ended questions that enable me to think of multiple possible answers.
II.D 6. Examples of excellent work are provided by my teacher so I understand what is expected of me.
I.C 7. In this class, students review each other's work and provide each other with helpful advice on how to improve.
II.D 8. When asked, I can explain what I am learning and why.
I.C 9. After I get feedback from my teacher, I know how to make my work better.
II.D 10. The work in this class is challenging but not too difficult for me.
I.A 11. During our lessons, I am asked to apply what I know to new types of challenging problems or tasks.
II.C 12. In this class, other students take the time to listen to my ideas.
I.A 13. When material in this subject is confusing, my teacher knows how to break it down so I can understand.
II.B 14. In my class, my teacher is interested in my well-being beyond just my class work.
II.A 15. If we finish our work early in class, my teacher has us do more challenging work.
I.B 16. My teacher asks me to rate my understanding of what we have learned in class.
I.A 17. I use evidence to explain my thinking when I write, present my work, and answer questions.
52
ESE Model Student Feedback Survey: ITEM KEY Grades 6-12: Short Form
Page 2 of 2 © 2014 Massachusetts Department of Elementary and Secondary Education. Permission is hereby granted to copy any or all parts of this document for non-commercial educational purposes. Please credit the “Massachusetts Department of Elementary and Secondary Education.”
Standard/ Indicator
# Item
II.B 18. In this class, students work together to help each other learn difficult content.
II.C 19. My teacher helps us identify our strengths and shows us how to use them to help us learn.
II.A 20. In this class, students are asked to teach other classmates a part or whole lesson.
II.B 21. Our class stays on task and does not waste time.
II.D 22. During a lesson, my teacher is quick to change how he or she teaches if the class does not understand (e.g., switch from using written explanations to using diagrams).
II.C 23. My teacher encourages us to accept different points of view when they are expressed in class.
II.A 24. I can show my learning in many ways (e.g., writing, graphs, pictures) in this class.
II.A 25. In this class, students are allowed to work on assignments that interest them personally.
53