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Course
name: _________________________________________________
Instructor:
_________________________________________________
Week of:
_________________________________________________
Directions:
Please rate the degree to which
you were able to implement the course objectives using the following
key:
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1
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2
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3
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4
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5
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6
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Not
at all
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Inconsistently/partly
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Entirely
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1.
Professional development teacher objectives
As
the result of this professional development activity I was able to:
Rating
A.
________________________________________________________________
_____
B.
________________________________________________________________
_____
C.
________________________________________________________________
_____
2.
Professional development student outcomes
Upon
implementation students were able to:
Rating
A.
________________________________________________________________
_____
B.
________________________________________________________________
_____
C.
________________________________________________________________
_____
3. Please attach
any evidence of implementation or impact (e.g., procedural checklists,
logs, journal entries, student data).
4.
Please describe any impediments (e.g., lack of materials, support,
resources, training) that need to be addressed for consistent,
successful implementation to be achieved.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
5.
Please describe strategies that you used to make implementation easier
and or more successful.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
6. (Optional)
What are some other ways that the professional development had
important impact on your practice?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
7. (Optional)
What are some other ways that the professional development had
important impact on student outcomes in your classroom?
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
General
comments:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Would
you like follow up? yes
no
Please
provide contact information (phone/e-mail) so that any questions or
difficulties implementing objectives can be addressed.
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
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