Commonwealth of Pennsylvania DEPARTMENT OF EDUCATION 333 Market St., Harrisburg, PA 17126-0333
PDE-430
1
Pennsylvania Statewide Evaluation Form for Student Professional Knowledge and Practice
Student/Candidate’s Last Name First Middle Social Security Number
Subject(s) Taught Grade Level
This form is to serve as a permanent record of a student teacher/candidate’s professional performance evaluation during a
specific time period, based on specific criteria. This form must be used at least twice during the 12-week (minimum) student
teaching experience.
PERFORMANCE EVALUATION
Directions: Examine all sources of evidence provided by the student teacher/candidate and bear in mind the aspects of
teaching for each of the four categories used in this form. Check the appropriate aspects of student teaching, and indicate the
sources of evidence used to determine the evaluation of the results in each category. Assign an evaluation for each of the four
categories and then assign an overall evaluation of performance. Sign the form and gain the signature of the student teacher.
Category I: Planning and Preparation – Student teacher/candidate demonstrates thorough knowledge of content and pedagogical skills in planning and
preparation. Student teacher makes plans and sets goals based on the content to be taught/learned, knowledge of assigned students, and the instructional
context.
Alignment: 354.33. (1)(i)(A), (B), (C), (G), (H)
Student Teacher/Candidate’s performance appropriately demonstrates:
• Knowledge of content
• Knowledge of pedagogy
• Knowledge of Pennsylvania’s K-12 Academic Standards
• Knowledge of students and how to use this knowledge to impart instruction
• Use of resources, materials, or technology available through the school or district
• Instructional goals that show a recognizable sequence with adaptations for individual student needs
• Assessments of student learning aligned to the instructional goals and adapted as required for student needs
• Use of educational psychological principles/theories in the construction of lesson plans and setting instructional goals
Sources of Evidence (Check all that apply and include dates, types/titles and number)
Lesson/Unit Plans
Resources/Materials/Technology
Assessment Materials
Information About Students
(Including IEP’s)
Student Teacher Interviews
Classroom Observations
Resource Documents
Other
Category Exemplary 3 Points Superior 2 Points Satisfactory 1 Point Unsatisfactory 0 Points
Criteria for Rating
The candidate consistently
and thoroughly
demonstrates indicators of
performance.
The candidate usually and
extensively demonstrates indicators
of performance.
The candidate sometimes and
adequately demonstrates
indicators of performance.
The candidate rarely or never and
inappropriately or superficially
demonstrates indicators of
performance.
Rating
(Indicate √)
Justification for Evaluation