Key: HHigh, MModerate, LLow, DDisengaged
Revised April 2016
Field Experience Assessment Form
Teacher
Candidate:
Student
Ed Prep
Supervisor:
Date:
ID:
School:
Cooperating
Teacher:
Subject/
Grade:
Strategies*
(Select only those strategies
Student
Engagement*
(Check one for each
strategy selected)
Observed Classroom Structure (5.1, 5.2, 5.3)
H
M
L
D
Evidence of Student Work (1.1)
Yes
No
Classroom Discussion
H
M
L
D
Learning Environment (5.2, 5.3)
Conducive to Learning Somewhat Conducive
Not Conducive
Disruptive Student(s) Behavior
Cooperative Learning
H
M
L
D
Curriculum/Instruction Observed (3.1, 3.2)
Group Work
H
M
L
D
Co-teaching
Yes No
Guided Practice
H
M
L
D
Accessible Materials
Yes
No
Hands On/Active Learning
H
M
L
D
Clear Learning Targets (6.1)
Yes No
H
M
L
D
Technology Integrated
Yes No
Learning Centers
H
M
L
D
Differentiated Instruction (2.4, 3.2)
Yes No
Lecture
H
M
L
D
Learning Assessments Observed (7.1, 7.2, 7.5)
Nonlinguistic
Representations
H
M
L
D
Question/Answer
Informal
Quiz or Test Group Response
Individual Response
Conference
Documentation of Assessment
Observation
None Other
Other
H
M
L
D
Overall Comments/Observations:
Peer Evaluation
H
M
L
D
Presentations
H
M
L
D
Project Based Learning
H
M
L
D
Question/Answer
H
M
L
D
Similarities/Differences
H
M
L
D
Summarizing/Note Taking
H
M
L
D
Teacher Candidate Signature
Date
Ed Prep Supervisor Signature
Date
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signature
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