Teacher as a Responsive, Reflective Professional: A Partner in Learning

Cleveland State UniversityCollege of Education and Human Services

Intern Observation and Formative Assessment Form – General

Step 1: Preparing for the Observation

  1. Intern sends an electronic copy of the lesson plan to the supervisor and mentor at least 24 hours prior to the observation. Supervisor stores lesson plan document on OFS-supplied USB drive.
  2. Observer may request intern to provide a hard copy of the plan for use during the observation.

Step 2: Completing the Observation Form

  1. Take notes during observation and complete Observation Form afterwards with scores and comments. If you wish to provide the intern with immediate feedback (optional), you may choose to leave a copy of your notes with the intern.
  2. If available, use licensure-specific Observation Form. If a licensure-specific form is unavailable, use the generic form.
  3. Choose any one of 3 formats: 1) Word 97-03 fill-in form; 2) a Word 2007 fill-in form; or 3)unprotected Word 2007 document. Fill-in forms feature automatic calculations but do not allow spell-check. Use unprotected forms carefully if you wish to use spell check.
  4. Fill in all heading information. Include at least 3 comments in each domain. Use “Specific Comments” to summarize the lesson and identify 2-4 opportunities for further growth.
  5. With fill-in forms, calculate averages by right-clicking each highlighted field (Mac computers use Ctrl-Click) and selecting “Update field.” If formulas do not calculate correctly, calculate scores manually and enter averages in the fill-in fields.

Step 3: Completing the Observation

  1. Intern completes Follow-Up Form and submits to observer within two days of the observation.
  2. E-mail electronic copy of the Observation Form to intern after receiving the Follow-up Form but within one week of the observation. Copy supervisor and mentor teacher so everyone has electronic copies of the form.
  3. Record averages on Field Experience Record and Evaluation Form (hard copy on NCR paper) and obtain intern’s initials at the next available opportunity.
  4. Supervisor stores electronic copies of the following documents in the student’s folder on the OFS-supplied USB drive:
  5. Lesson plan
  6. Observation Form
  7. Follow-up Form

Intern: / Date of Lesson: / Date of Post- Conference:
School: / Grade Level/Subject:
Mentor/CTE: / Supervisor:
Completed by: / SupervisorMentorCTE / Observation #: / 12345

Scoring and Performance Levels:

Exemplary
(4.0) / Proficient
(3.0) / Emerging
(2.0) / Unsatisfactory
(1.0) / Not attempted
(0.0)
Candidate demonstrates advanced skills for the item, prominently and consistently demonstrating exemplary knowledge, skills and dispositions beyond those seen in a typical entry-year teacher. / Candidate demonstrates a skill for this item at a level considered acceptable for a beginning teacher. Candidates must reach this level in most items to receive a satisfactory student teaching rating. / Candidate is still developing knowledge, skills, and/or dispositions in this area. Shows progress and promise for reaching a Proficient level with additional effort, experience, and/or coursework. / Candidate does not demonstrate the knowledge, skills and dispositions for the outcome, and may at times demonstrate behaviors incongruent with those required for the outcome.

For detailed descriptions of the levels of performance by item, refer to the companion Special Education Rubrics. All items must be scored for each observation using the available evidence for sub-items. Scorers are allowed to enter scores in between categories preferably using .5 intervals.

Domain A. Organizing Content Knowledge for
Student Learning
Primarily completed prior to observation using lesson plan / Score / Comments
A1. / Use of student background information for planning instruction (OSTP Standard 1) / Is plan readily available for mentor and supervisor? (Yes/No)
  • Plans relate to intern’s knowledge of students.
  • Plans accommodate for needs of English language learners and students with exceptionalities.
  • Plans vary instruction based on students’ background.
  • Plans demonstrate cultural competence by incorporating instructional content, resources, and strategies that are responsive to cultural, linguistic, and gender differences.
/ 3 comments minimum per domain; highlight effective practices and provide specific suggestions for improvement.
A2. / Instructional goals and objectives (OSTP Standard 2)
  • Plans establish clear goals.
  • Plans establish measurable objectives.
  • Goals and objectives relate to varied learning styles.
  • Goals and objectives establish appropriate expectations for all students.
  • Goals and objectives relate to Ohio Academic Content Standards and are aligned with school curriculum.

A3. / Content of instructional plans (OSTP Standard 2)
  • Plans demonstrate correct sequencing of subject matter.
  • Plans demonstrate accurate content knowledge.
  • Plans demonstrate cross-disciplinary connections where appropriate.

A4. / Structure of planned activities and materials (OSTP Standards 1.1, 4)
  • Structure of lesson is developmentally appropriate for students and subject matter.
  • Activities and materials match with identified instructional goals.
  • Activities and materials are appropriate for students’ diverse needs and characteristics.

A5. / Assessment (OSTP Standard 3)
  • Plan includes varied assessment strategies to measure the achievement of instructional goals and objectives.
  • Assessment strategies are appropriate for students.

Domain B. Enhancing the Learning Environment
Primarily completed using notes from the observation / Score / Comments
B1. / Fairness to students (OSTP Standard 5) / 3 comments minimum per domain; highlight effective practices and provide specific suggestions for improvement.
  • Intern establishes a climate of courtesy and respect
  • Intern makes eye contact with students.
  • Intern shows impartiality by involving all students.

B2. / Rapport with students (OSTP Standard 5)
  • Intern expresses interest in students and knows students’ names.
  • Intern shows enthusiasm and appropriate tone.
  • Intern establishes positive rapport with students.

B3. / Challenging expectations for learners (OSTP Standard 1)
  • Intern encourages students to ask questions.
  • Intern provides students with choices in learning.
  • Intern encourages students to pursue further learning.

B4. / Classroom management skills (OSTP Standard 5)
  • Intern states specific, appropriate expectations for classroom behavior and states reasons for expectations.
  • Intern applies rules consistently and fairly.
  • Intern maintains students’ attention throughout the lesson.
  • Intern promotes positive behavior.

B5. / Physical environment (OSTP Standard 5)
  • Intern maintains a safe learning environment.
  • Intern enhances student learning with bulletin boards/displays of student work.
  • Intern uses space and materials to vary physical environment to meet students’ needs and instructional goals.

Domain C. Teaching for Student Learning
Primarily completed using notes from the observation / Score / Comments
C1. / Communicating goals and procedures (OSTP Standard 4) / 3 comments minimum per domain; highlight effective practices and provide specific suggestions for improvement.
  • Intern makes goals and objectives clear to students.
  • Intern makes instructional procedures clear to students.

C2. / Communicating content (OSTP Standards 2, 4)
  • Intern conveys content clearly and accurately.
  • Intern uses correct language, spelling, and syntax in verbal and written explanations of content.
  • Intern clarifies content for students having difficulty understanding.

C3. / Structure and sequence of instructional activities (OSTP Standard 4)
  • Intern uses lesson structure and sequence that is developmentally appropriate for students and subject matter.
  • Intern uses a variety of individual and collaborative learning activities to achieve learning goals.
  • Intern uses appropriate manipulatives and instructional materials to support student learning.
  • Intern uses appropriate available technology to support student learning.
  • Intern provides appropriate adaptations for English language learners and students with exceptionalities.

C4. / Extending student thinking (OSTP Standards 1, 4)
  • Intern structures specific learning activities that encourage students to extend their thinking.
  • Intern recognizes and uses opportunities to help students extend their thinking.
  • Intern uses questioning and other interaction strategies to foster students’ understanding and to stimulate creative and critical thinking.
  • Intern allows sufficient wait-time for student response to questions.

C5. / Assessing student understanding (OSTP Standard 3)
  • Intern uses questioning and a variety of other appropriate assessment strategies to gauge student learning.
  • Intern correctly interprets students’ verbal and non-verbal cues for levels of understanding.
  • Plan includes varied assessment strategies to measure the achievement of instructional goals and objectives.
  • Assessment strategies are appropriate for students.

C6. / Use of assessment (OSTP Standards 3, 4)
  • Intern keeps written documentation of assessments to track student learning over time.
  • Intern adjusts instruction/activities based on formative assessment and uses teachable moments to meet students’ needs.
  • Intern monitors students and gives them substantive feedback.
Intern uses evaluation results in planning future instruction.
C7. / Use of time (OSTP Standard 5)
  • Instructional materials are ready prior to the lesson.
  • Intern sues routines and procedures to maximize instructional time.
  • Intern paces the lesson appropriately for the students and content.
  • Intern makes smooth transitions between instructional activities to maximize instructional time.

Domain D. Professionalism
Primarily completed after the observation, based on feedback from mentor teacher in conversation with the intern and mentor teacher. NOTE: Scores in this domain reflect cumulative performance in each indicator and are averaged independently of the observation score. / Score / Comments
D1. / Reflection and professional development (OSTP Standard 7) / 3 comments minimum per domain; highlight effective practices and provide specific suggestions for improvement.
  • Intern uses self-reflection to recognize and correct weaknesses.
  • Intern reflects on student achievement of the learning goals.
  • Intern uses feedback from prior observations to improve instruction.

D2. / Completion of work in the field (OSTP Standard 7)
  • Intern follows school policies to maintain accurate student records and grades.
  • Intern performs assigned professional duties in the classroom.
  • Intern demonstrates initiative in getting involved in the classroom and working with the mentor.

D3. / Collaboration (OSTP Standard 6)
  • Intern requests professional assistance from appropriate sources.
  • Intern establishes professional rapport with mentor and supervisor.
  • Intern maintains appropriate oral and written communication with families.

D4. / Professional habits in the field (OSTP Standard 7)
  • Intern follows school policies.
  • Intern displays dispositions listed on the CSU List of Student Dispositions (including punctuality, attendance, and appropriate appearance) in the field.
  • Intern participates in additional contractual teacher obligations as required by the experience (planning meetings, faculty meetings, parent-teacher conferences, professional development activities, school functions).
  • Intern uses appropriate vocabulary and correct grammar/punctuation in verbal and written communication.

D5. / Professional habits in seminar (OSTP Standard 7)
  • Intern displays dispositions listed on the CSU List of Student Dispositions (including punctuality, attendance, and active participation) in the seminar and with the supervisor.
  • Intern completes all assignments and submits written work, including portfolio artifacts, in a timely fashion as assigned by supervisor, seminar leader, or mentor teacher.
  • Intern uses appropriate vocabulary and correct grammar/punctuation in verbal and written communication.

Specific Comments
Provide a brief summary of the lesson and include 2-4 suggestions for the intern to consider for the next lesson.
Domain A / Domain B / Domain C / Observation Overall / To calculate averages,
Right click on each field in the table to the left and select “Update field”.
Domain A-C Averages / 0.00 / 0.00 / 0.00 / 0.00
Domain D Average / 0.00

If formulas don’t work in the table above, use the table below to enter the calculated values manually.

Domain A / Domain B / Domain C / Observation Overall / Domain D
Domain Averages

The complete formal observation record must contain the following written materials:

  • Intern’s written lesson plan (copies of handouts or assessments not required)
  • Intern Observation Form—completed by observer, signed and dated by intern and observer
  • Observation Follow-up Form—completed by intern

Rev Date: 03/14