1. Do you have a bachelor’s degree?
Yes
No
1a. In what year did you receive your bachelor’s degree?
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1b. What is the name of the college or university where you earned this degree?
______________________________________
College/university
In what city and state is it located?
______________________________________
City State
1c. Was this degree awarded by a college/university’s school or department of education?
Yes
No
1d. What was your major field of study?
___________________________
1e. Did you have a second major or minor field of study?
Yes Skip to question 1f
No Skip to question 2
1f. What was your second major or minor field of study?
______________________________
2. Do you have a master’s degree?
Yes Skip to question 2a
No Skip to question 3
2a. In what year did you receive your master’s degree?
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X1. What is the name of the college/university where you earned your master’s degree?
______________________________________
College/University
2b. Was this degree awarded by a college/university’s school or department of education?
Yes
No
2c. What was your major field of study?
___________________________
3. Have you earned any of the degrees or certificates listed below?
[If so, same three sub questions for each that applies]
Vocational certificate
Associate’s degree
SECOND Bachelor’s degree
SECOND Master’s degree
Educational specialist or professional diploma (at least one year beyond master’s level)
Certificate of Advanced Graduate Studies
Doctorate or first professional degree
4. Which of the following college courses have you completed?
Chemistry
Earth/Space Sciences
Environmental Sciences
Life Sciences
Physics
Other
5. How many college science courses have you completed?
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6. Which of the following describes the teaching certificate you currently hold in THIS state?
Regular or standard state certificate or advanced professional certificate
Certificate issued after satisfying all requirements except the completion of a probationary period
Certificate that requires some additional coursework, student teaching, or passing a test before regular certification can be obtained
Certificate issued to persons who must complete a certification program in order to continue teaching
I do not hold any of the above certifications in THIS state Skip to question 8
7. In which grades does this certificate allow you to teach science in THIS state? (Select all that apply)
Any grade, kindergarten – 5th
Any grade, 6th – 8th
Any grade, 9th – 12th (biology/life sciences)
Any grade, 9th – 12th (chemistry/physics/physical science)
Any grade, 9th – 12th (earth/space sciences)
Any grade, 9th – 12th (other science)
8. Did you enter teaching through an alternative certification program?
Yes
No
X1. Did you work in a field or a job in which you used science before becoming a teacher?
Yes
No
9. Are you male or female?
Female
Male
10. Are you of Hispanic or Latino origin?
Yes
No
11. What is your race? (Mark all that apply)
White
Black/African American
Asian
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native
12a. Including this year, how many years in total have you taught at the elementary level
(K-8)?
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Years |
12b. How many years in total have you taught in the secondary level (9-12)?
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Years |
12c. How many years have you taught any grades (K-12)?
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Years |
13. Counting this year, how many years have you taught science at the secondary level (9-12)?
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Years |
14. Counting this year, how many years in total have you taught in this school?
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Years |
15. Are you currently collecting a pension from a teacher retirement system or drawing money from a school/system sponsored 401(k) or 403(b) plan which includes funds you contributed as a teacher?
Yes
No
16. Indicate the extent to which you agree or disagree with each of the following statements as it applies to your science instruction:
Strongly Strongly
Disagree Disagree Agrees Agree
a. The amount a student can learn
is primarily related to family
background. О О О О
b. If students aren’t disciplined at
home, they aren’t likely to accept
any discipline. O O O O
c. A teacher is very limited in what
he/she can achieve because a
student’s home environment is a
large influence on his/her
achievement. O O O O
d. If parents would do more for their
children, I could do more
for my students. O O O O
e. If a student did not remember
information I gave in a previous
lesson, I would know how to
increase his/her retention in the next
lesson. O O O O
f. If a student in my class becomes
disruptive and noisy, I feel assured
that I know some techniques to
redirect him/her quickly. O O O O
g. If one of my students can’t do a
class assignment, I am able to
accurately assess whether the
assignment was at the correct level
of difficulty. O O O O
h. If I really try hard, I can get through
to even the most difficult or
unmotivated students. O O O O
i. When it comes right down to it,
a teacher really can’t do much
because most of a student’s
motivation and performance
depends on his or her home
environment. O O O O
17. How would you compare boys and girls in...
Girls are Girls Girls and boys Boys Boys
much are somewhat are the are somewhat are much
better better same better better
a. Reading О О О О О
b. Math О О О О О
c. Writing О О О О О
d. Science О О О О О
18. Indicate the extent to which you agree or disagree with each of the following statements about science teachers at this school:
Strongly Strongly
Disagree Disagree Agree Agree
a. Science teachers set high
standards for teaching. O O O O
b. Science teachers set high
standards for students’ learning. O O O O
c. Science teachers in this
school believe all students can
do well. O O O O
d. Science teachers make
expectations for instructional
goals clear to students. O O O O
e. Science teachers in this
school give up on some students. O O O O
f. Science teachers in this school
care only about smart students. O O O O
g. Science teachers in this school
expect very little from students. O O O O
h. Science teachers in this school
work hard to make sure all students
are learning. O O O O
19. Which of the following best describes this science course?
Anatomy/ Physiology
Biology I
Biology II
Biology AP
Chemistry I
Chemistry II
Chemistry AP
Earth Science
Environmental Science
Integrated Science I
Integrated Science II
Integrated Science III
Integrated Science IV
Physical Science
Physics I
Physics II
Physics AP
Other Science Course: ________________
For each class in which an HSLS student is enrolled:
(Note: program prompts the teacher; the linkage to class is preloaded into the computer.)
20. What textbook/program is primarily used in this class?
Publisher
Title
Edition
21. Approximately what percentage of the designated textbook/program do you plan to cover this school year?
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% |
22. What percentage of the instructional time in this class do you anticipate will be based on the following:
Primary science textbook/program
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% |
Other textbooks/programs
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% |
Other commercially available instructional materials
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% |
Materials obtained at conferences/conventions
(e.g., National Science Teachers’ Association)
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% |
Materials created by you
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% |
Other (please specify)________________ [field test only]
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% |
23. Thinking of a typical student in this class, which of the following best describes the difficulty level of the primary textbook/program? (Mark one)
It is much too easy
It is somewhat too easy
It is at the appropriate level
It is somewhat too difficult
It is much too difficult
24. How often do you plan the designated science textbook/program will be used in each of the following ways:
Some- All the
Never Rarely times Often time
a. I will follow the textbook/program
page by page. O O O O O
b. I will pick what is important from the
textbook/program and skip the rest. O O O O O
c. I will follow my district’s curriculum
recommendations regardless of what is in
the textbook/program. O O O O O
d. The textbook/program will guide the
structure (content emphasis) of my
course. O O O O O
e. I will incorporate activities from other
sources to supplement what the
textbook/program is lacking. O O O O O
f. I will read and review suggestions in the
textbook’s/program’s teacher guide to plan
my lessons. O O O O O
g. I will use the student textbook/program to
plan my lessons. O O O O O
h. I will assign homework from the
textbook/program. O O O O O
i. My students will use their textbook/program
during the science lesson. O O O O O
j. My students will use their textbook/program
for homework assignments. O O O O O
25. What percent of assessment materials that you plan to use in this class for determining student grades will be test items:
Included with the primary textbook/program
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% |
Drawn from other commercially available materials
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% |
Developed by the school/district
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% |
Developed by you
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% |
Other (please specify)______________ [field test only]
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% |
26. To what extent do you agree or disagree with each of the following statements about how high school science teaching assignments are made in this school?
Strongly Strongly
Disagree Disagree Agree Agree
a. Advanced courses are assigned to
teachers with the most seniority O O O O
b. Advanced courses are assigned to
teachers with the strongest
science background O O O O
c. All or most science teachers
are assigned at least one section
of advanced courses O O O O
d. Non-college prep courses are
assigned to teachers new to the
profession O O O O
e. Non-college prep courses are
assigned to teachers whose students
don’t perform well on standardized
tests. O O O O
f. All or most science teachers are
assigned at least one section of a
non-college prep course. O O O O
27. To what extent is each of the following a problem in this school?
Not Not at A A applicable all little Some lot
a. Student tardiness O O O O O
b. Student absenteeism O O O O O
c. Student class cutting O O O O O
d. Teacher absenteeism O O O O O
e. Students dropping out O O O O O
f. Student apathy O O O O O
g. Lack of parental involvement O O O O O
h. Poverty O O O O O
i. Students coming to school unprepared
to learn O O O O O
j. Poor student health O O O O O
k. Lack of resources and materials for
teachers O O O O O
28. In your view, to what extent do the following limit how you teach?
Not Not at A A applicable all little Some lot
a. Students with different academic
abilities in the same class O O O O O
b. Students who come from a wide range
of socio-economic backgrounds O O O O O
c. Students who come from a wide range
of language backgrounds O O O O O
d. Students with special needs
(e.g., hearing, vision, speech impairment,
physical disabilities, mental or
emotional/psychological impairment) O O O O O
e. Uninterested students O O O O O
f. Low morale among students O O O O O
g. Disruptive students O O O O O
h. Shortage of computer hardware/software O O O O O
i. Shortage of support for using computers O O O O O
j. Shortage of textbooks for student use O O O O O
k. Shortage of other instructional equipment
for students’ use O O O O O
l. Shortage of equipment for use in
demonstrations and other exercises O O O O O
m. Inadequate physical facilities O O O O O
n. High student/teacher ratio O O O O O
o. Lack of planning time O O O O O
p. Lack of autonomy in instructional
decisions O O O O O
q. Lack of parent/family support O O O O O
r. Inadequate opportunities for professional
development O O O O O
s. Inadequate administrative support O O O O O
29. Please indicate the extent to which you agree or disagree with each of the following statements:
Strongly Strongly
Agree Agree Disagree Disagree
a. The principal deals effectively
with pressures from outside the
school that might interfere with
my teaching O O O O
b. The principal does a poor job of
getting resources for this school O O O O
c. The principal sets priorities, makes
plans, and sees that they are carried
out O O O O
d. The principal knows what kind of
school he/she wants and has
communicated it to the staff O O O O
e. The principal lets staff members
know what is expected of them O O O O
f. The principal is interested in
innovation and new ideas O O O O
g. The principal usually consults with
staff members before he/she makes
decisions that affect us O O O O
30. To what extent do you agree or disagree with each of the following statements about the Science department in this school.
Strongly Strongly
Agree Agree Disagree Disagree
a. Science teachers share
ideas on teaching O O O O
b. Science teachers discuss O O O O
what was learned at a workshop
or conference O O O O
c. Science teachers share and
discuss student work O O O O
d. Science teachers discuss
particular lessons that were not
very successful O O O O
e. Science teachers in this
department discuss beliefs about
teaching and learning O O O O
f. Science teachers in this
department share and discuss
research on effective teaching
methods O O O O
g. Science teachers in this
department share and discuss
research on effective instructional
practices for English language
learners O O O O
h. Science teachers in this
department explore new teaching
approaches for under-performing
students O O O O
i. Science teachers in this
department make a conscious effort
to coordinate the content of courses
with other teachers in the school O O O O
j. Science teachers in this
department are effective at teaching
students science O O O O
k. Science teachers in this
department provide support to
new science teachers O O O O
l. The science department’s
chair or curricular area coordinator’s
behavior toward the staff is
supportive and encouraging O O O O
31. Indicate the extent to which you agree or disagree with each of the following statements:
Strongly Strongly
Agree Agree Disagree Disagree
a. Teachers in this school help
maintain discipline in the entire
school, not just their classroom. O O O O
b. Teachers in this school take
responsibility for improving
the school. O O O O
c. Teachers in this school set high
standards for themselves. O O O O
d. Teachers in this school feel
responsible for helping students
develop self-control. O O O O
e. Teachers in this school feel
responsible to help each other
do their best. O O O O
f. Teachers in this school feel
responsible that all students learn.O O O O
g. Teachers in this school feel
responsible when students in this
school fail. O O O O
Supporting
Statement Request for OMB Review (SF83I) G-
File Type | application/msword |
File Title | Appendix G |
Author | cbthompson |
Last Modified By | DoED User |
File Modified | 2008-07-09 |
File Created | 2008-07-09 |