Impacts of a Detailed Checklist on Formative Feedback to Teachers

Impacts of a Detailed Checklist on Formative Feedback to Teachers

Appendix G - Teacher Wave 1 and Wave 2 consent 121714

Impacts of a Detailed Checklist on Formative Feedback to Teachers

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As shown in Appendix B, ED’s contractor will first email all New Mexico principals inviting them to participate in the study. Those principals who agree will click on a link enclosed in the email invitation, which will direct principals to the following consent form. Principals must click on the button indicating that they have read and understand the terms of participation and agree to participate. Upon clicking that button, they are directed to the spring 2015 survey. Teachers have a parallel consent process. The consent statements shown here a duplicate of the first section of the surveys included in Appendix A.

Spring 2015 Teacher Survey

[[Version: Teachers. On-line administration. Wave 1.]]

Understanding Your Participation in the Study


Welcome to the spring 2015 survey for school leaders about the feedback you give to teachers’ regarding their instruction as a part of the NM TEACH Educator Effectiveness System.


Study Purpose. With funding from the federal Department of Education as a part of the Southwest Regional Educational Lab, this study is intended to learn about the feedback principals give to teachers under the NM TEACH Educator Effectiveness System, and teachers’ perceptions of that feedback. For more information about the study, please see {REL Southwest website}. In {month, year} REL Southwest researchers asked all New Mexico’s public school principals to participate in a study about evaluation feedback to teachers. Results will be used to provide New Mexico Public Education Department feedback regarding how to improve the NM TEACH Educator Effectiveness System training for principals and teachers.


Survey Purpose. This survey is intended to gather information on the provision of feedback to teachers after formal observations by school leaders. REL Southwest researchers will link your survey responses to basic employment information, such as race, ethnicity and years of experience that REL Southwest researchers will obtain from NM PED. Survey results will not be used to evaluate you, other teachers, or school leaders. REL Southwest researchers will ask study participants to fill out an on-line, 30-minute survey once in spring 2015 and again in spring 2016.


Procedures. Online completion of the survey should take approximately 30 minutes. By using your personal survey link provided in the invitation email, you will be able to complete the survey in multiple sessions; responses will be saved as you enter them. However, once you click “submit” at the very end of the survey, you will no longer be able to return.


Confidentiality. REL Southwest will keep all survey responses confidential and will only use them for the purpose of the study. Our reports will contain summaries, and responses will never be presented in any way that would permit readers to identify you or your school. No one at your school, district, or the state will have access to survey responses that include respondents’ names, school names, or other information that could potentially be used to identify individuals or schools.


Participants In each of the participating New Mexico public schools, REL Southwest has invited the principal to participate in this study Up to 10 teachers in your school were selected at random to be surveyed.


Benefits. Your completion of this survey gives you the opportunity to reflect on and share your perspective about the teacher evaluation system. You will be providing valuable information that may help New Mexico Public Education Department improve the NM TEACH Educator Effectiveness System.


Compensation. Within two weeks of completion of this online survey, you will receive via email a link to your $25 online gift card for completing the survey. We will provide another $25 online gift card upon completion of the spring 2016 survey to each participant.


Risks. The risks associated with your participation in this study are minimal.


Voluntary Participation. Your participation in this survey is completely voluntary. You can decide not to participate or to discontinue your participation at any time. A few survey questions, marked with a red asterisk, are required for routing to later questions.


PRA Burden Statement. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1850-xxxx.  Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  The obligation to respond to this collection is voluntary.  If you have comments or concerns regarding the status of your individual submission of this form, application or survey, please contact Chris Boccanfuso at (202) 219-1674, or at Institute of Education Sciences, 555 New Jersey Ave., NW, Suite 506D, Washington, DC 20001, directly. [Note: Please do not return the completed instrument, form, application or survey to this address.]


Questions? If you have any questions about this survey or the study as a whole, please feel free to call us toll-free at {XXX}. You can also contact {XX}, the survey coordinator, at {email} or by phone at {XX}. If you have concerns or questions about your rights as a participant, contact the REL Southwest at SEDL (which is responsible for the protection of project participants): {email}, toll free at {XX}, or c/o IRB, {address}.


[Required question] Informed Consent. By clicking the box below, you are indicating that you have read and understood the information provided to you about your participation in this survey.


  • I have read and understood the information and choose to participate..


Thank you very much for your help in this important study!


Spring 2016 Teacher Survey

[[Version: Teachers. On-line administration. Wave 2.]]

Understanding Your Participation in the Study


Welcome to the spring 2016 survey for teachers about feedback you receive about your instruction as a part of the NM TEACH Educator Effectiveness System. This is a follow-on to our spring 2015 survey to learn about the feedback you received from your school leaders last year.


Study Purpose. With funding from the federal Department of Education as a part of the Southwest Regional Educational Lab, this study is intended to learn about the feedback principals give to teachers under the NM TEACH Educator Effectiveness System, and teachers’ perceptions of that feedback For more information about the study, please see {REL Southwest website}. In {month, year} REL Southwest researchers asked all New Mexico’s public school principals to participate in a study about evaluation feedback to teachers. Results will be used to provide New Mexico Public Education Department feedback regarding how to improve the NM TEACH Educator Effectiveness System training for principals and teachers.


Survey Purpose. This survey is intended to gather information on the provision of feedback after formal observations by school leaders to teachers about their performance. REL Southwest researchers will link your survey responses to basic employment information, such as race, ethnicity and years of experience that REL Southwest researchers will obtain from NM PED. Survey results will not be used to evaluate you, other teachers, or school leaders.


Procedures. Online completion of the survey should take approximately 30 minutes. By using your personal survey link provided in the invitation email, you will be able to complete the survey in multiple sessions; responses will be saved as you enter them. However, once you click “submit” at the very end of the survey, you will no longer be able to return.


Confidentiality. REL Southwest will keep all survey responses confidential and will only use them for the purpose of the study. Our reports will contain summaries, and responses will never be presented in any way that would permit readers to identify you or your school. No one at your school, district, or the state will have access to survey responses that include respondents’ names, school names, or other information that could potentially be used to identify individuals or schools.


Participants. In each of the participating New Mexico public schools, REL Southwest has invited the principal to participate in this study. Up to 10 teachers in your school were selected at random to be surveyed. Only those teachers who completed surveys in spring 2015 are being sent this survey now in spring 2016.


Benefits. Your completion of this survey gives you the opportunity to reflect on and share your perspective about the teacher evaluation system. You will be providing valuable information that may help New Mexico Public Education Department improve the NM TEACH Educator Effectiveness System.


Compensation. Within two weeks of completion of the online survey, you will receive via email a link to your $25 online gift card for completing the survey.


Risks. The risks associated with your participation in this study are minimal.


Voluntary Participation. Your participation in this survey is completely voluntary. You can decide not to participate or to discontinue your participation at any time. A few survey questions, marked with a red asterisk, are required for routing to later questions.


PRA Burden Statement. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is 1850-xxxx.  Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  The obligation to respond to this collection is voluntary.  If you have comments or concerns regarding the status of your individual submission of this form, application or survey, please contact Chris Boccanfuso at (202) 219-1674, or at Institute of Education Sciences, 555 New Jersey Ave., NW, Suite 506D, Washington, DC 20001, directly. [Note: Please do not return the completed instrument, form, application or survey to this address.]


Questions? If you have any questions about this survey or the study as a whole, please feel free to call us toll-free at {XXX}. You can also contact {XX}, the survey coordinator, at {email} or by phone at {XX}. If you have concerns or questions about your rights as a participant, contact the REL Southwest at SEDL (which is responsible for the protection of project participants): {email}, toll free at {XX}, or c/o IRB, {address}.


[Required question] Informed Consent. By clicking the box below, you are indicating that you have read and understood the information provided to you about your participation in this survey.


  • I have read and understood the information and choose to participate.


Thank you very much for your help in this important study!



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