Impact Study of Feedback for Teachers Based on Classroom Videos

APPENDIX A
TEACHER PARTICIPATION FORMS

This page has been left blank for double-sided copying.

Impact Study of Feedback for Teachers Based on Classroom Videos
Sponsored by the U.S. Department of Education
Conducted by Mathematica Policy Research and its Study Partners

Your district is participating in a U.S. Department of Education study that will provide
individualized feedback and coaching to support new teachers. Selected teachers will be assigned a coach
who reviews video recordings of their classroom and provides actionable steps that teachers can take to
improve their instruction. We are inviting you to participate in this opportunity that is available to fourth
and fifth grade teachers who are entering their first year of teaching in 2017-2018.
The program. Eligible teachers will receive individualized feedback and coaching 10 times throughout
the school year. The feedback will focus on skills that new teachers often struggle to master in their first
year, such as classroom management, engaging students in classroom instruction, and providing feedback
to extend students’ learning. A coaching cycle will involve the following steps:
1. The study team will video record the teacher’s classroom. The study team will work with teachers
to schedule video recordings at convenient times.
2. The coach will review the video and provide written feedback to the teacher.
3. The teacher will review the video of their teaching and the coach’s feedback.
4. The coach will hold a one-on-one discussion with the teacher to review the feedback and provide
suggestions for improving their teaching practices.
Study design. To learn how this feedback and coaching affects teacher practices and student
achievement, the study team will assign each participating teacher, by lottery, to one of two groups:
1. The feedback and coaching group will receive written feedback plus one-on-one discussions
with a coach (via video or phone) based on video recordings of their classrooms 10 times during
the 2017–2018 school year.
2. The comparison group will not receive feedback or coaching through the study.
Teachers in both groups will continue to participate in the district’s usual supports for new teachers and
professional development activities for the 2017–2018 school year.
The study team will examine the effect on teachers’ practices (based on video recordings of classrooms)
and student achievement (based on students’ scores on spring state assessments) of providing feedback
using multiple videos of their classroom practices as described above.
Study activities. Teachers participating in the study will be asked to:
 Attend a one-day orientation session in summer 2017. During the orientation session, teachers in
the feedback and coaching group will learn about the individualized feedback and coaching they will
receive. All participating teachers will take two assessments (the Praxis Principles of Learning and
Teaching (PLT) and Haberman Star Teacher Pre-screener) and be briefed about classroom video
recordings and data collection activities. Teachers who have already taken the PLT can give us
permission to obtain their scores and may not need to take the PLT in summer 2017.
 Allow the study team to video record their classrooms. The study team will video record the
classrooms of teachers in both study groups at the beginning and end of the school year. Teachers in
the feedback and coaching group will also have their classrooms video recorded during the school year
(these are the videos used by coaches to provide feedback). Teachers in the feedback and coaching
group will be video recorded a total of 15 times, and teachers in the comparison group will be video
recorded 6 times.

3

 Participate in the feedback and coaching activities if assigned to the feedback and coaching
group. If assigned to the feedback and coaching group, teachers agree to participate in the feedback
and coaching activities described above.
 Complete survey and assessment in spring 2018. Teachers in both study groups will complete an
online survey and follow-up Praxis Principles of Learning and Teaching assessment in spring 2018.
We want you to know the following:
 Participation in the study is voluntary and will not affect any staffing decisions or professional
development activities provided by the school district
 All information collected by the study will be confidential and collected for research purposes
only. Specifically,
o
o
o

Coaches will be provided by a coaching provider that has been selected through a national
competition. They will not be district employees.
Only the study coaches and members of the study team will be allowed to view the written
feedback and videos of your classroom. The videos will not be shared with others in your district.
The study will not release information identifying any school, classroom, teacher, or student,
except as required by law.

 Teachers will be compensated for their time spent on study data collection activities. Teachers
will be compensated for completing the 30-minute Haberman Star assessment ($30), the Praxis
assessment ($100 for each completed two-hour assessment), and the 30-minute spring survey ($30).
 Participation in the study will not impose any risks to you as a respondent. If you have any
questions about your rights as a research volunteer, contact the New England IRB, toll free 1-800-2329570.
To learn more about the study and participate. Please contact [RECRUITER NAME] from the study
team if you would like to participate, by phone at [RECRUITER PHONE] or by email at [RECRUITER
EMAIL]. You can find additional information about the study at [WEBSITE] and you can contact
[RECRUITER NAME] with any questions you have about this important study.
Please complete the following 15-minute XX-page form to provide the study team with some
important information to confirm your eligibility and agreement to participate. Once complete,
please return the form to your [DISTRICT LIAISON/STUDY TEAM MEMBER] [INSERT
DISTRICT LIAISON/STUDY TEAM MEMBER AND CONTACT INFORMATION].

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 xxxx-xxxx. The
time required to complete this information collection is estimated to average 15 minutes, including the time to review instructions,
search existing data sources, gather the data needed, and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate or suggestions for improving this form, please write to: U.S. Department
of Education, Washington, DC 20202. If you have comments or concerns regarding the content or the status of your individual
submission of this form, write directly to: U.S. Department of Education, Institute of Education Sciences, 550 12th Street, SW,
Washington, DC 20202.

4

OMB Control No.: XXXX-XXXX
Expiration Date: XX/XX/XXXX

Impact Study of Feedback for Teachers
Based on Classroom Videos
Conducted on behalf of the United States Department of Education

TEACHER PARTICIPATION FORM
2017-2018

_____________________________________________________________________________
TEACHER FIRST NAME

TEACHER LAST NAME

_____________________________________________________________________________
DISTRICT NAME

_____________________________________________________________________________
SCHOOL NAME

|

|

|

|-|

|

|

|-|

|

|

|

|

HOME OR CELL PHONE NUMBER

_____________________________________________________________________________
PERSONAL EMAIL ADDRESS

_____________________________________________________________________________
DISTRICT EMAIL ADDRESS

1.

Please indicate the grade level(s) that you are likely to teach in the 2017–2018 school year.
MARK ALL THAT APPLY
1
2
3
4
5
6
7
8
9
10
11
d

□
□
□
□
□
□
□
□
□
□
□
□

Pre-kindergarten or Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th - 12th grade
Ungraded
Don’t know

5

2.

In the 2017-2018 school year, are you likely to teach one self-contained class (where you
teach the same group of students most or all of the day in multiple subjects) or will you
teach several classes of different students in one or more academic subjects ?
MARK ONE ONLY
1
2
d

3.

□
□
□

I expect to teach one self-contained class
I expect to teach several classes of different students
Don’t know

Please indicate the types of classes you are likely to teach in the 2017-2018 school year.
MARK ALL THAT APPLY
1
2

3
4
5
d

4.

□
□
□
□
□
□

General education
Special instruction for English Language Learners (ELL) or Limited English Proficient
(LEP) students
English as a Second Language (ESL)
Bilingual classes (taught partly in English and partly in Spanish or some other language)
Special education
Don’t know

How many years have you worked as a classroom teacher prior to the 2017–2018 school
year? (Please do not include time spent working as a teaching assistant, substitute
teacher, student teacher, or paraprofessional, or working in classrooms in any position
other than classroom teacher.)
Please enter 0 if the 2017-2018 school year will be your first year teaching in any district.
|

|
d

□

| YEARS
Don’t know

6

Please note:

5.

Answers to the following questions will have no effect on your eligibility for the
study or your selection to receive the coaching and feedback.

Which of the following statements best describes how you became a teacher?
MARK ONE ONLY
1

□

The “traditional” route to teacher certification (candidates complete training for
initial certification and earn a bachelor’s or master’s degree before they become
a full-time teacher).
Please enter the name and location of the college or university where you completed this
program:
_______________________________________________________________________
COLLEGE OR UNIVERSITY NAME

_______________________________________________________________________
CITY AND STATE OF COLLEGE OR UNIVERSITY

2

□

An “alternative” route to teacher certification (candidates with a bachelor’s degree
become full-time teachers before completing all training and requirements for initial
certification, such as Teach for America or a teacher residency program)
Please enter the name of this program:
_______________________________________________________________________

6.

During your teacher preparation program, did you have a practice teaching experience, for
example, a student teaching experience?
A practice teaching experience is school-based and may be supervised by a classroom teacher
and/or a program supervisor. It is generally a requirement of pre-service teachers who have
completed the education coursework leading to a degree and are seeking certification or licensure
to teach in a public school. In teacher residency/internship programs, the residency year counts as
student teaching.
1
0

7.

□
□

Yes
No

GO TO QUESTION 9

How many total weeks did you spend in a classroom during your practice teaching
experience?
If you did not spend any time in a classroom during your practice teaching experience, enter “0”.

|

|

|

TOTAL WEEKS IN A CLASSROOM

For how many of those weeks in the classroom did you have full responsibility for the
classroom?

|

|

|

WEEKS WITH FULL RESPONSIBILITY FOR THE CLASSROOM

7

8.

9.

Was your practice teaching experience in the same district where you currently teach?
1

 Yes

0

 No

During your teacher preparation program, did you ever receive feedback based on
observations of your classroom teaching?
1
0

10.

□
□

Yes
No

GO TO QUESTION 13

What methods were used to observe your classroom teaching during your teacher
preparation program?
MARK ONE ONLY
1
2
3

11.

□
□
□

Observed in-person only
Video recorded only
Both observed in-person and video recorded

How was feedback on your classroom teaching provided to you during your teacher
preparation program?
MARK ALL THAT APPLY
1
2
3

□
□
□

Oral feedback during a follow-up meeting or discussion after the observation
Formal written feedback
Other (specify) __________________________________________________________

8

12.

Which of these items are true about the feedback you received on your classroom
teaching during your teacher preparation program?
MARK ONE ONLY

The feedback I received from observations of
my teaching. . .
a.

NEVER

RARELY

MOST OF
SOMETIMES THE TIME

ALWAYS

Examined my performance on a clearly defined set
of teaching practices...............................................

1

□

2

□

3

□

4

□

5

□

Provided a score or rating of my performance
based on a classroom observation rubric or
instrument ...............................................................

1

□

2

□

3

□

4

□

5

□

Provided specific techniques or strategies that I
could implement in my classroom...........................

1

□

2

□

3

□

4

□

5

□

Referred to specific moments of teaching from my
classroom observation............................................

1

□

2

□

3

□

4

□

5

□

Provided questions that encouraged me to reflect
on my own teaching................................................

1

□

2

□

3

□

4

□

5

□

Identified aspects of my teaching where I was
performing well .......................................................

1

□

2

□

3

□

4

□

5

□

Identified aspects of my teaching where I needed
to improve ...............................................................

1

□

2

□

3

□

4

□

5

□

Included a plan with next steps for me to improve
my teaching ............................................................

1

□

2

□

3

□

4

□

5

□

Involved watching a video of my instruction while
discussing feedback ...............................................

1

□

2

□

3

□

4

□

5

□

Provided or recommended videos of expert
teachers to illustrate practices described in the
feedback (i.e., a successful veteran or exemplary
teacher) ..................................................................

1

□

2

□

3

□

4

□

5

□

Provided opportunities for me to observe a
demonstration of specific teaching techniques or
strategies by the person providing feedback ..........

1

□

2

□

3

□

4

□

5

□

Provided an opportunity for me to demonstrate
specific teaching techniques or strategies for the
person providing feedback .....................................

1

□

2

□

3

□

4

□

5

□

m. Provided useful or actionable feedback ..................

1

□

2

□

3

□

4

□

5

□

b.

c.
d.
e.
f.
g.
h.
i.
j.

k.

l.

9

13.

How prepared do you feel to handle a range of classroom behavior or discipline
situations?
MARK ONE ONLY
1
2
3
4

14.

□
□
□
□

Not at all prepared
Somewhat prepared
Well prepared
Very well prepared

How confident are you in your ability to teach math?
MARK ONE ONLY
1
2
3
4

15.

□
□
□
□

Not at all confident
Somewhat confident
Confident
Very confident

How confident are you in your ability to teach English Language Arts/reading?
MARK ONE ONLY
1
2
3
4

16.

Not at all confident
Somewhat confident
Confident
Very confident

Did you take the edTPA performance assessment?
1
0

17.

□
□
□
□

□
□

Yes

|

|

|

TOTAL edTPA SCORE (OUT OF 75)

No

Have you taken the Praxis Principles of Learning and Teaching (PLT) test? If yes, you will
not need to take the PLT in summer 2017 if the study can obtain your scores from the test
administrator (ETS). To obtain your scores, you will need to provide your name, date of
birth, and state in which you took the test.
1

□

Yes, I have already taken the Praxis PLT and would like you to obtain my score from the
test administrator, ETS.

_____________________________________________________________________________
YOUR NAME AT THE TIME OF THE TEST, IF DIFFERENT FROM ABOVE (I.E., MAIDEN NAME)
Date of Birth: |

| |/| | |/|
Month
Day

|

| |
Year

|

_____________________________________________________________________________
STATE IN WHICH YOU TOOK THE TEST

0

□

No, I have not taken the Praxis PLT

10

Please sign below to indicate your interest in the study. Members of the study team will be available
for the duration of the study to address any questions or concerns as they arise.

I understand the scope of this study and my participation in it. I commit to participate in the study
data collection activities described above. If I am selected for the feedback and coaching group, I
commit to participate fully in the activities described above.
_____________________________________________________________________________
TEACHER NAME (PLEASE PRINT)
_____________________________________________________________________________
TEACHER SIGNATURE

_____________________________________________________________________________
DATE

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
xxxxxxxx. The time required to complete this information collection is estimated to average 15 minutes, including the time to
review instructions, search existing data sources, gather the data needed, and complete and review the information
collection. If you have any comments concerning the accuracy of the time estimate or suggestions for improving this form,
please write to: U.S. Department of Education, Washington, DC 20202. If you have comments or concerns regarding the
content or the status of your individual submission of this form, write directly to: U.S. Department of Education, Institute of
Education Sciences, 550 12th Street, SW, Washington, DC 20202.

11

This page has been left blank for double-sided copying.

Impact Study of Feedback for Teachers Based on Classroom Videos
Sponsored by the U.S. Department of Education
Conducted by Mathematica Policy Research and its Study Partners

Your district is participating in a U.S. Department of Education study that will provide individualized
feedback and coaching to support new teachers. Selected teachers will be assigned a coach who reviews
video recordings of their classroom and provides actionable steps that teachers can take to improve their
instruction. We are inviting you to participate in this opportunity that is available to fourth and fifth grade
teachers who will be entering their second, third, or fourth year of teaching in fall 2018.
The program. Eligible teachers will receive individualized feedback and coaching 5 or 10 times
throughout the school year. The feedback will focus on skills that teachers often struggle to master in their
first few years, such as classroom management, engaging students in classroom instruction, and providing
feedback to extend students’ learning. A coaching cycle will involve the following steps:
3. The study team will video record the teacher’s classroom. The study team will work with teachers to
schedule video recordings at convenient times.
4. The coach will review the video and provide written feedback to the teacher.
5. The teacher will review the video of their teaching and the coach’s feedback.
6. The coach will hold a one-on-one discussion with the teacher to review the feedback and provide
suggestions for improving their teaching practices.
Study design. To learn how this feedback and coaching affects teacher practices and student
achievement, the study team will assign each participating teacher, by lottery, to one of three groups:
7. The first feedback and coaching group will receive written feedback plus one-on-one discussions
with a coach (via video or phone) based on video recordings of their classrooms 10 times during the
2018–2019 school year.
8. The second feedback and coaching group will receive written feedback plus one-on-one discussions
with a coach (in person or via video or phone) based on video recordings of their classrooms 5 times
during the 2018–2019 school year.
9. The comparison group will not receive the feedback or coaching through the study.
Teachers in both groups will continue to participate in the district’s usual supports and professional
development activities for the 2018–2019 school year.
The study team will examine the effect on teachers’ practices (based on video recordings of classrooms)
and student achievement (based on students’ scores on spring state assessments) of providing feedback
using multiple videos of their classroom practices as described for groups 1 and 2 above.
Study activities. Teachers who participate in the study will be asked to:
 Attend a one-day orientation session in summer 2018. During the orientation session, teachers in
the feedback and coaching groups will learn about the individualized feedback and coaching they will
receive. All participating teachers will be briefed about classroom video recordings and data collection
activities.
 Allow the study team to video record their classrooms. The study team will video record the
classrooms of teachers in all three study groups at the beginning and end of the school year. Teachers
in the feedback and coaching groups will also have their classrooms video recorded during the school
year (these are the videos used by coaches to provide feedback). Teachers in the first feedback and
coaching group will be video recorded 15 times, teachers in the second feedback and coaching group
will be video recorded 10 times, and teachers in the comparison group will be video recorded 6 times.

13

 Participate in the feedback and coaching activities if assigned to one of the feedback and
coaching groups. If assigned to one of the feedback and coaching groups, teachers agree to participate
in the feedback and coaching activities described above.
 Complete survey in spring 2019. Teachers in all three study groups will complete an online survey in
spring 2019.
We want you to know the following:
 Participation in the study is voluntary and will not affect any staffing decisions or professional
development activities provided by the school district.
 All information collected by the study will be confidential and collected for research purposes
only. Specifically,
o Coaches will be provided by a coaching provider that has been selected through a national
competition. They will not be district employees.
o Only the study coaches and members of the study team will be allowed to view the written
feedback and videos of your classroom. The videos will not be shared with others in your district.
o The study will not release information identifying any school, classroom, teacher, or student, except
as required by law.
 Teachers will be compensated for their time spent on study data collection activities. Teachers
will be compensated for completing the 30-minute spring survey ($30).
 Participation in the study will not impose any risks to you as a respondent. If you have any
questions about your rights as a research volunteer, contact New England IRB, toll free 1-800-2329570
To learn more about the study and participate. Please contact [RECRUITER NAME] from the study
team if you would like to participate, by phone at [RECRUITER PHONE] or by email at [RECRUITER
EMAIL]. You can find additional information about the study at [WEBSITE] and you can contact
[RECRUITER NAME] with any questions you have about this important study.
Please complete the following 15 minute XX-page form to provide the study team with some
important information to confirm your eligibility and agreement to participate. Once complete,
please return the form to your [DISTRICT LIAIS1ON/STUDY TEAM MEMBER] at [INSERT
DISTRICT LIAISON/STUDY TEAM MEMBER AND CONTACT INFORMATION].

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 xxxx-xxxx. The
time required to complete this information collection is estimated to average 15 minutes, including the time to review instructions,
search existing data sources, gather the data needed, and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate or suggestions for improving this form, please write to: U.S. Department
of Education, Washington, DC 20202. If you have comments or concerns regarding the content or the status of your individual
submission of this form, write directly to: U.S. Department of Education, Institute of Education Sciences, 550 12th Street, SW,
Washington, DC 20202.

14

OMB Control No.: XXXX-XXXX
Expiration Date: XX/XX/XXXX

Impact Study of Feedback for Teachers
Based on Classroom Videos
Conducted on behalf of the United States Department of Education

TEACHER PARTICIPATION FORM
2018-2019
_____________________________________________________________________________
TEACHER FIRST NAME

TEACHER LAST NAME

_____________________________________________________________________________
DISTRICT NAME

_____________________________________________________________________________
SCHOOL NAME

|

|

|

|-|

|

|

|-|

|

|

|

|

HOME OR CELL PHONE NUMBER

_____________________________________________________________________________
PERSONAL EMAIL ADDRESS

_____________________________________________________________________________
DISTRICT EMAIL ADDRESS

1.

Please indicate the grade level(s) that you are likely to teach in the 2018–2019 school year.
MARK ALL THAT APPLY
1
2
3
4
5
6
7
8
9
10
11
d

□
□
□
□
□
□
□
□
□
□
□
□

Pre-kindergarten or Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th - 12th grade
Ungraded
Don’t know

15

2.

In the 2018-2019 school year, are you likely to teach one self-contained class (where you
teach the same group of students most or all of the day in multiple subjects) or will you
teach several classes of different students in one or more academic subjects?
MARK ONE ONLY
1
2
d

3.

□
□
□

I teach one self-contained class
I teach several classes of different students
Don’t know

Please indicate the types of classes you are likely to teach in the 2018-2019 school year.
MARK ALL THAT APPLY
1
2

3
4
5
d

4.

□
□
□
□
□
□

General education
Special instruction for English Language Learners (ELL) or Limited English Proficient
(LEP) students
English as a Second Language (ESL)
Bilingual classes (taught partly in English and partly in Spanish or some other language)
Special education
Don’t know

How many years have you worked as a classroom teacher prior to the 2018–2019 school
year? (Please do not include time spent working as a teaching assistant, substitute
teacher, student teacher, or paraprofessional, or working in classrooms in any position
other than classroom teacher.)
Please enter 0 if the 2018-2019 school year will be your first year teaching in any district.
|

|
d

□

| YEARS
Don’t know

16

Please note:

5.

Answers to the following questions will have no effect on your eligibility for the
study or your selection to receive the coaching and feedback.

Which of the following statements best describes how you became a teacher?
MARK ONE ONLY
1

□

The “traditional” route to teacher certification (candidates complete training for initial
certification and earn a bachelor’s or master’s degree before they become a full-time
teacher).
Please enter the name and location of the college or university where you completed this
program:
_______________________________________________________________________
COLLEGE OR UNIVERSITY NAME

_______________________________________________________________________
CITY AND STATE OF COLLEGE OR UNIVERSITY
2

□

An “alternative” route to teacher certification (candidates with a bachelor’s degree
become full-time teachers before completing all training and requirements for initial
certification, such as Teach for America or a teacher residency program)
Please enter the name of this program:
_______________________________________________________________________

6.

During the 2017-2018 school year (or most recent year of teaching), did you ever receive
feedback based on observations of your classroom teaching?
1
0

7.

□
□

Yes
No

GO TO QUESTION 10

What methods were used to observe your classroom teaching during the 2017-2018
school year (or most recent year of teaching)?
MARK ONE ONLY
1
2
3

8.

□
□
□

Observed in-person only
Video recorded only
Both observed in-person and video recorded

How was feedback on your classroom teaching provided to you during the 2017-2018
school year (or most recent year of teaching)?
MARK ALL THAT APPLY
1
2
3

□
□
□

Oral feedback during a follow-up meeting or discussion after the observation
Formal written feedback
Other (specify) __________________________________________________________

17

9.

Which of these items are true about the feedback you received on your classroom
teaching during the 2017-2018 school year (or most recent year of teaching)?
MARK ONE ONLY

The feedback I received from observations of
my teaching. . .
a.

RARELY

MOST OF
SOMETIMES THE TIME

ALWAYS

Examined my performance on a clearly defined set
of teaching practices...............................................

1

□

2

□

3

□

4

□

5

□

Provided a score or rating of my performance
based on a classroom observation rubric or
instrument ...............................................................

1

□

2

□

3

□

4

□

5

□

Provided specific techniques or strategies that I
could implement in my classroom...........................

1

□

2

□

3

□

4

□

5

□

Referred to specific moments of teaching from my
classroom observation............................................

1

□

2

□

3

□

4

□

5

□

Provided questions that encouraged me to reflect
on my own teaching................................................

1

□

2

□

3

□

4

□

5

□

Identified aspects of my teaching where I was
performing well .......................................................

1

□

2

□

3

□

4

□

5

□

Identified aspects of my teaching where I needed
to improve ...............................................................

1

□

2

□

3

□

4

□

5

□

Included a plan with next steps for me to improve
my teaching ............................................................

1

□

2

□

3

□

4

□

5

□

Involved watching a video of my instruction while
discussing feedback ...............................................

1

□

2

□

3

□

4

□

5

□

Provided or recommended videos of expert
teachers to illustrate practices described in the
feedback (i.e., a successful veteran or exemplary
teacher) ..................................................................

1

□

2

□

3

□

4

□

5

□

Provided opportunities for me to observe a
demonstration of specific teaching techniques or
strategies by the person providing feedback ..........

1

□

2

□

3

□

4

□

5

□

Provided an opportunity for me to demonstrate
specific teaching techniques or strategies for the
person providing feedback .....................................

1

□

2

□

3

□

4

□

5

□

m. Provided useful or actionable feedback ..................

1

□

2

□

3

□

4

□

5

□

b.

c.
d.
e.
f.
g.
h.
i.
j.

k.

l.

10.

NEVER

How prepared do you feel to handle a range of classroom behavior or discipline situations?
MARK ONE ONLY
1
2
3
4

□
□
□
□

Not at all prepared
Somewhat prepared
Well prepared
Very well prepared

18

11.

How confident are you in your ability to teach math?
MARK ONE ONLY
1
2
3
4

12.

□
□
□
□

Not at all confident
Somewhat confident
Confident
Very confident

How confident are you in your ability to teach English Language Arts/reading?
MARK ONE ONLY
1
2
3
4

13.

□
□
□
□

Not at all confident
Somewhat confident
Confident
Very confident

Did you take the edTPA performance assessment?
1
0

□
□

Yes

|

|

|

TOTAL edTPA SCORE (OUT OF 75)

No

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