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Facilitator: _________________________ School_____________________________
Lesson number_____ Lesson Title_______________________________ Grade_______
Classroom grade level(s): 9th
Dates completed:
Please use a check mark to identify any problems you experienced in delivering this lesson. This section will help us differentiate between lessons that need minor changes and those that need to be completely reworked. Note specifics in the blank spaces after the questions.
General
Small changes needed. (Typos, concept that needs clarification, student handbook item doesn’t match teacher’s guide, a reference is outdated)
One or more activities not working. (A worksheet that needs redesign, for example)
Additional worksheet needed to focus student attention.
Activities would work better in a different order.
Consider an adaptation for next revision, described below.
Lesson doesn’t teach what it intends to teach.
Execution
Advisor Feedback Form adapted from Roads to Success Facilitator’s Journal

7 Difficult to execute. (For example, video viewing and computer lab in same lesson)
8 Needs a non-computer option.
9 Too much writing or paper-shuffling.
10 Too much material for one class period.
11
X
Too little material for one class period.
12
X
Match to Student Needs & Interests
Students not engaged or off-task for major parts of the lesson. (If student reaction varied, describe those who had difficulty below.)
13 Too juvenile for this age group.
14 Students lacked background info on this topic. (For example, we investigated a specific post-secondary option without adequate description of the choices available)
15 Students lacked skills needed to complete the lesson. (For example, they couldn’t calculate percentages)
16 Material was too difficult conceptually. (For example, students couldn’t figure out why career outlook might be important to them)
17 Lower-level learners struggled.
Advisor Feedback Form adapted from Roads to Success Facilitator’s Journal

The Lesson
1.
What worked well?
2.
What was frustrating? (for you or your students)
3.
What knowledge did your students gain as a result of this lesson?
4.
Please describe students’ level of engagement with the Student Handbook and Portfolio pages. Check the description that best applies, and give specific details where possible.
Detailed Explanation:
5.
Describe any logistical concerns related to the way the lesson was written or structured (space, supplies, etc.)
6.
Describe any classroom management concerns that related to the way the lesson was written or structured.
7.
What was the level of student engagement like? If it varied throughout the lesson, please tell us what parts caused problems and which were ok.
8. If there were any opportunities to celebrate student achievement with prizes,
acknowledgements, treasure box, etc., please tell us what the student reaction was.
9. What adaptations, if any, did you make to the lesson and why? Were they successful?
10. What recommendations would you make, if any, about changing this lesson for next year?
Personal Reflection
11. If you were to teach this lesson again, what would you change in your facilitation?
Why?
12. What do you think you did well?
Advisor Feedback Form adapted from Roads to Success Facilitator’s Journal